King, SL, Vanicek, N and O'Brien, TD (2018) Joint moment strategies during stair descent in patients with peripheral arterial disease and intermittent claudication. Gait and Posture, 62. pp. 359-365. ISSN 0966-6362

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Abstract

Objective: To determine the lower limb joint kinetic strategies during stair descent in claudicants with peripheral arterial disease (PAD-IC).
Design: Cross-sectional observation study.
Setting: University laboratory.
Participants: A total of 22 participants; 10 healthy controls and 12 patients diagnosed with PAD-IC.
Main Outcome Measures: Between-group comparisons of ground reaction force (GRF) and, hip, knee and ankle kinetics during steady-state stair descent.
Results: The claudicating-limb group demonstrated reduced vertical and posterior GRF compared to healthy controls (ES=-1.46 [-2.32,-0.69] and ES=-1.08 [-0.42,-0.26] as well as demonstrating a greater contribution to support moment from the ankle and trends towards a smaller hip contribution (42±14% vs 28±7%, P=.005 and Hip 16±8% vs 21±11%, P=.056, respectively). A unique sub-group was identified within the PAD-IC cohort demonstrating different hip moment strategies during weight acceptance: a novel hip extensor group (PAD-IC HExt) and stereotypical hip flexor group (PAD-IC HFlex). Compared to both healthy controls and the PAD-IC HFlex groups, the PAD-IC HExt group demonstrated increased hip extensor moment (ES=3.05 [1.67,4.42] and ES=3.62 [1.89,5.35]) and reduced knee extensor moment (ES=-2.00 [-3.15,-0.85] and ES=-1.36 [-2.60,-0.11] respectively) during weight acceptance.
Conclusions: A novel hip extensor strategy was identified in a sub-group of claudicants which acts to reduce the demand on the knee extensors, but not the plantarflexors. Weakness in the knee extensors may prevent redistribution of the task demand, typically seen in older adults in stair descent, away from the functionally limited plantarflexor muscle group. Further investigation into multi-level joint strength and the relationship to functional tasks is warranted to inform targeted intervention programmes.

Item Type:	Article
Uncontrolled Keywords:	1103 Clinical Sciences, 1106 Human Movement And Sports Science, 0913 Mechanical Engineering
Subjects:	Q Science > QP Physiology R Medicine > R Medicine (General)
Divisions:	Sport & Exercise Sciences
Publisher:	Elsevier
Related URLs:	Author
Date Deposited:	14 Jun 2018 08:53
Last Modified:	04 Sep 2021 10:23
DOI or ID number:	10.1016/j.gaitpost.2018.03.035
URI:	https://researchonline.ljmu.ac.uk/id/eprint/8838

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