Out-of-plane trunk movements and trunk muscle activity after a trip during walking

Tripping during gait occurs frequently. A successful balance recovery implies that the forward body rotation is sufficiently reduced. In view of this, adequate control of the trunk momentum is important, as the trunk has a high inertia. The aim of this study was to establish out-of-plane trunk movements after a trip and to determine trunk muscle responses. Ten male volunteers repeatedly walked over a platform in which 21 obstacles were hidden. Each subject was tripped over one of these obstacles at mid-swing of the left foot in at least five trials. Kinematics, dynamics, and muscle activity of the main trunk muscles were measured. After a trip, an increase in trunk flexion was observed (peak flexion 37 degrees). In addition, considerable movements outside the sagittal plane (up to 20 degrees) occurred. Already before landing of the blocked foot, the trunk forward bending movement was reduced, while trunk torsion and lateral rotation were still increasing. Fast responses were seen in both abdominal and back muscles, indicating stiffening of the trunk. These muscle responses preceded the mechanical trunk disturbances, which implies that these responses were triggered by other mechanisms (such as afferent signals from the extremities) rather than a simple stretch reflex. A second burst of predominantly trunk muscle extensor activity was seen at landing, suggesting specific anticipation of the trunk muscles to minimize trunk movements due to landing. In conclusion, despite large movements outside the sagittal plane, it appears that trunk muscle responses to trips are aspecific and especially aimed at minimizing trunk forward bending.