ELSEVIER Gait&Posture 5 (1997) 6-12

Patterns of spinal motion during walking

Jack Crosbie*“, Roongtiwa Vachalathitib, Richard Smith”

aSchool of Physiotherapy, University of Sydney, Sydney, Australia
bSchool of Physiotherapy, Mahidol University, Bangkok, Thailand
‘Department of Biomedical Sciences, University of Sydney, Sydney, Australia

Received27 December 1994;accepted13 November 1995

Abstract

We present the results of a study in which we investigated the patterns of movement of the lower thoracic and lumbar spinal
segments and the pelvis in subjects walking at a self-selected speed. Our subjects were 108 healthy adults aged from 20 to 82 years
and were equally divided with respect to gender. Measurements were carried out using a video-based system by which the trunk
was partitioned into segments and the movements of these segments about three orthogonal axes recorded. We found consistent
patterns within and between segments and movements, with apparent consequential trunk motion following pelvic displacements.
This suggests that the spinal movements associated with walking are linked to the primary motions of the pelvis and the lower limbs.

Keywords: Gait; Movement; Lumbar spine; Thoracic spine

1. Introduction tions have occurred. It is interesting to note that, with

The importance of the trunk in walking has been
emphasised for over forty years. Saunders et al. [l],
having identified six major determinants of gait,
reported that three of these related to motion of the
pelvis. These major determinants are fundamental to
progression by clearing a pathway for the advancing
limb and reducing the displacement of the centre of
mass (CoM) during walking, so conserving energy.
Most investigations of spinal kinematics during walk-
ing have considered either the entire trunk as a single
segment or only the lumbar spine. There has been some
concordance between studies for calculated ranges of
spinal motion, but many of the conventionally accepted
values have been derived by measurement techniques
which have been superceded in terms of accuracy and
sensitivity. In particular, the methods by which three
dimensional angulation has been calculated have been
imprecise in determining the axes about which the rota-
* Corresponding author, P.O. Box 170, East Street, Lidcombe,
NSW 2141, Australia. Tel.: +612 6466549; Fax: +612 6466601.
the development of more sensitive measurement systems
with improved resolution and the ability to realise three
dimensional kinematic values within order-independent
joint coordinate systems [2], the reported values for
trunk rotation about the longitudinal axis, which were
of the order of nine degrees according to the studies of
the 1960s [3,4], have been revised down to nearer half
that value [5].
Spinal movements associated with walking have not
been considered with respect to separate component
segments. Several studies have considered the entire
trunk with respect to the pelvis, usually locating upper
markers or measurement transducers in the region of the
acromion processes or sternum [3-71. Other studies
have considered movements of the lumbar spine and the
pelvis [8-lo] or of the pelvis and lower limbs [ 1,111.
There has been no reported study in which the thoracic
component of the spine has been considered as a seg-
ment contributing to, or influenced by, trunk movement
during walking. Although the upper part of the thorax
is constrained, and its movements predictably limited,
by the secure attachments of the first six or seven ribs,

