Effects of back loading on the biomechanics of sit-to-stand motion in healthy children.

The goal of the present study was to determine the thus far unstudied effects of back loading on the kinematics and kinetics of sit-to-stand (STS) motion in healthy children. Fifteen children (8 boys, 7 girls, mean age 9.6 years, SD 1.2 years) were tested with no back load and with a back load of 10% and 20% of body weight, respectively. A motion analysis system was used with six infrared cameras and two force plates. Total STS duration did not change; however, differential effects were shown for the durations of its phases. Back loading increased ankle dorsiflexion yielding a greater maximal dorsiflexion angle. Effects on the knee angle were limited except for a significant decrease in final knee flexion. Initial and maximal hip flexion increased but final hip angle did not change. Initial backward pelvic tilt decreased and a shift to forward pelvic tilt occurred at an earlier stage of STS motion. Back loading affected trunk motion: maximal and final forward shoulder tilt increased. Maximal ankle and knee moments and powers increased; however, hip joint kinetics was not affected significantly. Therefore, while maintaining the general pattern of STS motion, participants showed selectively significant adjustments to back loading during its different phases. The main kinematic adjustments were increased trunk flexion and greater ankle dorsiflexion, while the major kinetic adjustment was increased knee extension moment. Increased back loading yielded more pronounced effects, primarily in the ankle. In sum, back loading substantially affected the biomechanics of STS motion even for the lower load level studied. This finding may be of clinical relevance for musculoskeletal disorders, but this needs to be examined.