Effect of a hip flexor-stretching program on gait in the elderly

Area of Science:

• Gerontology
• Biomechanics
• Physical Therapy

Background:

• Elderly individuals often exhibit reduced peak hip extension during walking's terminal stance phase compared to young adults.
• This reduction may be due to hip flexor contracture or dynamic gait alterations.

Purpose of the Study:

• To determine if reduced hip extension in the elderly is caused by hip flexor contracture.
• To test if hip flexor stretching improves hip extension and other age-related gait changes.

Main Methods:

• A double-blinded, randomized controlled trial involving 96 healthy elderly participants.
• Participants were assigned to a hip flexor stretching group or a shoulder abductor stretching control group.
• Exercises were performed at home twice daily for 10 weeks, with pre- and post-assessments in a gait laboratory.

Main Results:

• The hip flexor stretching group showed a modest improvement in static peak hip extension (P=.032).
• Dynamic hip extension showed a trend towards improvement at comfortable and fast walking speeds in the treatment group (P=.103 and P=.093, respectively).
• Significant improvements were observed in peak ankle plantarflexion and a tendency towards improved ankle power generation.

Conclusions:

• The similar magnitude of static and dynamic improvements suggests age-related reductions in hip extension are due to static hip flexion contracture.
• Age-related ankle kinematic and kinetic changes may be secondary to hip flexion contracture.
• Unsupervised exercises limited results; supervised programs may yield more substantial gait improvements.