0966-6362/97/$17.00 Copyright 0 1997 Elsevier Science B.V. All rights reserved

PII SO966-6362(96)01066-I
 J. Crosbie
the lower thoracic spine has the capability to move,
albeit within a limited range, during the gait cycle. Evi-
dence from planar investigations of the thoracic spine,
between the sixth and twelfth thoracic vertebral levels,
has suggested that movements with amplitudes of over
30 degrees may be quite common about each of the three
axes during full range active motion [ 121.
We propose in this study to describe the motion of the
spine during self-selected free-speed walking. To that
end, we subdivided the spine into lower thoracic, lumbar
and pelvic segments and compared the movement pat-
terns of these segments during walking. The population
tested was equally represented by male and female sub-
jects and used subjects ranging in age from 20 to 82
years. This study formed part of a project which includ-
ed investigation of age, gender and speed effects on spi-
nal kinematics. Reporting the patterns and ranges of
motion during unconstrained gait was an essential
precursor to more specific analyses.
2. Procedures
2.1. Subjects
We tested a total of 108 subjects (50 males and 58
females) aged between 20 and 82 years (Table 1).
Subjects’ body mass index values (BMI = height/
weight2) suggested that our sample was normally distri-
buted across a range consistent with the general popula-
tion. We decided that subjects whose BMI ratio lay
outside 1.5 standard deviations (SD.) from the median
value for the population in general [ 131would be exclud-
ed from the study. No subjects were excluded as a result
of this criterion.
Subjects were volunteers from the local community.
All subjects included were healthy, reporting no inci-
dence of serious neurological or musculoskeletal illness
or injury prior to testing. None of the subjects had suf-
fered back, hip or leg pain during the six months
preceding the study. None of the subjects was using
prescribed medication at the time of testing. We inter-
viewed the subjects prior to inclusion in the study to
categorise their activity levels. On the basis of questions
derived from the Australian Heart Association’s activity
questionnaire, all subjects were graded as physically ac-
tive and lived independently. The study was approved
by the University of Sydney Human Ethics Committee.
Table 1
Subject characteristics
Age (years) Height (m)
Mean SD. Range Mean
Females 45.24 18.55 20-80 1.61
Males 46.34 18.25 20-82 1.72
et al. I Gait & Posture 5 (1997) 612 I
2.2. Instrumentation
The kinematic analysis was performed on data
collected by an automated video-based system (Expert-
vision; Motion Analysis Corporation (MAC), Santa
Rosa, Ca.). Four video cameras (NEC model Tl-23A
CCD; MAC) with 12.5-75 mm zoom lenses were used
to record images from body markers at a sampling fre-
quency of 60 frames per second. The test zone was 2.5
metres long by 2 metres high by approximately 2 metres
wide, with the long axis aligned with the plane of pro-
gression. Simultaneous input from the four cameras was
processed automatically (VP320 video processor; MAC)
and the data files were transferred to a dedicated com-
puter workstation (SUN Graphics 4/l 10; Sun Micro-
systems Inc, Mountain View, Ca.). Processing of the
data files included lens correction algorithms and utilis-
ed commercial and in-house software for data reduction
and analysis.
Prior to data collection, we calibrated the camera sys-
tem using an accurately constructed and surveyed rigid
steel cube of dimension 1 m3 with 18 spherical
retroreflective markers. The resolution and error of the
camera system was evaluated using static and dynamic
images to assess the accuracy and reliability of the sys-
tem under test conditions. Results indicated average
measurement errors of less than 0.1% for all coor-
dinates. These values are comparable with the data
reported by Linden et al. [14] which demonstrated high
accuracy and reproducibility for the Motion Analysis
video system. The theoretical and empirical resolution
and sensitivity of the system is less than 0.5 degrees
based upon a test model of similar dimensions to the
subjects tested in this study. For the purposes of analy-
sis, we report angular displacement values of less than
one degree but do not consider differences of this
magnitude to represent functionally relevant values
irrespective of statistical significance.
Following transfer of the video files, the coordinate
data were analysed using Fourier analysis. Coordinate
data were filtered using a Butterworth-type digital filter
with a low pass value of 5 Hz.
2.3. Protocol
Subjects wore a backless swimsuit or similar clothing
for the test. We applied lightweight adhesive body mark-
ers, consisting of 2.5 cm hollow spherical reflective tar-
Weight (kg)
S.D. Range Mean S.D. Range
0.07 1.43-1.8 59.6 9.83 41-95
0.08 1.57-1.9 73.7 10.5 55-100
 J. Crosbie
Fig. I. Location of reflective markers
gets. Thirteen body markers were attached to the dorsal
surface of the trunk and three each to the right and left
thighs. A further marker was used to define each foot
for identification of the temporal and spatial parameters
of gait (Fig. 1). In order to minimise and check for rela-
tive motion between the markers and the skin surface,
we examined each marker between every test walk and
at the conclusion of the test. Markers were applied to
the skin over the bony landmarks as indicated in the fig-
ure. The thigh markers were located according to a
predetetmined orientation which permitted transforma-
tion of the loci to define the three dimensional motion
of the thigh segment relative to the pelvis and thus rec-
ord the hip joint motion.
We required the subjects to walk three times over a
clear, level floor area without restricting them to a
marked walkway. Subjects walked barefoot across a 10
metre area towards a target marker at the far end of the
room. The central zone of the walkway acted as the test
area, but subjects were not aware of the ‘active’ portion
of the laboratory. We tested each subject at a walking
speed which was self-selected by the subject but followed
simple instructions from the investigator, that is, that
subjects should walk at the speed which they considered
most comfortable.
2.4. Coordinate systems
The global reference frame was defined with respect
to the laboratory. The X-axis corresponded to the line
of progression of the subject across the room and was
positive in that direction. The Y-axis was defined as
