Stepping over an obstacle increases the motions and moments of the joints of the trailing limb in young adults

Tripping over obstacles is the most frequently mentioned causes of falls. Thus, this study was performed to test the hypotheses that when crossing obstacles, toe-obstacle clearance and the three-dimensional motions and moments at the hip, knee, and ankle of the trailing limb (limb crossing the obstacle last) increase with obstacle height. Data were collected using an optoelectronic digitizing system and force platform. Fourteen healthy young adults were tested during unobstructed level walking and when stepping over obstacles of 51, 102, 153, or 204 mm heights. Toe-obstacle clearances of the trailing foot increased from 31 mm during unobstructed gait to an average of 146 mm when stepping over obstacles of any of these heights. Obstacle height was not found to affect toe-obstacle clearance. When the toe of the trailing limb was over the obstacle,the flexion angles of the hip and knee increased linearly with obstacle height. Compared to flexion of the hip or ankle, flexion of the knee appears to be of primary importance when crossing obstacles with the trailing limb. The maximum extension moment at the hip joint during late stance decreased linearly with obstacle height. At the knee joint, the maximum flexion moment during early stance and the maximum adduction moment during late stance increased linearly with obstacle height. At the ankle joint, the maximum dorsiflexion moment during late stance increased linearly with obstacle height. These greater demands on motions and moments may affect the abilities of those elderly having decreased muscle strengths to step over obstacles. (C) 1997 Elsevier Science Ltd.