Elsevier

Journal of Biomechanics

Volume 70, 21 March 2018, Pages 185-195
Journal of Biomechanics

Effect of arm swinging on lumbar spine and hip joint forces

https://doi.org/10.1016/j.jbiomech.2017.09.011Get rights and content

Abstract

During level walking, arm swing plays a key role in improving dynamic stability. In vivo investigations with a telemeterized vertebral body replacement showed that spinal loads can be affected by differences in arm positions during sitting and standing. However, little is known about how arm swing could influence the lumbar spine and hip joint forces and motions during walking. The present study aims to provide better understanding of the contribution of the upper limbs to human gait, investigating ranges of motion and joint reaction forces.

A three-dimensional motion analysis was carried out via a motion capturing system on six healthy males and five patients with hip instrumented implant. Each subject performed walking with different arm swing amplitudes (small, normal, and large) and arm positions (bound to the body, and folded across the chest). The motion data were imported in a commercial musculoskeletal analysis software for kinematic and inverse dynamic investigation.

The range of motion of the thorax with respect to the pelvis and of the pelvis with respect to the ground in the transversal plane were significantly associated with arm position and swing amplitude during gait. The hip external-internal rotation range of motion statistically varied only for non-dominant limb. Unlike hip joint reaction forces, predicted peak spinal loads at T12-L1 and L5-S1 showed significant differences at approximately the time of contralateral toe off and contralateral heel strike.

Therefore, arm position and swing amplitude have a relevant effect on kinematic variables and spinal loads, but not on hip loads during walking.

Introduction

Walking is one of the most important activities in daily life and exposes the spine to cyclic loading conditions, with an average load approximately equal to 170% the one observed in the standing position (Rohlmann et al., 2014). The motion of the arms in opposite direction to the lower limbs as well as the trunk axial rotation are distinctive features of the human gait. Arm swing (AS) improves the dynamic body stability (Nakakubo et al., 2014, Ortega et al., 2008, Punt et al., 2015) by counterbalancing the angular momentum produced by legs (Elftman, 1939, Hinrichs, 1990, Park, 2008). Additionally, it reduces the vertical displacement of the centre of mass (Hinrichs, 1990, Murray et al., 1967, Umberger, 2008) and the free vertical moment generated at the contact between the foot and the ground (Angelini et al., 2016, Li et al., 2001, Witte et al., 1991).

Current studies on the influence of arm movement during level walking were mainly focused on the investigation of metabolic variables (Umberger, 2008), force plate data (Angelini et al., 2016, Li et al., 2001), gait parameters (Angelini et al., 2016) or lower limb kinematics and kinetics (Umberger, 2008). To our best knowledge, only Callaghan et al. (1999) examined the AS effects on low back joint forces during walking, yet considering only two arm conditions (i.e., free AS or arms crossed across the chest). In vivo studies on spinal loads in patients with a vertebral body replacement (VBR) showed that the arm position could affect the load transfer mechanism in sitting and standing (Dreischarf et al., 2010, Zander et al., 2015).

The present study aimed to investigate the effect of different arm positions and AS amplitudes on the kinematics and on joint reaction forces on the hip and on the upper and lower lumbar spine. For this purpose, the research was divided into two steps: an experimental campaign for acquiring human motion data during barefoot level walking, and a second step focused on musculoskeletal simulations. A statistical analysis was performed to investigate the significance of arm position and AS amplitude on several selected output quantities, including the range of motion (RoM) at several joints and the joint reaction forces (JRFs). Experimental data from instrumented implants were used to validate the musculoskeletal model.

Section snippets

Study participants

Six healthy male volunteers (Group A) and five patients with instrumented hip implant (Group B) were considered (Table 1). In Group A, only subjects with no current or previous back or hip pain and musculoskeletal disorders were included. The patients of Group B were in good physical condition to perform all investigated activities without limitations. Both, subjects of Group A and patients of Group B received a physical exam by a clinician to exclude the presence of spine deformities.

The

Model validation

As a first step in the analysis of results, hip JRFs resulting from numerical simulations and recorded from instrumented implants were compared, with the aim of validating the model. For instance, Fig. 3A shows the resultant hip force (Fres) and the three force components predicted by the musculoskeletal model and measured in vivo for the patient H2R during walking with a NAS. They are expressed in the femur coordinate reference system of the implant. Fres showed two typical peak values at

Discussion

In order to investigate how arm position or AS amplitude could affect the hip and spine kinematics and JRFs during level walking, motion data of both, six asymptomatic subjects and five patients with instrumented hip implant were captured in Vicon system. A total of 180 musculoskeletal simulations for Group A were run to compare the RoMs and the JRFs during the five walking tasks, including three different AS amplitudes and two different arm positions.

Acknowledgments

This study was financially supported by the Bundesinstitut für Sportwissenschaften, BiSp (MiSpEx - Network).

Conflict of interest

There are no conflicts of interest.

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