et al. I Gait & Posture 5 (1997) 4-12
on subject and conventions used to define axes and motions.
perpendicular to the X-axis and parallel to the ground,
with the positive direction towards the left side, the Z-
axis was vertical and mutually perpendicular to the
other axes, being positive upwards.
We divided the trunk and lower limbs into discrete
segments using the reflective marker coordinates to
define a series of rigid bodies. An upper trunk segment
was defined using markers located over the spinous pro-
cess of the first thoracic vertebra (Tl), the spinous pro-
cess of the sixth thoracic vertebra (T6) and the two
paravertebral markers at the T6 level located over the
angles of the ribs. The direction of the principal local
embedded axis (caudo-cephalic) was defined by the ver-
tebral markers, the provisional mediolateral axis by the
lateral markers and the anteroposterior axis as the cross
product of the first and second axes. The corrected sec-
ond axis was then computed as the cross product of the
first and third axes [15].
Similar procedures were used to define the lower
trunk segment, the lumbar segment, the pelvic segment
and the two thigh segments. The model used in the study
treated the defined segments as rigid bodies and we
defined movement within spinal regions in terms of the
relative motion between the rigid body above and the
rigid body below the region of interest. Thus, motion of
the lumbar spine was defined as the relative motion of
the lower trunk segment with respect to the pelvic
segment and the lower thoracic region was defined by
the relative motion of the lumbar and upper trunk
segments.
We defined motion about the three orthogonal local
 J. Crosbie
Pelvis
Fig. 2. Patterns of lateral flexion in the lower thoracic and lumbar
regions and in the pelvis (pelvic list) during free-speed walking. Thick
lines represent mean values and tine lines represent f standard error
of the mean (S.E.M.). Time values are referred to the complete gait
cycle from right heel strike (0%) to the subsequent right heel strike
(100%). Toe off times are indicated (LTO and RTO). Positive values
(up on the vertical axis) refer to rotation about the local anteropos-
terior axis towards the right side (see text).
axes using the right hand convention; thus, counter-
clockwise rotation about the axis, as viewed looking
back along the axis towards the body, was expressed as
a positive value. Using conventional descriptors of ana-
tomical motion, we describe rotation about the X-axis
as lateral flexion, with bending towards the right side of
the subject’s body of the cephalad segment with respect
to the caudal defined as positive. Rotation about the
Y-axis corresponds to forward flexion and extension.
Positive motion is forward flexion. Similarly, rotation
about the Z-axis is termed axial rotation, with the posi-
tive motion involving rotation of the cephalad segment
towards the left with respect to the caudal segment
(Fig. 1).
Because the movements within the trunk may be
directed towards providing the upper trunk segment
with a relative stability with respect to the global frame
of reference [5], we also investigated the relative attitude
of the rigid bodies representing the trunk segments with
respect to the ground. We used similar conventions to
describe global motion of the segments as we employed
for the relative segmental motion. In these cases, we
refer to the lower trunk rigid body (LT), defined by the
twelfth thoracic vertebra (T12) as its caudal extremity,
and the upper trunk rigid body (UT) with T6 as its
caudal extremity.
The hip joint motion was defined in terms of the rela-
tive motion between the relevant thigh rigid body and
the pelvis. The movements of the pelvis were considered
with respect to the global reference system. Particular
conventions have evolved for description of the move-
ments of the pelvis in space. We employed a convention
et al. I Gait & Posture 5 (1997) 61.2 9
based upon those described by Inman et al. 1161 and
Sutherland [ 171:
l pelvic tilt, occurring about the transverse (Y) axis;
positive pelvic tilt involves the counter-clockwise rota-
tion of the pelvis as viewed from the left side
l pelvic list, occurring around the anteroposterior (X)
axis; positive pelvic list involves counter-clockwise rota-
tion of the pelvis as viewed from the front
l pelvic rotation, occurring around the cephalo-caudal
axis; positive pelvic rotation involves counter-clockwise
rotation of the pelvis as viewed from above (Fig. 1).
2.5. Analysis
We established the temporal events of the gait cycle
with reference to heel strike on each side. Heel strike was
defined as the time at which the heel marker ceased
moving vertically downwards after the swing phase. The
data were time normalised with respect to one complete
gait cycle (right heel strike to the next right heel strike).
We preceded this normalisation by performing all analy-
ses to which time variables were pertinent. The three
cycles were averaged for each subject. Statistical analysis
was performed using the SPSSx program (SPSS Inc.,
Chicago).
3.Redts
We have followed a conventional description of the
temporal divisions of the gait cycle [ 161. Based upon our
data, the double support phase extended from 0% to
10% and from 50% to 60% of the cycle, single sup-
port/swing phase from 10% to 50% and from 60% to
1Ooo! of the cycle and mid-stance at 30% and 80% of the
gait cycle. The cycle was taken from right heel strike to
the next right heel strike. We observed a high level of
inter-subject consistency in all the data obtained during
testing (Figs. 2-7). Subjects walked at their self-
determined speed, which averaged 1.3 m.s-’ (S.D.
0.19). When normal&d for height, this value equated to
0.78 statures.s-’ (S.D. 0.1). Subjects walked with a
cadence of 57.1 stepsmin-’ (S.D. 5.2) and their average
height normal&d step length was 0.69 statures (S.D.
0.09).
3.1. Lateral jlexion
Peak lateral flexion occurred at 15% and 65% of the
gait cycle, which coincides with early swing phase (Fig.
2). In the lower thoracic and lumbar regions, the dis-
placement was towards the weight bearing limb, while
the pelvic segment listed towards the swinging side. The
segmental motions demonstrated close time correla-
tions. The pelvis and trunk ‘stabilise’ near the neutral
position for around 15% to 20% of the cycle, correspon-
ding to the period of late swing and early double
support.
The motion of the LT segment with respect to the
 J. Crosbie et al. I Gait & Posture 5 (1997) 612

