{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:09:17Z","timestamp":1740146957909,"version":"3.37.3"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005236","name":"Chinese Universities Scientific Fund","doi-asserted-by":"publisher","award":["2022QN007"],"award-info":[{"award-number":["2022QN007"]}],"id":[{"id":"10.13039\/501100005236","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beijing Natural Science Foundation","award":["1232020"],"award-info":[{"award-number":["1232020"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Gait and weight carrying method may change the femoral neck load during stair descent. Applying specific gait and weight carrying methods may reduce the femoral neck load during stair descent, which may reduce hip pain, hip pain related falls and fall related fractures for the older population. The purpose of this study was to test the effect of different gait types (step-over-step v.s. step-by-step) and external weight carrying strategies (ipsilateral v.s. contralateral side) on the femoral neck load, discover which method could reduce the femoral neck load effectively. Seventeen healthy adults from 50 to 70 yrs old were recruited. The kinematic and kinetic analysis, musculoskeletal modelling method were used to estimate the joint and muscle loads for the lower extremities. Finite element analysis was used with the femur model to calculate the femoral neck strains during stair descent with different gait types and weight carrying strategies. The compressive strains were reduced for step-by-step gait method than step-over-step (p&lt;0.015, 12.3\u201317.4% decrease of strains), the tensile strains were significantly increased for the trailing leg of step-by-step than the leading leg (p&lt;0.001, 24.7% increase of strains). Contralateral weight carrying increased compressive and tensile strains than ipsilateral (p&lt;0.001, 9.9\u201324.5% increase of strains) in most conditions. Applying step-by-step method and avoiding contralateral side weight carrying could be effective to reduce femoral neck strains. These outcomes could be helpful for the older population to reduce the risks of hip pain, femoral neck pain or pain related falls and fractures.<\/jats:p>","DOI":"10.1371\/journal.pone.0294181","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T18:32:43Z","timestamp":1700591563000},"page":"e0294181","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of gait types and external weight carrying strategies on the femoral neck strains during stair descent"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0541-2069","authenticated-orcid":true,"given":"Chen","family":"Deng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4358-4731","authenticated-orcid":true,"given":"Jason C.","family":"Gillette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy R.","family":"Derrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,11,21]]},"reference":[{"issue":"1","key":"pone.0294181.ref001","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4103\/0019-5413.73656","article-title":"Epidemiology of hip fracture: Worldwide geographic variation.","volume":"45","author":"D Dhanwal","year":"2011","journal-title":"Indian J Orthop."},{"issue":"6","key":"pone.0294181.ref002","first-page":"770","article-title":"Early infection after hip fracture surgery: risk factors, costs and outcome.","volume":"90","author":"C Edwards","year":"2008","journal-title":"Bone Joint J."},{"key":"pone.0294181.ref003","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s00198-015-3277-9","article-title":"Impact of hip fracture on hospital care costs: a population-based study.","volume":"27","author":"J Leal","year":"2016","journal-title":"Osteoporos Int."},{"issue":"1","key":"pone.0294181.ref004","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2106\/JBJS.J.01077","article-title":"Impact of Comorbidities on Hospitalization Costs Following Hip Fracture.","volume":"94","author":"LE Nikkel","year":"2012","journal-title":"J Bone Joint Surg"},{"issue":"2","key":"pone.0294181.ref005","first-page":"131","article-title":"Surgical approach to bone healing in osteoporosis","volume":"6","author":"V Pesce","year":"2009","journal-title":"Clin Cases Miner Bone Metab"},{"issue":"6","key":"pone.0294181.ref006","first-page":"1335","article-title":"Rate of mortality for elderly patients after fracture of the hip in the 1980\u2019s","volume":"69","author":"BL White","year":"1987","journal-title":"J Bone Joint Surg Am"},{"issue":"10","key":"pone.0294181.ref007","doi-asserted-by":"crossref","first-page":"2725","DOI":"10.1007\/s00198-013-2375-9","article-title":"The impact of decreasing U.S. hip fracture rates on future hip fracture estimates.","volume":"24","author":"JA Stevens","year":"2013","journal-title":"Osteoporos Int"},{"issue":"2","key":"pone.0294181.ref008","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.gaitpost.2008.08.013","article-title":"The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender.","volume":"29","author":"T Herman","year":"2009","journal-title":"Gait Posture."