Local Dynamic Stability of the Locomotion of Lower Extremity Joints and Trunk During Backward Upslope Walking.

Backward slope walking was considered as a practical rehabilitation and training skill. However, its gait stability has been hardly studied, resulting in its limited application as a rehabilitation tool. In this study, the effect of walking direction and slope grade were investigated on the local dynamic stability of the motion of lower extremity joints and trunk segment during backward and forward upslope walking (BUW/FUW). The local divergence exponents (lambda(S)) of 16 adults were calculated during their BUW and FUW at grades of 0%, 5%, 10%, and 15%. Mean standard deviation over strides (MeanSD) was analyzed as their gait variability. Backward walking showed larger lambda(S) for the abduction-adduction and rotational angles of knee and ankle on inclined surface than forward walking, while lambda(S) for hip flexion-extension angle at steeper grades was opposite. No grade effect for any joint existed during BUW, while lambda(S) increased with the increasing grade during FUW. As to the trunk, walking direction did little impact on lambda(S). Still, significant larger lambda(S) for its medial-lateral and vertical motion were found at the steeper grades during both FUW and BUW. Results indicate that during BUW, the backward direction may influence the stability of joint motions, while the trunk stability was challenged by the increasing grades. Therefore, BUW may be a training tool for the stability of both upper and lower body motion during gait.