0 20 10 60 80 100
Time (percenla,oegail CJ&)

Fig. 4. Patterns of forward flexion and extension in the lower thoracic

Fig. 3. Patterns of lateral fiexion of the upper and lower trunk and lumbar regions and in the pelvis (pelvic tilt) during free-speed
segments with respect to the ground coordinate system. Conventions walking. Conventions are as for Fig. 2. Positive values (up on the
are as for Fig. 2. vertical axis) refer to rotation about the local transverse axis into
flexion (see text).

global reference system appeared reduced when com-
pared to the intra-segmental motions. The segment UT
moved in a complementary manner to the pelvis with re-
spect to the ground (Fig. 3).
The peak-to-peak range of motion for lateral flexion
(Table 2) indicated that the lumbar segment displaced
more than the other segments, reaching nine degrees
(S.D. 3.5 degrees). This range was significantly greater
than that found in the pelvis or lower thoracic segments
(F2,21= 16.55; P < 0.001). There was no significant dif-
ference between values for the pelvis and lower thoracic
segment. Lateral flexion range was consistently and
significantly greater in all segments than the other move-
ments (F2.r1 = 56.46; P < 0.001).
3.2. Forward Jlexion/extension
The patterns of flexion and extension demonstrated
biphasic movements through the gait cycle correspon-
ding to one flexionextension cycle per step (Fig. 4). The
pelvis rotated into negative pelvic tilt at heel strike. This
was followed by a counter-motion during the first 10%
of the cycle to a maximum positive pelvic tilt in the early
single support phase. The pelvis then progressively
reversed its tilt to the next heel strike. The lower thoracic
segment extended maximally at heel strike, returned to
a neutral position at mid-stance, then extended again
through late stance.
The patterns of movement in the lumbar segment
complemented those of the pelvis. Maximum lumbar
spine flexion occurred at heel strike. This was followed
by a relatively rapid extension back to neutral until the
beginning of single support. A relatively slow flexion
then followed, reaching maximum at heel strike.
The upper trunk demonstrated a greater oscillation
with respect to the ground than did the lower trunk (Fig.
5). Both segments were in a near neutral orientation at
‘toe off, being displaced into a few degrees of extension
at heel strike.
0

Table 2
Peak-to-peak range of motion of spinal segments, pelvis and hip
during free-speed gait cycle (standard deviation)

Segment Lateral flexion Flexion/ Axial

extension rotation

Lower thoracic 7.0 (3.0) 2.5 (1.5) 4.0 (2.5) 0 20 40 60 80 100

Lumbar 9.0 (3.5) 3.5 (2.0) 4.5 (2.0) Time $ercrntqegoir cycle)

Pelvis 6.0 (2.5) 3.5 (1.5) 4.0 (2.5)