},{"issue":"10","key":"pone.0294181.ref009","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1016\/j.clinbiomech.2015.08.002","article-title":"Gender differences of sagittal knee and ankle biomechanics during stair to ground descent transition.","volume":"30","author":"YNG Hong","year":"2015","journal-title":"Clin Biomech"},{"issue":"2","key":"pone.0294181.ref010","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/s12024-018-9964-z","article-title":"Fatal falls involving stairs: an anthropological analysis of skeletal trauma.","volume":"14","author":"SK Rowbotham","year":"2018","journal-title":"Forensic Sci Med Pathol"},{"key":"pone.0294181.ref011","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.gaitpost.2016.06.030","article-title":"A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury.","volume":"49","author":"JV Jacobs","year":"2016","journal-title":"Gait Posture"},{"issue":"3","key":"pone.0294181.ref012","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3143\/geriatrics.42.346","article-title":"Development of a portable fall risk index for elderly people living in the community","volume":"42","author":"K Toba","year":"2005","journal-title":"Jpn J Geriatr"},{"issue":"6","key":"pone.0294181.ref013","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1093\/ageing\/afv125","article-title":"Pain and falls and fractures in community-dwelling older men","volume":"44","author":"T Munch","year":"2015","journal-title":"Age Ageing"},{"issue":"7","key":"pone.0294181.ref014","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1002\/jor.22852","article-title":"Gait alterations to effectively reduce hip contact forces","volume":"33","author":"M Wesseling","year":"2015","journal-title":"J Orthop Res"},{"issue":"4","key":"pone.0294181.ref015","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.gaitpost.2015.08.008","article-title":"Walking patterns and hip contact forces in patients with hip dysplasia.","volume":"42","author":"O Skalsh\u00f8i","year":"2015","journal-title":"Gait Posture"},{"issue":"1","key":"pone.0294181.ref016","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.clinbiomech.2010.08.005","article-title":"The relationship between lower-extremity stress fractures and the ground reaction force: A systematic review.","volume":"26","author":"AA Zadpoor","year":"2011","journal-title":"Clin Biomech"},{"issue":"7","key":"pone.0294181.ref017","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0021-9290(01)00040-9","article-title":"Hip contact forces and gait patterns from routine activities","volume":"34","author":"G Bergmann","year":"2001","journal-title":"J Biomech"},{"issue":"19","key":"pone.0294181.ref018","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.2106\/JBJS.17.01298","article-title":"Physical Activities That Cause High Friction Moments at the Cup in Hip Implants.","volume":"100","author":"G Bergmann","year":"2018","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"pone.0294181.ref019","doi-asserted-by":"crossref","first-page":"e0207014","DOI":"10.1371\/journal.pone.0207014","article-title":"Loading of the hip and knee joints during whole body vibration training.","volume":"13","author":"G Bergmann","year":"2018","journal-title":"Plos One."},{"key":"pone.0294181.ref020","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.jbiomech.2016.11.060","article-title":"Comparison of in vivo measured loads in knee, hip and spinal implants during level walking","volume":"51","author":"P Damm","year":"2016","journal-title":"J Biomech"},{"key":"pone.0294181.ref021","article-title":"In vivo hip and lumbar spine implant loads during activities in forward bent postures","author":"P Damm","year":"2018","journal-title":"J Biomech"},{"issue":"1","key":"pone.0294181.ref022","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.gaitpost.2010.09.024","article-title":"Sagittal and frontal lower limb joint moments during stair ascent and descent in young and older adults.","volume":"33","author":"AC Novak","year":"2011","journal-title":"Gait Posture."},{"issue":"2","key":"pone.0294181.ref023","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.clinbiomech.2006.09.010","article-title":"Hip, knee, ankle kinematics and kinetics during stair ascent and descent in healthy young individuals.","volume":"22","author":"A Protopapadaki","year":"2007","journal-title":"Clin Biomech"},{"key":"pone.0294181.ref024","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1123\/jab.2017-0122","article-title":"Femoral Neck Stress in Older Adults During Stair Ascent and Descent.","volume":"34","author":"C Deng","year":"2018","journal-title":"J Appl Biomech."},{"issue":"1","key":"pone.0294181.ref025","doi-asserted-by":"crossref","first-page":"e0245658","DOI":"10.1371\/journal.pone.0245658","article-title":"Measuring femoral neck loads in healthy young and older adults during stair ascent and descent.","volume":"16","author":"C Deng","year":"2021","journal-title":"Plos One"},{"issue":"4","key":"pone.0294181.ref026","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/S0736-0266(00)00046-2","article-title":"Effect of force direction on femoral fracture load for two types of loading conditions.","volume":"19","author":"JH Keyak","year":"2001","journal-title":"J Orthop Surg Res"},{"issue":"3","key":"pone.0294181.ref027","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.jbiomech.2011.11.048","article-title":"Are spontaneous fractures possible? An example of clinical application for personalised, multiscale neuro-musculo-skeletal modelling","volume":"45","author":"M Viceconti","year":"2012","journal-title":"J Biomech"},{"issue":"5","key":"pone.0294181.ref028","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/0021-9290(94)00106-E","article-title":"Influence of thigh