Abdominal Muscle Activity and Lower Limb Forces When Walking
With Nordic Walking Poles
Valerie Sparkes, Lucy Warren
Katie Whitehouse
Background
• Research into the effects of walking for patients with low back pain has been shown to be beneficial Callaghan et al (1999)
• Abdominal muscles appear to influence the stability of the spine via their connection to the thoracolumbar fascia
Walking and abdominal
• Abdominal muscle activity has been shown to change when patients have LBP
• Theories: (i)changes in muscle activity cause spinal pain (muscle-tension or pain-spasm-pain model)
• or (ii) changes in muscle activity serve to restrict spinal motion (pain adaptation model) Hodges and Moseley (2003)
• Disturbed muscle function seems to be a risk factor for developing LBP Anders et al (2005)
Abdominal muscles
• All trunk muscles play a role on supporting spine
• Internal and external oblique play an equally important role in maintaining spinal stability and trunk rotation Kavcic et al, (2004), Ng et al, (2006).
Internal and external obliques
• Internal and external oblique show relatively constant activity throughout the gait cycle White and McNair (2002).
• IO being most active during the late-stance phase and EO most active at mid-stance Waters and Morris, (1972), Dofferhof and Vink, (1985), Krebs et al, (1992) Callaghan et al (1999)
Forces through lower limb
• effect of supervised NW compared to unsupervised NW or advice to remain active (126 LBP subjects).
• no differences between 8 weeks of supervised or unsupervised NW and advice to remain active
• all groups experienced some improvement in pain and disability during the intervention period Hartvigsen et al (2010)
Forces through lower limb
• Walking with NW poles provides 30-50% load reduction to joints of the lower limb Geyer (2005) and INWF (2009)
Effects of walking poles on lower extremitygait mechanics
• All walking with poles conditions significantly increased walking speed, stride length, and stance time compared with the no poles condition.
• decrease in average vertical GRF walking with poles
• decrease in vertical (compressive) knee joint reaction force
• (13 subjects) Willson et al (2001)
Forces when walking with Nordic walking poles
• No-significant reductions in knee-joint loading when comparing walking with NW poles with normal walking,
Schwameder and Ring (2006), Jöllenbeck et al (2006) and Grüneberg et al (2006)
Aim
• There is no evidence to date on the effect of walking with
Nordic Walking Poles on abdominal muscle activity• Conflicting evidence regarding the effect on lower limb
forces
Aim: To determine effect of walking with Nordic
Walking Poles on:
• Internal & External oblique muscle activity • Lower limb vertical ground reaction forces
Nordic Walker® Trainer CR
Method• Crossover experimental study
• 15 (10F, 5M) Healthy subjects, • 21.06 (± 0.88) years• All provide informed consent
• Subjects underwent training period from International Nordic Walking Trainer,
Karen Ingram
Outcome measures
• Surface EMG • Maximum Voluntary
contractions of IO & EO (% MVC)
• Kistler force platform Vertical Ground reaction forces (Newtons)
Method
• Study conducted in Research Centre of Clinical Kinaesiology
• Split group into 2. Group 1 were tested walking without poles first then with poles
• Group 2 were tested walking with poles first and without poles
• Practice time walking with and without NW poles in the Lab placing right foot on force plate
Method
• Walked at a self selected speed along eight metre walkway during both conditions
• Three sets of data were collected for each condition
• The mean muscle activities of IO & EO over the last five seconds of each condition were measured.
• Data processing:MATLAB 71• Data analysis (SPSS) Version
16• Paired t test as data normally
distributed.
Results: Muscle activity and forces
• Significant Increases IO & EO walking with poles p=0.002
• Internal oblique No poles 31.94 (39.9)With Poles 53.05 (40.6)
• External oblique No poles 46.45 (30.9) With Poles 87.93 (60.5)
• Significant Increase in VGRF walking with poles p=0.008 (11.13%)
No poles 871.6 (237.00) Newtons
With Poles 968.33 (210.8) Newtons
Summary
Increased IO & EOactivity may be of valuefor some LBP patientswhere increases in muscleactivity are the objectives oftreatment.
EO largest values whenwalking with poles ?due to rotationalcomponent of walkingpattern or arm activity
• VGRF increased? due to novice
walkers lack of practice
• subjects concentration on hitting force platform
Limitations & further research
• Small numbers of subjects
• Novice walkers• Laboratory data
collection
• Collect speed of gait data
• Forces through ankle/knee/hip
• Erector spinae muscles as well as abdominals
• Walking further distance
http://www.nordicwalking.co.uk/