Journal of Research in Rehabilitation Sciences

Comparison of Range of Motion of Lower Limb Joints during Walking on Flat and Sloping Surfaces in Middle-Aged Climbers with and without Backpacks: Quasi-Experimental Study

Document Type : Original Articles

Authors

1 MSc, Department of Biomechanics and Sports Pathology, School of Physical Education and Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran

2 Associate Professor, Department of Sports Biomechanics, School of Physical Education and Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran

3 MSc, Department of Biomechanics and Sports Pathology, School of Physical Education and Sports Sciences, Kharazmi University, Karaj, Iran

10.48305/jrrs.2023.41417.1025

Abstract

Introduction: Understanding the biomechanical impact of carrying a backpack when walking downhill can be valuable in designing injury prevention programs and physical preparation plans. The aim of this study was to compare the range of motion of lower limb joints during walking on flat and sloped surfaces in middle-aged climbers with and without backpacks.
Materials and Methods: In the present study, 14 middle-aged mountaineers performed 4 walking trials with and without a backpack on a treadmill with a slope of 0 degrees and a negative slope of 15 degrees. Three-dimensional motion analysis system was used to record kinematic data. The range of motion (ROM) of the ankle, knee, and thigh joints was processed in the sagittal plane. If data followed a normal distribution, paired t-test was used.
Results: On a slope of -15 degrees with a backpack, hip joint (P = 0.044) and ankle joint (P = 0.007) ROM was significantly lower than without a backpack. In the case of using a backpack, knee joint ROM was significantly lower on a 0 degree slope (P = 0.038) and -15 degrees slope (P = 0.029) compared to without a backpack. Moreover, ankle joint ROM significantly differed only when using a backpack (P = 0.032). Furthermore, for the knee and thigh joints, there was a significant difference in the ROM between slopes with (P = 0.006 and P = 0.012, respectively) and without a backpack (P = 0.025 and P = 0.015 respectively).
Conclusion: Carrying a backpack with 25% of the body weight on a negative slope has significant effects on the ROM of the lower limb joints. It seems that negative slope may have far greater effects than load on the ROM of the lower limb joints, especially the ankle joint in middle-aged climbers. Since downhill descent is a part of every climbing program, using a light backpack and optimizing the style of carrying the backpack is recommended to climbers to prevent injuries and improve performance.