muscles on the axial strains in a proximal femur during early stance in gait","volume":"28","author":"L. Cristofolini","year":"2018","journal-title":"J Biomech"},{"key":"pone.0294181.ref029","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1123\/jab.29.5.505","article-title":"Effects of age-related differences in femoral loading and bone mineral density on strains in the proximal femur during controlled walking","volume":"29","author":"DE Anderson","year":"2013","journal-title":"J Appl Biomech"},{"key":"pone.0294181.ref030","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1016\/j.jbiomech.2016.03.007","article-title":"Femoral strain during walking predicted with muscle forces from static and dynamic optimization","volume":"49","author":"BW Edwards","year":"2016","journal-title":"J Biomech"},{"issue":"11","key":"pone.0294181.ref031","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1002\/jbmr.3529","article-title":"Mechanical loading of the femoral neck in human locomotion","volume":"33","author":"ME Kersh","year":"2018","journal-title":"J Bone Miner Res"},{"issue":"8","key":"pone.0294181.ref032","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1016\/j.jbiomech.2014.03.036","article-title":"Strain energy in the femoral neck during exercise","volume":"47","author":"S Martelli","year":"2014","journal-title":"J Biomech"},{"issue":"3","key":"pone.0294181.ref033","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1123\/jab.15.3.318","article-title":"Estimate of the optimum cutoff frequency for the Butterworth low-pass digital filter.","volume":"15","author":"B Yu","year":"1999","journal-title":"J Appl Biomech."},{"edition":"2","year":"1992","author":"C Vaughan","key":"pone.0294181.ref034"},{"issue":"2","key":"pone.0294181.ref035","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s10439-009-9852-5","article-title":"A Model of the Lower Limb for Analysis of Human Movement","volume":"38","author":"EM Arnold","year":"2010","journal-title":"Ann Biomed Eng"},{"issue":"4","key":"pone.0294181.ref036","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1007\/s11999-008-0594-8","article-title":"Are Current Measurements of Lower Extremity Muscle Architecture Accurate?","volume":"467","author":"SR Ward","year":"2009","journal-title":"Clin Orthop Relat Res"},{"issue":"11\u201312","key":"pone.0294181.ref037","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/S0021-9290(97)00089-4","article-title":"The three-dimensional determination of internal loads in the lower extremity","volume":"30","author":"U Glitsch","year":"1997","journal-title":"J Biomech"},{"issue":"7","key":"pone.0294181.ref038","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/S0021-9290(01)00039-2","article-title":"Musculo-skeletal loading conditions at the hip during walking and stair climbing","volume":"34","author":"MO Heller","year":"2001","journal-title":"J Biomech"},{"issue":"3\u20134","key":"pone.0294181.ref039","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1080\/14639220412331529591","article-title":"The VAKHUM project: virtual animation of the kinematics of the human","volume":"6","author":"S. Van Sint Jan","year":"2005","journal-title":"Teor Issues Ergon Sci"},{"issue":"13","key":"pone.0294181.ref040","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jbiomech.2007.02.010","article-title":"Subject-specific finite element models can accurately predict strain levels in long bones","volume":"40","author":"E Schileo","year":"2007","journal-title":"J Biomech"},{"issue":"4079","key":"pone.0294181.ref041","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1126\/science.179.4079.1201","article-title":"Size and shape in biology.","volume":"179","author":"T McMahon","year":"1973","journal-title":"Science"},{"issue":"1","key":"pone.0294181.ref042","doi-asserted-by":"crossref","first-page":"82","DOI":"10.2106\/00004623-197658010-00015","article-title":"Aging of bone tissue: mechanical properties","volume":"58","author":"AH Burstein","year":"1976","journal-title":"J Bone Joint Surg"},{"issue":"7","key":"pone.0294181.ref043","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/S0021-9290(03)00071-X","article-title":"Trabecular bone modulus-density relationships depend on anatomic site","volume":"36","author":"EF Morgan","year":"2003","journal-title":"J Biomech"},{"issue":"10","key":"pone.0294181.ref044","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1016\/j.jbiomech.2006.10.038","article-title":"Physiologically based boundary conditions in finite element modelling","volume":"40","author":"AD Speirs","year":"2007","journal-title":"J Biomech"},{"issue":"3","key":"pone.0294181.ref045","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1243\/095441103765212677","article-title":"Strain distribution within the human femur due to physiological and simplified loading: finite element analysis using the muscle standardized femur model","volume":"217","author":"K Polgar","year":"2003","journal-title":"Proc Inst Mech Eng H"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T18:33:07Z","timestamp":1700591587000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0294181"}},"subtitle":[],"editor":[{"given":"Ryan T.","family":"Roemmich","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,11,21]]},"references-count":45,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0294181","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2023,11,21]]}}}