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Trunk and lower limb biomechanics during stair climbing in those with symptomatic femoroacetabular impingement compared to asymptomatic healthy individuals Hammond, Connor


Introduction: Femoroacetabular impingement is a pathomechanical hip condition that leads to pain, impaired physical function and, if left untreated, potentially hip osteoarthritis. It has been shown that those with femoroacetabular impingement exhibit altered gait characteristics during level walking and stair climbing, and decreased muscle force production during isometric contractions. However, to-date no studies have looked at muscle activation during dynamic movements such as stair climbing in this patient population. Purpose: The purpose of this study was to compare three-dimensional gait kinematics of the trunk and lower limb joint kinetics, and activation of the hip, knee and ankle musculature during stair climbing in those with femoroacetabular impingement and pain free controls. Methods: Trunk, hip knee and ankle kinematics, as well as hip, knee and ankle kinetics and EMG activity of nine lower limb muscles were collected during stair climbing for 20 people with femoroacetabular impingement and compared to 20 pain-free individuals. Results: Those with femoroacetabular impingement had significantly increased peak trunk forward flexion angles (p=0.01) and external hip flexion moments (0.01), and decreased peak external knee flexion moments (0.01) and lateral gastrocnemius activation (p=0.04) compared to the control group. Conclusion: Findings from this study indicate that those with FAI may increase their trunk forward flexion to potentially compensate for reduced gastrocnemius activation, to decrease the demand on the quadriceps or as a response to pain. However, a trunk lean may also be a potential cause of FAI due to increased external hip flexion moments. This should all be taken into account by clinicians when rehabilitating those with FAI.

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