Does the choice of stair gait cycle affect resulting knee joint kinematics and moments?

Abstract

Stair gait is a useful activity for the assessment of knee function. The aim of this study was to determine whether knee joint kinematics and moments are affected by the choice of stair gait cycle (SGC) and the step used to measure ground reaction forces (GRFs). This was investigated through motion analysis of ten non-pathological subjects as they ascended and descended a four-step staircase. The SGCs compared for ascent were, first, step 1 (measuring GRFs) to step 3 and, second, step 2 (measuring GRFs) to step 4, and vice versa for stair descent. Knee joint kinematics were not significantly influenced by the choice of SGC. For ascent, significantly larger peak adduction moments were measured for SGCs beginning on step 1 (0.30 ± 0.08 N m/kg) than for SGCs beginning on step 2 (0.23 ± 0.09 N m/kg). For descent, the second flexion moment peak was found to be significantly larger for SGCs ending on step 2 (1.17 ± 0.25 N m/kg) than for SGCs ending on step 1 (0.97 ± 0.19 N m/kg), and the first adduction moment peak was found to be significantly larger for SGCs ending on step 2 (0.28 ± 0.15 N m/kg) than for SGCs ending on step 1 (0.21 ± 0.18 N m/kg). This study highlights important considerations when planning stair gait measurement protocols and comparing results from studies made by other laboratories.

Keywords

stair gait cycle stair ascent stair descent knee joint moments knee kinematics motion analysis

Get full access to this article

View all access options for this article.

References

McFadyen

B. J.

Winter

D. A.

‘An integrated biomechanical analysis of normal stair ascent and descent.’

J. Biomechanics 21 (9) (1988): 733–744

Andriacchi

T. P.

Andersson

G. B. J.

Fermier

R. W.

Stern

Galante

J. O.

‘A study of lower-limb mechanics during stair-climbing.’

J. Bone Jt Surg. Am. 62 (1980): 749–757

Kowalk

D. L.

Duncan

J. A.

Vaughan

C. L.

‘Abduction—adduction moments at the knee during stair ascent and descent.’

J. Biomech. 29 (3) (1996): 383–388

Stuart

M. J.

Kienbacher

Growney

E. S.

K.-N.

‘Valgus—varus motion of the knee in normal level walking and stair climbing.’

Clin. Biomech. 12 (5) (1997): 286–293

Costigan

P. A.

Deluzio

K. J.

Wyss

U. P.

‘Knee and hip kinetics during normal stair climbing.’

Gait Posture 16 (2002): 31–37

Protopapadaki

Drechsler

W. I.

Cramp

M. C.

Coutts

F. J.

Scott

O. M.

‘Hip, knee, ankle kinematics and kinetics during stair ascent and descent in healthy young individuals.’

Clin. Biomech. 22 (2007): 203–210

Christina

K. A.

Cavanagh

P. R.

‘Ground reaction forces and frictional demands during stair descent: Effects of age and illumination.’

Gait Posture 15 (2002): 153–158

Nadeau

McFadyen

B. J.

Malouin

‘Frontal and sagittal plane analyses of the stair climbing task in healthy adults aged over 40 years: What are the challenges compared to level walking?’

Clin. Biomech. 18 (2003): 950–959

Stacoff

Diezi

Luder

Stüssi

Kramers-de Quervain

I. A.

‘Ground reaction forces on stairs: Effects of stair inclination and age.’

Gait Posture 21 (2005): 24–38

10.

Reeves

N. D.

Spanjaard

Mohagheghi

A. A.

Balzopoulos

Maganaris

C. N.

‘Influence of light handrail use on the biomechanics of stair negotiation in old age.’

Gait Posture 28 (2008): 327–336

11.

Reeves

N. D.

Spanjaard

Mohagheghi

A. A.

Baltzopoulos

Maganaris

C. N.

‘Older adults employ alternative strategies to operate within their maximum capabilities when ascending stairs.’

J. Electomyogr. Kinesiol. 19 (2009): e57-e68.

12.

Mital

‘A biomechanical evaluation of staircase riser heights and tread depths during stair-climbing.’

Clin. Biomech. 2 (1987): 162–164

13.

Reiner

Rabuffetti

Frigo

‘Stair ascent and descent at different inclinations.’

Gait Posture 15 (2002): 32–44

14.

Spanjaard

Reeves

N. D.

van Dieen

J. H.

Baltzopoulos

Maganaris

C. N.

‘Lower-limb biomechanics during stair descent: Influence of step-height and body mass.’

J. Expl Biol. 211 (2008): 1368–1375

15.

Thambyah

Thiagarajan

Goh Cho Hong

‘Knee joint moments during stair climbing of patients with anterior cruciate ligament deficiency.’

Clin. Biomech. 19 (2004): 489–496

16.

Andriacchi

T. P.

‘Functional analysis of pre and post-knee surgery: Total knee arthroplasty and ACL reconstruction.’

Trans. ASME, J. Biomech. Engng 115 (4B) (1993): 575–581

17.

Kaufman

K. R.

Hughes

Morrey

B. F.

Morrey

‘Gait characteristics of patients with knee osteoarthritis.’

J. Biomech. 34 (2001): 907–915

18.

Andriacchi

T. P.

Galante

J. O.

Fermier

R. W.

‘The influence of total knee-replacement design on walking and stair-climbing.’

J. Bone Jt Surg. Am. 64 (9) (1982): 1328–1335

19.

Catani

Benedetti

M. G.

De Felice

Buzzi

Giannini

Aglietti

‘Mobile and fixed bearing total knee prosthesis functional comparison during stair climbing.’

Clin. Biomech. 18 (2003): 410–418

20.

van Dieën

J. H.

Spanjaard

Konemann

Bron

Pijnappels

‘Balance control in stepping down expected and unexpected level changes.’

J. Biomech. 40 (2007): 3641–3649

21.

Whatling

G. M.

Evans

S. L.

Holt

C. A.

‘Comparing different data collection and analysis techniques for quantifying healthy knee joint function during stair ascent and descent.’

Proc. IMechE, Part H: J. Engineering in Medicine 223 (H8) (2009): 981–990 DOI: 10.1243/09544119JEIM648.

22.

Whatling

G. M.

Evans

S. L.

Holt

C. A.

‘Introducing a new staircase design to quantify healthy knee function during stair ascent and descent.’

Comput. Meth. Biomech. Biomed. Enging 13 (3) (2010).

23.

B. Y.

Kienbacher

Growney

E. S.

Johnson

M. E.

K.-N.

‘Reproducibility of the kinematics and kinetics of the lower extremity during normal stair-climbing.’

J. Orthop. Res. 15 (1997): 348–352

24.

Bell

A. L.

Pederson

D. R.

Brand

R. A.

‘Prediction of hip joint center location from external landmarks.’

Hum. Movement Sci. 8 (1989): 3–16

25.

Townsend

M. A.

Tsai

T. C.

‘Biomechanics and modelling of bipedal climbing and descending.’

J. Biomech. 9 (1976): 227–239