Altered biomechanical strategies of the paretic hip and knee joints during a step-up task

Goyal, Vatsala; Dragunas, Andrew C.; Askew, Robert L.; Sukal-Moulton, Theresa; López-Rosado, Roberto

doi:10.1080/10749357.2021.2008596

Cited by 2 publications

(8 citation statements)

References 32 publications

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“…To independently capture joint biomechanics from the right and left lower limbs, two 10.2-cm tall platforms were placed on two side-by-side anterior force plates. We purposefully chose a low step height in order to replicate this experiment in the future with pediatric clinical populations, who may have a difficult time completing the protocol on a higher platform (Goyal et al, 2022). A 10-camera motion capture system (Qualisys, Göteborg, Sweden) recorded participant kinematics at a frequency of 100 Hz using a modified Cleveland Clinic marker set (Kaufman et al, 2016).…”

Section: Experimental Set-upmentioning

confidence: 99%

“…Data were then imported into Visual 3D (C-Motion, Germantown, MD). Marker and ground reaction force data were interpolated to fill in small gaps and filtered using a low-pass 4th-order Butterworth filter with a 6 Hz cutoff frequency to remove high-frequency fluctuations (Goyal et al, 2022). We performed inverse dynamics calculations in Visual 3D to calculate hip, knee, and ankle joint moments in the sagittal and frontal plane.…”

Section: Data Processing and Analysismentioning

confidence: 99%

“…To account for the step height during these calculations, the two corresponding force plates were modified virtually to create raised force platforms. We used ground reaction force data to identify four gait events occurring during each step-up: leading limb lift-off, leading limb initial contact on the step, trailing limb lift-off, and trailing limb initial contact on the step (Goyal et al, 2022).…”

Section: Data Processing and Analysismentioning

confidence: 99%

“…The handful of studies that have investigated lower limb moments of a step-up task have all been in adults, and even fewer studies have explored the effect of load modulation (Goyal et al, 2022; Wang and Gillette, 2018). It has been confirmed that substantial hip abduction moments are necessary to maintain mediolateral stability and considerable sagittal plane extensor moments are required to keep the body upright in adults (Goyal et al, 2022; Novak and Brouwer, 2011; Wang and Gillette, 2018). There is a need for a robust biomechanical model defining how these joint moments change across multiple load conditions in a typical pediatric population, especially during single limb stance where upright stability is most critical.…”

Section: Introductionmentioning

confidence: 99%

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Load modulation affects pediatric lower limb joint moments during a step-up task

Goyal,

Gordon,

Sukal-Moulton

2023

Preprint

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Performance in a single step has been suggested to be sensitive measure of movement quality in pediatric clinical populations. Although there is less information available in children with typical development, researchers have postulated the importance of analyzing the effect of body weight modulation on the initiation of stair ascent, especially during single limb stance where upright stability is most critical. The purpose of this study was to investigate the effect of load modulation from -20% to +15% of body weight on typical pediatric lower limb joint moments during a step-up task. Fourteen participants between 5-21 years with no known history of neurological or musculoskeletal concerns were recruited to perform multiple step-up trials. Peak extensor support and hip abduction moments were identified during the push-off and pull-up stance phases. Linear regressions were used to determine the relationship between peak moments and load. Mixed effects models were used to estimate the effect of load on hip, knee, and ankle percent contributions to peak support moments. There was a positive linear relationship between peak support moments and load in both stance phases, where these moments scaled with load. There was no relationship between peak hip abduction moments and load. While the ankle and knee were the primary contributors to the support moments, the hip contributed more than expected in the pull-up phase. Clinicians can use these results to contextualize movement differences in pediatric clinical populations including cerebral palsy and highlight potential target areas for rehabilitation for populations such as adolescent athletes.

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Section: Experimental Set-upmentioning

confidence: 99%

Section: Data Processing and Analysismentioning

confidence: 99%

Section: Data Processing and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Load modulation affects pediatric lower limb joint moments during a step-up task

Goyal,

Gordon,

Sukal-Moulton

2023

Preprint

Self Cite

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“…Individuals with and without CP spend approximately 70% of an inclined gait cycle in the stance phase ( Ma et al, 2019 ), suggesting that researchers should prioritize this phase of a step-up task. In individuals with typical development (TD), substantial hip abduction moments and extensor support moments, especially from the knee and ankle, are used to complete a step-up task ( Wang and Gillette, 2018 ; Goyal et al, 2023a , b ). However, bilateral lower limb motor impairments from bilateral CP can affect the biomechanics of this task.…”

Section: Introductionmentioning

confidence: 99%

Children with bilateral cerebral palsy use their hip joint to complete a step-up task

Goyal,

Gordon,

Sukal-Moulton

2024

Front. Hum. Neurosci.

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Performance in stair-climbing is largely associated with disruptions to mobility and community participation in children with cerebral palsy (CP). It is important to understand the nature of motor impairments responsible for making stairs a challenge in children with bilateral CP to clarify underlying causes of impaired mobility. In pediatric clinical populations, sensitive measurements of movement quality can be captured during the initial step of stair ascent. Thus, the purpose of this study was to quantify the lower limb joint moments of children with bilateral CP during the stance phases of a step-up task. Participants performed multiple stepping trials in a university gait laboratory. Outcome measures included extensor support moments (the sum of hip, knee, and ankle sagittal plane moments), hip abduction moments, and their timing. We recruited seven participants per group. We found that peak support and hip abduction moments were similar in the bilateral CP group compared to the typical development (TD) group. We also found that children with bilateral CP timed their peak moments closer together and increasingly depended on the hip joint to complete the task, especially in their more affected (MA) lower limb. Our investigation highlights some underlying causes that may make stair climbing a challenge for the CP population, including a loss of selective voluntary motor control (SVMC), and provides a possible treatment approach to strengthen lower limb muscles.

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Altered biomechanical strategies of the paretic hip and knee joints during a step-up task

Cited by 2 publications

References 32 publications

Load modulation affects pediatric lower limb joint moments during a step-up task

Load modulation affects pediatric lower limb joint moments during a step-up task

Children with bilateral cerebral palsy use their hip joint to complete a step-up task

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