Pelvis perturbations in various directions while standing in staggered stance elicit concurrent responses in both the sagittal and frontal plane

PloS one(2022)

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Walking very slowly increases the time spent in the double support phase, which could be resembled by the staggered stance posture. Maintaining balance in this posture is important in order to continue walking safely. We therefore aimed to increase the understanding of balance recovery in staggered stance. We studied balance responses on joint- and muscle level to pelvis perturbations in various directions while standing in this posture. Ten healthy individuals participated in this study. We used one motor beside and one behind the participant to apply perturbations in mediolateral (ML), anteroposterior (AP) and diagonal directions, with a magnitude of 3, 6, 9 and 12% of the participant’s body weight. Meanwhile motion capture, ground reaction forces and moments, and electromyography of the muscles around the ankles and hips were recorded. The perturbations caused movements of the centre of mass (CoM) and centre of pressure (CoP) in the direction of the perturbation. Furthermore, these were often accompanied by motions in a direction different from the perturbation direction. After ML perturbations and diagonal perturbations transverse to the line between both feet, large and significant CoM and CoP deviations were present in the sagittal plane. Also, stronger responses on joint and muscle level were present after these perturbations, compared to AP and diagonal perturbations collinear with the line between both feet. The hip, knee and ankle joints significantly responded to all perturbation directions, but in different manners and modes of cooperation. To conclude, standing in a staggered stance posture makes individuals more vulnerable to perturbations in ML direction and transverse to the line between both feet, requiring larger responses on joint level as well as contributions in the sagittal plane. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement All the authors declare that the research was funded by the Dutch Research Council (NWO), awarded to HvdK and EA. This work is part of the research program Wearable Robotics with project number P16-05. The following companies contributed in-cash to the research: Motek Medical ([][1]), Duchenne parent project ([][2]), FSHD Patient Foundation ([][3]) and Xsens ([][4]). The authors decision to publish was accepted by the funders. The funders had no role in the study design, data collection, data analysis and preparation of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study, involving human participants, was approved by the EWI/ET Ethics committee of the University of Twente. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Not Applicable The data used for this study is published on 4TU.ResearchData and can be found via the following DOI: [1]: [2]: [3]: [4]:
staggered stance
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