The effect of increasing trunk flexion during normal walking

Background: The head, arms and trunk segment constitute a large proportion of the body's mass. Therefore, small alterations in trunk inclination may affect lower limb joint moments and muscle activation patterns. Although previous research has investigated the effect of changing frontal plane inclination of the trunk, it is not clear how increasing trunk flexion will impact on the activation of the lower limb muscles. Research question: What is the effect of independently manipulating trunk flexion angle on lower limb kinematics, moments and muscle function? Methods: Gait analysis was carried out on 20 healthy people under four trunk flexion conditions: normal walking (NW), NW-5 degrees, NW+5 degrees and NW+10 degrees. For the latter three conditions, a biofeedback approach was used to tightly control trunk flexion angle. A linear mixed model was used to investigate the effect of changing trunk flexion on joint angles, moments, and knee muscle activation. Results: There were clear increases in hip and ankle moments as trunk flexion was increased, but no change in knee moments. The results also showed a linear increase in knee flexor muscle activity and a corresponding increase in co-contraction as trunk flexion increased. Interestingly, there was a dramatic change in the profile of hamstring activity. In the medial hamstrings, this change led to a 100% increase in activation during early stance as flexion was increased by 5 degrees from NW. Significance: This is the first study to demonstrate a strong dependence of knee flexor muscle activity on trunk flexion. This is important as people with knee osteoarthritis have been observed to walk with elevated muscle activation and this has been linked to increased joint loads. It is possible that these altered muscle patterns may result from increased trunk flexion during walking.

Automated summary

This study demonstrated a strong correlation between trunk flexion and knee flexor muscle activity, highlighting the importance of trunk flexion in influencing lower limb kinetics and muscle activation patterns. Increasing trunk flexion was found to increase hip and ankle moments, but did not change knee moments. Additionally, there was a notable shift in hamstring activity with increasing trunk flexion, particularly in the medial hamstrings.