Lumbar spinal stenosis causes cauda equina and nerve root compression, resulting in neurological symptoms. Although trunk flexion during level walking may alleviate these symptoms by enabling spinal canal decompression, some patients do not use this strategy. We aimed to identify the kinetic and kinematic variables that affect trunk flexion in patients during level walking. Gait was recorded in 111 patients using a three-dimensional motion capture system and six force plates. From the data recorded, walking velocity, bilateral step length, cycle time, maximum trunk flexion angle, forward pelvic tilt angle, pelvic rotation angle, maximum and minimum joint angles, and moment and power of the lower limb were calculated. Then a step-wise multiple regression analysis was conducted to identify kinetic and kinematic variables affecting trunk flexion. The maximum hip extension angle (β = 0.416), maximum hip flexion moment (β = -0.348), and step length (β = 0.257) were identified as variables significantly affecting the trunk flexion angle. The coefficient of determination adjusted for the degree of freedom was 0.294 (p < 0.05). Our results suggest that patients with lumbar spinal stenosis choose one of two strategies to alleviate symptoms during walking. One strategy is gait with trunk flexion posture to increase step length and hip extension angle. The other strategy is gait with trunk upright posture to decrease step length and hip extension angle.
[Purpose] The purpose of this study was to clarify postural control and muscle activity of the gluteus medius and musculus erector spinae in a single-leg stance before and after hip muscle abductor fatigue.[Subjects] Subjects were 22 healthy male adults (mean age; 21.4 yrs) with no significant medical history or current medical problems.[Methods] We examined postural control and muscle activity in a single-leg standing position before and after hip muscle abductor fatigue. A statistical analysis was performed using the paired t-test before and after muscle fatigue, and Pearson's rank correlation coefficient was obtained for muscle activity associated with postural control.[Results] The results indicate a significant increase in stability indices, a decrease in gluteus medius muscle activity, and an increase in right musculus erector spinae activity after fatigue. There was a positive correlation between the increase in right musculus erector spinae activity and increase in postural control. [Conclusion] We believe that postural control increased in the orientation related to the working of the muscles due to their fatigue, and that muscle activity increased to compensate.
[Purpose] The purpose of this study was to clarify the relationships between lumbar movement and pelvis, thorax and shoulder range of motion during forward arm elevation by patients with lumbar spinal stenosis.[Subjects and Methods] The subjects were 19 patients with lumbar spinal stenosis. The pelvic, thoracic, and lumbar movements during forward arm elevation, and shoulder range of motion were measured. The relationships between lumbar movement and the other parameters, and between shoulder range of motion and the pelvic and thoracic angles were analyzed.[Results] There were significant relationships between lumbar movement and pelvis angle, thorax angle, shoulder flexion angle, 1st internal rotation and 2nd external rotation, and between thoracic movement and shoulder flexion angle, 1st internal rotation and 2nd external rotation.
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