The effects of age and step length on joint kinematics and kinetics of large out-and-back steps

Background Maximum step length (MSL) is a clinical test that has been shown to correlate with age, various measures of fall risk, and knee and hip joint extension speed, strength, and power capacities, but little is known about the kinematics and kinetics of the large out-and-back step utilized. Methods Body motions and ground reaction forces were recorded for 11 unimpaired younger and 10 older women while attaining maximum step length. Joint kinematics and kinetics were calculated using inverse dynamics. The effects of age group and step length on the biomechanics of these large out-and-back steps were determined. Findings Maximum step length was 40% greater in the younger than in the older women (P < 0.0001). Peak knee and hip, but not ankle, angle, velocity, moment, and power were generally greater for younger women and longer steps. After controlling for age group, step length generally explained significant additional variance in hip and torso kinematics and kinetics (incremental R2 = 0.09–0.37). The young reached their peak knee extension moment immediately after landing of the step out, while the old reached their peak knee extension moment just before the return step liftoff (P = 0.03). Interpretation Maximum step length is strongly associated with hip kinematics and kinetics. Delays in peak knee extension moment that appear to be unrelated to step length, may indicate a reduced ability of older women to rapidly apply force to the ground with the stepping leg and thus arrest the momentum of a fall.