Individual joint contributions to forward propulsion are not related to stability during walking in young or older adults.
Francesca E Wade, Bryce C Daniels, David J Clark and 4 others
PMID 39341103WHAT IT FOUND
Older adults who rely more on their hips for forward propulsion show greater side-to-side stability, but this hip shift has no clear link to forward-backward stability.
The change in propulsion strategy appears related to lateral balance control rather than general instability.
Key findings
01Low-functioning older adults relied most on hip musculature for propulsion, while young adults relied primarily on the ankle.
02As reliance on hip propulsion increased, mediolateral (side-to-side) stability improved, but there was little relationship between hip propulsion and anteroposterior (forward-backward) stability.
03Low-functioning older adults walked significantly slower and had different stability measures at various points in the gait cycle compared to high-functioning older adults and young adults.
STILL TO COME
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What it does not show
The study is cross-sectional, so it cannot prove that hip propulsion causes better lateral stability, only that they are associated. RR values were higher than previous studies, possibly due to overground walking versus treadmill walking, or differences in participant function. Using the lateral ankle marker to define the base of support may overestimate lateral instability in patients who walk with a toe-out posture. The Plug-in Gait model has known limitations in accurately calculating hip joint power due to difficulty locating the hip joint center. Body mass was higher in the low-functioning group, and mass is associated with lateral stability, so the effect of weight cannot be fully separated from the propulsion strategy.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH grant U01AG061389.
The easy way to misread this
Do not interpret the increased hip propulsion in older adults as a failure of ankle strength alone. The data suggests this shift may be a functional adaptation to improve side-to-side stability, so targeting ankle power without considering lateral balance control might miss the underlying compensatory strategy.