AGE AND SEX-RELATED NORMATIVE JOINT KINEMATIC AND KINETIC WALKING STRATEGIES IN A HEALTHY ADULT POPULATION

Abstract

A comprehensive understanding of sex-specific gait patterns throughout the lifespan is important considering differences between males and females that can manifest biomechanically, and epidemiological evidence of female sex being a risk factor for some age-related pathologies such as osteoarthritis. This thesis aimed to, 1) characterize the differences in lower extremity joint kinematics and kinetics during gait between healthy women and men in different age groups, and 2) define salient inter-joint kinematic coordination strategies in healthy adult gait. Gait data from 154 asymptomatic adult participants was analyzed. Waveform principal component analysis (PCA) was applied to hip, knee and ankle joint angles and net external moments to extract major patterns of variability. Using a two-factor ANOVA, PC scores were examined for significant sex, age and interaction effects. A second series of PCA models were also developed with the PC scores of the kinematic features of each joint to model the inter-joint kinematic coordination. Demographics, anthropometrics and root mean square (RMS) of EMG waveforms for the high and low groups (85th and 15th percentile) of the retained kinematic strategies were statistically compared using a one-way ANOVA analysis. 13 PC features differed between healthy male and female gait patterns and were independent of age category. No PC features significantly differed between the age groups, and there was no significant sex by age interactions. Four different kinematic gait coordination strategies were identified, one with a significant sex-effect. Therefore, both analyses supported sex-differences in gait biomechanics and the importance of using sex-specific normative data in clinical gait studies. Additionally, the results suggest underlying kinematic differences within asymptomatic adults are concentrated in the patterns of their gait mechanics. Understanding how these strategies may link to susceptibility of injury and disease has important implications for patient-centered care and may provide important insight into age-related pathology and disease.