Pelvic Morphology in Quiet Posture and Its Effect on Gait

Overview

Pelvic orientations observed in the pelvis during quiet standing position the standard orientation of the pelvis, causing pelvic tilt, pelvic obliquity and pelvic rotation. There is a need to understand the relationship between these orientation disorders and gait. This is because the orientation of the pelvis both in standard standing posture and during gait is an integral part of physiotherapy assessment due to the various problems associated with abnormal pelvic position, including musculoskeletal disorders of the lumbar spine, pelvis, hips and knees. The aim of this study was to describe the morphology of pelvic orientation during static standing posture in an asymptomatic young Turkish population aged 19 to 29 years and to examine the relationship between morphologic changes and changes in pelvic tilt, pelvic obliquity and pelvic rotation angles during gait.

The pelvic bones are the key structures that connect the trunk to the lower extremities, support the body's weight and transfer the load to the lower extremities. The symmetrical orientation of the pelvis about the horizontal plane determines the morphology of the pelvis during static standing posture. When the symmetry of the pelvis is disturbed, its effect on gait parameters is unclear. In clinical practice, the pelvis functionally has 3 basic rotational movements during a gait activity. These are associated with upward (positive) or downward (negative) movement of the pelvis in the coronal plane; forward or backward movement in the sagittal plane; and internal (positive) or external (negative) movement in the horizontal plane. Although these angles are determined by the balance of muscle and ligament forces acting between the pelvis and adjacent segments, they can also be affected by changes in pelvic morphology. If the height of the iliac crest in the coronal plane is significantly different on the right and left, this indicates a pelvic oblique asymmetry. On the other hand, pelvic asymmetries can also be seen in the sagittal plane. Here, the pelvic tilt angles on the right and left are usually significantly different from each other. In the literature, morphologic analyses of the pelvis in static standing posture or dynamically during a gait activity have been performed separately. However, to our knowledge, there is no study on the extent to which pelvic asymmetries seen during gait are affected by the morphology of the pelvis in static standing posture. In this study, the pelvis of young adults aged 19-29 years will be evaluated in two stages. In the first stage, pelvic orientation (pelvic tilt, pelvic obliquity and pelvic rotation) will be measured during static standing using a PALM (palpation meter pelvic inclinometer) inclinometer and leg length will be measured using a tape measure. In the second stage, spatio-temporal parameters and pelvic parallels will be assessed during walking using a wearable inertial sensor. With the data obtained, it is aimed to classify the pelvic morphology of the participants as symmetrical and asymmetrical in the literature and to reveal the effects of pelvis types specific to this classification on the parameters during walking. The results of this study will accurately and precisely measure the orientation of the pelvis with objective tools under static and dynamic conditions, which may increase the reasoning skills and understanding of rehabilitation strategies to be developed for pathologies related to this region. In addition, this study will elucidate the effect of pelvic asymmetries on the kinetic and kinematics of the pelvis on gait quality.