Effect of body position and external ankle load on the pendulum test in adults

The pendulum test is commonly used to measure passive stiffness about the knee in healthy and clinical populations. While most studies used an upright position, some studies explored different body positions, particularly with children. Additionally, including external ankle load increases the passive motion of the lower leg in children with Down syndrome. Does combining body position and ankle loading affect joint kinematics and muscle activity of the knee extensors during the pendulum test?

Twenty young adults participated in this study. Three body positions were included: 90-dgree upright, 45-degree incline, and 0-degree supine. Three load conditions were tested: no load (0%), and ankle loads equal to 3% and 6% of the subject's body mass. This resulted in a total of 9 conditions. Five trials were collected for each condition.

The upright position elicited a greater number of leg swings and a longer duration of the first knee flexion, while the incline position produced a higher relaxation index. Both ankle load conditions (3% and 6%) increased the magnitude of the first flexion excursion and relaxation index, and the 6% condition produced greater kinematic variables than the 3% load condition. Neither body position nor ankle load elicited muscle activity of the quadriceps.

Body position and external ankle load can affect the kinematics of leg swing during the pendulum test in healthy young adults. Particularly, ankle loads may increase passive motion about the knee. However, we wonder whether small differences across body positions would be clinically relevant.