Keywords

Main Subjects

  1. Howatson G, Hough P, Pattison J, Hill JA, Blagrove R, Glaister M, et al. Trekking poles reduce exercise-induced muscle injury during mountain walking. Med Sci Sports Exerc 2011; 43(1): 140-5.
  2. Gasser B. Deathly accidents while high-altitude mountaineering in the Swiss Alps-An observational analysis from 2009 to 2021. Int J Environ Res Public Health 2022; 19(19): 12498.
  3. Drain J, Attwells R, Orr R, Billing D. Load carriage capacity of the dismounted combatant - a commander's guide (DSTO-TR-2765). Fairbairn, Canberra, Australia: Defence Science and Technology Organisation; 2012.
  4. Strutzenberger G, Leutgeb L, Claussen L, Schwameder H. Gait on slopes: Differences in temporo-spatial, kinematic and kinetic gait parameters between walking on a ramp and on a treadmill. Gait Posture 2022; 91: 73-8.
  5. Lee J, Yoon YJ, Shin CS. The effect of backpack load carriage on the kinetics and kinematics of ankle and knee joints during uphill walking. J Appl Biomech 2017; 33(6): 397-405.
  6. Rosa RGD, Gomenuka NA, Oliveira HB, Peyre-Tartaruga LA. Inclined weight-loaded walking at different speeds: Pelvis-shoulder coordination, trunk movements and cost of transport. J Mot Behav 2018; 50(1): 73-9.
  7. D'Addio G, Dionisi L, Pagano G, Mercogliano L, Cesarelli M, Cesarelli G. Effects of the school backpack on walking kinematics: A mechanical overload potentially causing musculoskeletal disorders in developmental age?. G Ital Med Lav Ergon 2020; 42(3): 201-7. [In Italian].
  8. Barbosa J, Marques M, Forte P, Santos C, Neiva H, Izquierdo M, et al. Effects of a modified backpack model on ground reaction forces in children of different ages during walking and running. J Mens Health 2022; 18(5): 109.
  9. Huang L, Yang Z, Wang R, Xie L. Physiological and biomechanical effects on the human musculoskeletal system while carrying a suspended-load backpack. J. Biomech 2020; 108: 109894.
  10. Suri C, Shojaei I, Bazrgari B. Effects of school backpacks on spine biomechanics during daily activities: A narrative review of literature. Hum Factors 2020; 62(6): 909-18.
  11. Wang J, Stephenson ML, Hass CJ, Janelle CM, Tillman MD. Carrying asymmetric loads while walking on a treadmill interferes with lower limb coordination. Int J Environ Res Public Health 2021; 18(9).
  12. Alexander N, Schwameder H. Lower limb joint forces during walking on the level and slopes at different inclinations. Gait Posture 2016; 45: 137-42.
  13. Dewolf AH, Ivanenko YP, Zelik KE, Lacquaniti F, Willems PA. Differential activation of lumbar and sacral motor pools during walking at different speeds and slopes. J Neurophysiol 2019; 122(2): 872-87.
  14. Liu Y, Qiang L, Song Q, Zhao M, Guan X. Effects of backpack loads on leg muscle activation during slope walking. Appl Sci 2020; 10: 4890.
  15. Lay AN, Hass CJ, Gregor RJ. The effects of sloped surfaces on locomotion: A kinematic and kinetic analysis. J Biomech 2006; 39(9): 1621-8.
  16. Ahmadi-Goodini F, Khaleghi-Tazji M, Letafakar A. The effect of backpack carriage in different weights and gradients on ground reaction force parameters of 10-12-year-old schoolchildren's gait in Tehran, Iran. J Res Rehabil Sci 2020; 16: 17-23. [In Persian].
  17. Najafian Najafabadi M, Sadeghi H, Tehrani P. The effect of backpack carriage on selected biomechanical variables of lower extremity of girls and boys with 7-10 years age during walking. Journal of Rehabilitation Medicine 2021; 10(4): 724-37. [In Persian].
  18. Li SSW, Chan OHT, Ng TY, Kam LH, Ng CY, Chung WC, et al. Gender differences in energy expenditure during walking with backpack and double-pack loads. Hum Factors 2018; 61(2): 18720818799190.
  19. Kellis E, Arampatzi F. Effects of sex and mode of carrying schoolbags on ground reaction forces and temporal characteristics of gait. J Pediatr Orthop B 2009; 18(5): 275-82.
  20. Harman EA, Frykman PN, Knapik JJ, Han K-H. 785 backpack vs. front-back pack: Differential effects of load on walking posture. Med Sci Sport Exerc 1994; 26(5): S140.
  21. Harman E, Hoon K, Frykman P, Pandorf C. The effects of backpack weight on the biomechanics of load carriage. Natick, MA: Military Perfomance Divisin, US Army Research Institute of Environmental Medicine; 2000.
