Kinetic and kinematic effects of using a walker during the sit-to-stand transfer after lumbar spinal fusion: A cross-sectional, within-subjects study
Abstract
Background: High pain levels after lumbar spinal fusion surgery often alter sit-to-stand kinematics, including reducing forward trunk inclination. These adaptations can lead to long-term kinematic deviations and chronic pain. Interventions are needed to facilitate sit-to-stand kinematics resembling those of healthy individuals while minimizing post-surgical pain. This study compared the effects of using both hands on a walker during sit-to-stand to pushing up from the sitting surface on several kinetic and kinematic variables. Methods: Fifteen participants (mean age 52.3 ± 14.1 years), on average 10 days after lumbar spinal fusion, performed alternating sit-to-stand trials. Data were collected using 3D motion capture and force plates to analyze differences between the two hand placement conditions. Findings: Using a walker did not significantly reduce trunk-pelvis external flexion moment (mean difference = 4.1 Nm, P = .582) when modeling the trunk as a rigid segment, but reduced ground reaction forces (?312.1 N), promoted a less acute trunk-pelvis angle (+6.9°), and decreased hip flexion moment (?71.3 Nm; all P < .001). Contrary to common concerns, no walker tipping occurred during the 45 sit-to-stand trials. Interpretation: Using hands on a walker for sit-to-stand after recent lumbar spinal fusion appears safe for individuals with presumably intact cognition. The lack of reduction in trunk-pelvis external flexion moments may reflect adaptive movement patterns employed to complete the task when the trunk is unsupported. Lower hip moments and a less acute trunk-pelvis angle when using the walker may support early mobilization by reducing joint loading and motion demands, potentially lessening pain.
Department(s)
School of Health Care Professions
Document Type
Article
DOI
10.1016/j.clinbiomech.2025.106601
Keywords
Lumbar flexion moment, Lumbar spinal fusion, Sit-to-stand kinematics, Sit-to-stand kinetics, Sit-to-stand transfer
Publication Date
7-1-2025
Recommended Citation
Shaw, Jason L.; Anderson, Renee E.; Birchell, Ryan B.; Clements, Ryan R.; Gibbs, Austin C.; Ludwig, Andrew M.; and Hackney, James M., "Kinetic and kinematic effects of using a walker during the sit-to-stand transfer after lumbar spinal fusion: A cross-sectional, within-subjects study" (2025). Faculty Scholarship. 129.
https://bearworks.missouristate.edu/articles00/129
Journal Title
Clinical Biomechanics
