Sagittal spine and lower limb movement during sit-to-stand in healthy young subjects

Investigators: Mr Reza Fotoohabadi, Dr Elizabeth Tully, Prof Mary Galea

This study investigated the sagittal movement relationships between thoracic, lumbar spine and hip joints during sit to stand (STS). More specifically the aims were to determine (i) the sagittal plane contribution of the lumbar and thoracic spine to trunk movement, (ii) the movement interaction between the lumbar spine and pelvi-femoral or 'true' hip joint, and (iii) the coordination of hip and knee joints during STS in healthy young subjects. Forty-seven healthy young adults were videotaped performing STS at their preferred speed from a chair set at 100% knee height.   The videotapes were digitized and data anlaysed using the Peak Motus Motion Analysis System .

Forward trunk lean prior to buttock lift-off (LO) was accomplished by concurrent lumbar and hip flexion (1:3). As the lumbar spine flexed the thoracic spine extended, resulting in a LO trunk angle of 45.7°(±5.8°). Following LO, the hip(s) and lumbar spine extended and the thoracic spine flexed, with the standing thoracic angle approximating the initial thoracic posture in sitting.   For appropriate facilitation of STS in patients with movement dysfunction, clinicians need to be aware of the sagittal contributions of the thoracic and lumbar spine to the forward and upward movement of the trunk, and of the coordinated movement between the hip joint(s) and lumbar spine during the movement. This study has provided the basis for examination of the thoracolumbar contribution to STS in subjects with pathology.

Figure 1 . Line plots representing the change in flexion-extension angle throughout sit-to-stand in the thoracic (A) and lumbar spine (B). The continuous lines represent the average of 47 subjects, whilst the broken lines indicate plus or minus one standard deviation. The open circle indicates the point of lift off (at 41% of the total test duration).

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