  22. Oberhofer K, Wettenschwiler PD, Singh N, Ferguson SJ, Annaheim S, Rossi RM, et al. The influence of backpack weight and hip belt tension on movement and loading in the pelvis and lower limbs during walking. Appl Bionics Biomech 2018; 2018: 4671956.
  23. Birrell SA, Haslam RA. The effect of military load carriage on 3-D lower limb kinematics and spatiotemporal parameters. Ergonomics 2009; 52(10): 1298-304.
  24. Genitrini M, Dotti F, Bianca E, Ferri A. Impact of backpacks on ergonomics: Biomechanical and physiological effects: A narrative review. Int J Environ Res Public Health 2022; 19(11).
  25. Mecagni C, Smith JP, Roberts KE, O'Sullivan SB. Balance and ankle range of motion in community-dwelling women aged 64 to 87 years: A correlational study. Phys Ther 2000; 80(10): 1004-11.
  26. Brady L, Carse B, Morrison D, Morton A, Porteous N, Scott H. WestMARC Knee Guide for the Prosthetic Multidisciplinary Team [Online]. [cited 2020]; Available from: URL: http://www.knowledge.scot.nhs.uk/westmarckneeguide.aspx
  27. Sadeghi H, Prince F, Zabjek KF, Sadeghi S, Labelle H. Knee flexors/extensors in gait of elderly and young able-bodied men (II). Knee 2002; 9(1): 55-63.
  28. Dahl KD, Wang H, Popp JK, Dickin DC. Load distribution and postural changes in young adults when wearing a traditional backpack versus the BackTpack. Gait Posture 2016; 45: 90-6.
  29. Montgomery JR, Grabowski AM. The contributions of ankle, knee and hip joint work to individual leg work change during uphill and downhill walking over a range of speeds. R Soc Open Sci 2018; 5(8): 180550.
  30. Caster BL. The effects of height and post-landing movement task on lower extremity landing biomechanics [PhD Thesis]. Eugene, OR: University of Oregon; 1996.
  31. Morales B. The effect of backpack load on gait biomechanics in college-aged individuals [MSc Thesis]. Corpus Christi, TX: Texas A&M University - Corpus Christi; 2023.
  32. Hall M, Boyer ER, Gillette JC, Mirka GA. Medial knee joint loading during stair ambulation and walking while carrying loads. Gait Posture 2013; 37(3): 460-2.
  33. Ahmadi E, Atashak S. Kinematic changes in walking of male students with lumbar lordosis after carrying backpacks with different weights. Proceeding of the 2nd National Conference of Applied Sports and Health Sciences; 2006 Sep 29; Tabriz, Iran. [In Persian].
  34. Zarei H, Norasteh AA, Koohboomi M. The relationship between muscle strength and range of motion in lower extremity with balance and risk of falling in elderl. Physical Treatment 2020; 10(1): 33-40. [In Persian].
  35. Valizadeh A. The effect of fatigue on coordination and change of coordination between trunk-pelvis-thigh while running at different speeds on a treadmill in active men and women. [MSc Thesis]. Tehran, Iran: Faculty of Physical Education and Sports Sciences, Kharazmi University; 2017. [In Persian].
  36. Chow DH, Kwok ML, Au-Yang AC, Holmes AD, Cheng JC, Yao FY, et al. The effect of backpack load on the gait of normal adolescent girls. Ergonomics 2005; 48(6): 642-56.
  37. Ghamari Hoveyda SS, Babakhani F, hajilou b, Anbarian M. The effect of backpack carriage with different loads on kinematics variables during walking in elementary school students in Hamedan city. Journal of Practical Studies of Biosciences in Sport 2018; 5(10): 87-97. [In Persian].
  38. Özgül B, Akalan E, Kuchimov S, Uygur F, Temelli Y, Polat MG. During asymmetrical backpack loading: Is unloaded side of body segments truly unloaded? J Biomech 2011; 44(Suppl 1): 7.
  39. Panoutsakopoulos V, Kotzamanidou MC, Papaiakovou G, Kollias IA. The ankle joint range of motion and its effect on squat jump performance with and without arm swing in adolescent female volleyball players. J Funct Morphol Kinesiol 2021; 6(1): 14.
  40. Brockett CL, Chapman GJ. Biomechanics of the ankle. Orthop Trauma 2016; 30(3): 232-8.
  41. Ozgul B, Akalan NE, Kuchimov S, Uygur F, Temelli Y, Polat MG. Effects of unilateral backpack carriage on biomechanics of gait in adolescents: A kinematic analysis. Acta Orthop Traumatol Turc 2012; 46(4): 269-74.
  42. Toghroli R, Reisy L, Mansourian M, Azar FEF, Ziapour A, Mehedi N, et al. Backpack improper use causes musculoskeletal injuries in adolescents: A systematic review. J Educ Health Promot 2021; 10: 237.
Journal of Research in Rehabilitation Sciences
Volume 18, Issue 1
2022
Pages 75-83
  • Receive Date: 12 January 2023
  • Revise Date: 26 August 2023
  • Accept Date: 29 August 2023