Hip - 44.5 (4.5) - Fig. 5. Patterns of flexion and extension of the upper and lower trunk
segments with respect to the ground coordinate system.
 J. Crosbie
0 20 40 60 SO 100
Time (percerr~agge gait c~cte)
Fig. 6. Patterns of axial rotation in the lower thoracic and lumbar
regjons and in the pelvis (pelvic tilt) during free-speed walking. Posi-
tive values (up on the vertical axis) refer to rotation about the local
vertical axis towards the left side (see text).
Range of peak-to-peak motion was significantly less
in the lower thoracic segment than in the other two
(4.21 = 9.29; P < 0.001) (Table 2). Flexion/extension
range was also significantly less than the ranges of later-
al flexion or axial rotation in the lower thoracic segment
(F2.21 = 7.6; P < O.Ol), but not significantly different
from axial rotation in the lumbar and pelvic segments.
3.3. Axial rotation
Throughout the spinal segments, the ranges of axial
rotation were limited; however, we discerned certain
consistent patterns of movement (Fig. 6). These patterns
were restricted to about two degrees in each direction
and oscillated to a greater extent than we observed with
respect to the other movements. In particular, the pelvis
rotated about the neutral position through three cycles
from right heel strike to the subsequent right heel strike.
Fig. 7. Patterns of axial rotation of the upper and lower trunk
segments with respect to the ground coordinate system.
et al. / Gait & Posture 5 (1997) 612 11
The variance of the pelvis was substantially greater than
that of the other segments.
The lower thoracic segment rotated towards the
swinging side at the beginning of single support, retum-
ed to the neutral position at mid-stance, then started to
rotate towards the opposite side at the next heel strike.
The patterns of lumbar spine rotation were similar to
those of the lower trunk, but demonstrated a phase lag
with respect to the former (Fig. 6).
The upper and lower trunk segments were in a neutral
orientation with respect to the ground at heel strike,
then rotated towards the swinging side during single
support (Fig. 7). Peak to peak range of motion demon-
strated no significant difference between the three
segments (F2,21= 0.59; P = 0.552).
4. Discussion
Total displacement, with respect to individual seg-
ment motion, is generally small, particularly in the cases
of axial rotation and forward flexion and extension.
Nevertheless, the displacements are large enough to be
distinguished from measurement and other inaccuracies.
There does tend to be some inter-subject variability, al-
though we observed intra-subject consistency.
The results of our investigation, and the three dimen-
sional patterns of segmental motion which we report,
suggest that the spinal segments move in response to the
motion of the lower limbs. For example, the maximally
negative pelvic tilt at heel strike, combined with the
maximum extension of the contralateral hip, stretches
the contralateral hip flexor muscles. Such stretching is
likely to increase the efficiency of the iliopsoas, which is
active at the initiation of the swing phase of that limb
[ 161. The pelvic listing (lateral flexion), dipping towards
the swinging side, supports Saunders et al.‘s explanation
of decreasing the vertical excursion of the CoM with a
consequent reduction in the energy costs [l].
The small amplitudes of axial rotation are presumably
adequate to allow the ‘pelvic step’ described in previous
studies [12]. Our values, while considerably smaller than
early reports (e.g. [3,4]), are consistent with those
presented by contemporary investigators such as Krebs
et al. [5]. We recognise that the marker set used in our
study may be subject to greater marker movement error
with regard to axial rotation than with the other two
movements. Consequently, our results for axial rotation
may be distorted to some extent. Nevertheless, we are
intrigued by these patterns of movement. Although the
lumbar and lower thoracic segments display limited
movements, the patterns of axial rotation suggest that
the cephalad segment starts the rotation towards the
swinging side and the lumbar segment follows. This
could be explained in terms of an overall conservation
of angular momentum, with arm swing affecting these
segments in a cephalad-caudal direction, while the pelvis
12 J. Crosbie et al. I Gait & Posture 5 (1997) 612

is more directly associated with motion of the lower Acknowledgements

limbs.
Appreciation is expressed to Ms. Anne Moseley and
It seems entirely consistent with the findings of this Mr. Robert West for assistance in data processing and
study to believe that the displacement of the CoM is a to Mr. Ray Patton for technical assistance in the con-
function of the placement of the feet and that the lateral duct of this study. This project was supported by the
displacement of the CoM, combined with the weight of University of Sydney Research Grant Scheme.
the free swinging lower limb, in turn brings about a
listing of the pelvis to the swinging side. If the subject References
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