Three-dimensional relationships between the movements of the pelvis and lumbar spine during normal gait
Introduction
It has long been known that the pelvis moves in all three planes during the course of the gait cycle (Saunders, Inman & Eberhart, 1953). If the rib cage and thoracic spine were to remain at a completely fixed attitude while this was happening, there would be a corresponding triplanar motion of the lumbar spine. However, the rib cage does not maintain a fixed attitude, and movement occurs in the thoracic, as well as the lumbar spine. The object of the present study is to obtain more information on the relationships between pelvic motion and the motion of the lumbar spine in a group of normal subjects.
The use of an opto-electronic system, with rigs attached to the pelvis and the thoracolumbar junction (Fig. 1), has made it possible to measure the motion of the lumbar spine, initially confined to the sagittal plane (Whittle & Levine, 1997). The technique was later extended to make measurements in all three planes, and a study of three-dimensional lumbar spinal motion during walking was conducted on 20 normal adult males (Whittle, Levine & Burke, 1998). The present paper makes use of these data, in an attempt to define the extent to which lumbar spinal motion is simply a reflection of pelvic movement, and the extent to which the two movements are independent. Lumbar spinal motion during walking was also measured by Rowe and White (1996), using a magnetic tracking device, and by Crosbie, Vachalathiti and Smith (1997), using an opto-electronic system, but with skin-mounted markers, rather than rigs. The results from the present study will be compared with those from these two other studies. Complete agreement is not to be expected, because of differences in technique, particularly with regard to the definitions of coordinate systems.
Section snippets
Methods
The three-dimensional motion of the lumbar spine was measured in 20 healthy young adult males, using the Vicon television–computer system (Oxford Metrics, Oxford, England) with rigs (Fig. 1) attached to the skin over the sacrum and the spine at the level of the thoracolumbar junction (Whittle et al., 1998). Motion of the pelvis was referred to a room-based coordinate system, as is usual in gait analysis using the Vicon Clinical Manager software. Motion of the lumbar spine was derived from the
Results
Table 1 shows the total range of motion for pelvic motion and lumbar spinal motion, in the sagittal, frontal and transverse planes. Fig. 2, Fig. 3, Fig. 4 show the mean (±2 s.d.) pelvic motion for all 20 subjects, over the gait cycle from right initial contact to the following right initial contact, in the same three planes. Fig. 5, Fig. 6, Fig. 7 show the corresponding data for the three-dimensional motion of the lumbar spine. Fig. 8, Fig. 9 show angle–angle plots relating pelvic motion to
Discussion
Motion of the lumbar spine and pelvis takes place simultaneously in all three dimensions. However, three-dimensional motion is difficult to visualize, so the following description will treat separately the motions in the three axes. This assumes that the motions are independent of each other, which may not be true, particularly when “coupling” takes place between lateral bend and axial rotation in the lumbar spine. This will be the subject of a further paper.
Inspection of Fig. 2, Fig. 5 shows
Summary
(1) The measurement of the three-dimensional motion of the lumbar spine, by rigs on the pelvis and at the thoracolumbar junction, is practical and convenient, with a high degree of inter-subject reliability.
(2) Changes in lumbar lordosis during the gait cycle are very variable from one subject to another, and it is impossible to make generalizations about the pattern of motion.
(3) The pattern of lateral bend of the lumbar spine corresponds closely to that of pelvic motion in the frontal plane,
Acknowledgments
The authors are grateful to Dr. Jack Crosbie, from the University of Sydney, Australia, for making available some of the data from his study.
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