Differences in lower limb transverse plane joint moments during gait when expressed in two alternative reference frames

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Abstract

When comparing previous studies that have measured the three-dimensional moments acting about the lower limb joints (either external moments or opposing internal joint moments) during able-bodied adult gait, significant variation is apparent in the profiles of the reported transverse plane moments. This variation cannot be explained on the basis of adopted convention (i.e. external versus internal joint moment) or inherent variability in gait strategies. The aim of the current study was to determine whether in fact the frame in which moments are expressed has a dominant effect upon transverse plane moments and thus provides a valid explanation for the observed inconsistency in the literature. Kinematic and ground reaction force data were acquired from nine able-bodied adult subjects walking at a self-selected speed. Three-dimensional hip, knee and ankle joint moments during gait were calculated using a standard inverse dynamics approach. In addition to calculating internal joint moments, the components of the external moment occurring in the transverse plane at each of the lower limb joints were calculated to determine their independent effects. All moments were expressed in both the laboratory frame (LF) as well as the anatomical frame (AF) of the distal segment. With the exception of the ankle rotation moment in the foot AF, lower limb transverse plane joint moments during gait were found to display characteristic profiles that were consistent across subjects. Furthermore, lower limb transverse plane joint moments during gait differed when expressed in the distal segment AF compared to the LF. At the hip, the two alternative reference frames produced near reciprocal joint moment profiles. The components of the external moment revealed that the external ground reaction force moment was primarily responsible for this result. Lower limb transverse plane joint moments during gait were therefore found to be highly sensitive to a change in reference frame. These findings indicate that the different transverse plane joint moment profiles during able-bodied adult gait reported in the literature are likely to be explained on this basis.

Introduction

Numerous studies have measured the three-dimensional (3D) moments acting about the lower limb joints (either external moments or opposing internal joint moments) during able-bodied adult gait (Allard et al., 1996; Andriacchi and Strickland, 1985; Benedetti et al., 1998; Besier et al., 2003; Bowsher and Vaughan, 1995; Bresler and Frankel, 1950; Eng and Winter, 1995; Ramakrishnan et al., 1987). Irrespective of the adopted convention (i.e. external versus internal joint moment), all studies in general report consistent joint moment profiles for the sagittal and frontal planes. However, significant variation does exist when comparing the transverse plane joint moment profiles, particularly for the hip. This was first noted by Allard et al. (1996) and is highlighted when comparing two technical notes, the first by Eng and Winter (1995) and the second by Bowsher and Vaughan (1995), both of which were published consecutively in Volume 28, Edition No. 6 of the Journal of Biomechanics. These two studies report 3D internal joint moments at the hip during gait. The sagittal and frontal plane hip joint moments are consistent but the transverse plane joint moments are opposite. Eng and Winter (1995) report an ‘external rotator’ hip joint moment during initial stance followed by an ‘internal rotator’ hip joint moment during terminal stance. Bowsher and Vaughan (1995) report a profile of similar shape but reversed convention. Whilst at first it may be suggested that this inconsistency is merely a product of inherent variability in gait strategies across subjects, such an explanation does not fit the findings. In contrast to this notion, it has been demonstrated that the transverse plane hip joint moment during the stance phase of gait does in fact display a characteristic profile that is remarkably consistent across subjects (Andriacchi and Strickland, 1985; Benedetti et al., 1998; Eng and Winter, 1995; Ramakrishnan et al., 1987). Furthermore, it is rather difficult to comprehend how a change in gait strategy would have almost no effect upon sagittal and frontal plane hip joint moments yet an apparent opposing effect upon the transverse plane hip joint moment. These factors would therefore suggest that an alternative explanation must exist.

It is possible that transverse plane joint moments during gait are highly sensitive to the reference frame in which they are expressed. A comparison of lower limb transverse plane joint moment profiles during gait from previous studies would suggest that this is feasible. Studies that have expressed the net moment vector in the transverse plane of the laboratory frame (LF) (Andriacchi and Strickland, 1985; Bresler and Frankel, 1950; Eng and Winter, 1995; Ramakrishnan et al., 1987) report markedly different lower limb transverse plane joint moment profiles during gait when compared to studies that have expressed the net moment vector in the transverse plane of the distal segment anatomical frame (AF) (Allard et al., 1996; Benedetti et al., 1998; Besier et al., 2003; Bowsher and Vaughan, 1995). Based on this, it was hypothesised that the contrasting transverse plane hip joint moment profiles during gait from Eng and Winter (1995) and Bowsher and Vaughan (1995) could be explained on the basis of differing reference frames. The aim of the current study was to therefore test this hypothesis and compare lower limb transverse plane joint moments during gait when expressed in the LF versus the distal segment AF. If this hypothesis proved to be true, then an additional aim was to analyse the relative effects of each component of the external moment acting in the transverse plane at the lower limb joints in an endeavour to provide a thorough explanation for this finding.

Section snippets

Subjects

Nine able-bodied adults (two males; seven females) with a mean height of 164.5 (SD 8.5) cm, body mass of 60.0 (SD 11.1) kg and age of 19.8 (SD 2.1) years were voluntarily recruited. Approval was obtained from the Royal Children's Hospital Ethics in Human Research Committee prior to commencement and subjects signed a consent form.

Instrumentation

Kinematic data were acquired using a 3D motion analysis system (VICON, Oxford Metrics, Oxford, England) with six cameras operating at a sampling rate of 120 Hz. The LF

Results

Lower limb transverse plane internal joint moments during gait are illustrated in Fig. 1. Except for the ankle rotation moment expressed in the foot AF, the patterns were found to be quite consistent across subjects, as indicated by the relatively small standard deviation bands. The transverse plane joint moments expressed in the distal segment AF displayed dramatically different patterns to the equivalent moments expressed in the LF. For the hip joint in particular, the two reference frames

Discussion

There are two major findings from this study. First, with the exception of the ankle rotation moment in the foot AF, lower limb transverse plane joint moments during gait displayed characteristic profiles that were consistent across subjects. This is in accordance with previous studies (Andriacchi and Strickland, 1985; Benedetti et al., 1998; Eng and Winter, 1995; Ramakrishnan et al., 1987). Second, lower limb transverse plane joint moments during gait differed when expressed in the distal

Acknowledgments

This project was financially supported by a Health Professional Research Training Fellowship from the Australian National Health and Medical Research Council (Grant ID: 237153). We would also like to acknowledge the assistance of Mr Bill Reid from the Educational Resource Centre at the Royal Children's Hospital, Melbourne, Australia for the preparation of the figures presented in this study.

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