Smoothness of the knee joint movement during the stance phase in patients with severe knee osteoarthritis

Background and Objectives: The purpose of this study was to compare the side-to-side differences in knee joint movement and moment for the degree of pain in the walking stance phase in patients with bilateral knee osteoarthritis (KOA) of comparable severity. We hypothesized that knee joint movement and moment on the side with strong pain were lower compared with the side with weak pain. Materials and Methods: We included 11 patients diagnosed with bilateral severe KOA. In all patients’ left and right knees, the Kellgren–Lawrence radiographic scoring system grade was level 4, and the femorotibial angle and knee range of motion were equivalent. Following patients’ interviews with an orthopedic surgeon, we performed a comparative study with KOA with strong pain (KOAs) as the strong painful side and KOA with weak pain (KOAw) as the weak painful side. Data for changes in bilateral knee joint angles in three dimensions during the stance phase and bilateral knee sagittal and frontal moments exerted in the early and late stance phases were extracted from kinematics and kinetics analyses. Results: Three-dimensional joint movements in the knee joint were not significantly different in all phases between KOAs and KOAw. Knee extensor moment in the early stance phase in KOAs was significantly smaller than that in KOAw. Knee abductor moment in the early and late stance phase was not significantly different between KOAs and KOAw. Conclusions: Although we found no difference in joint motion in bilateral knee joints, knee extensor moment on the side with strong pain was decreased. In patients with bilateral severe KOA, it was suggested that the magnitude of knee pain contributed to the decrease in knee joint function.

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Relations between external moment and movement of the knee joint during the stance phase in patients with severe knee osteoarthritis

Journal of Orthopaedics ◽

10.1016/j.jor.2018.12.014 ◽

2019 ◽

Vol 16 (1) ◽

pp. 101-104 ◽

Cited By ~ 3

Author(s):

Takashi Fukaya ◽

Hirotaka Mutsuzaki ◽

Koichi Mori

Keyword(s):

Knee Joint ◽

Knee Osteoarthritis ◽

Stance Phase ◽

External Moment

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Total knee arthroplasty for patients with medial knee osteoarthritis improves trunk movement during gait

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-181383 ◽

2020 ◽

Vol 33 (5) ◽

pp. 727-734

Author(s):

Wataru Kuwahara ◽

Kazuyoshi Nakanishi ◽

Hiroshi Kurumadani ◽

Noboru Shimada ◽

Makoto Asaeda ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Stance Phase ◽

Knee Extension ◽

Trunk Movement ◽

Medial Knee ◽

Anterior Trunk ◽

Total Knee ◽

Trunk Tilt

BACKGROUND: Previous studies have indicated that the kinematics of the knee joint affect the trunk and pelvis during gait. However, the factors that influence trunk movement in knee osteoarthritis patients during gait after surgery remain unclear. OBJECTIVE: To examine the effect of total knee arthroplasty (TKA) on trunk movement during gait by comparing knee osteoarthritis patients with healthy controls. METHODS: Fourteen medial knee osteoarthritis patients who underwent initial unilateral TKA and 11 controls participated in this study. Knee and hip joint flexion and trunk and pelvic tilts during gait were acquired using a three-dimensional motion analysis system. Knee joint range of motion, pain, and kinematic data were collected preoperatively and 1 year postoperatively for knee osteoarthritis patients. RESULTS: Knee extension limitation and pain significantly improved postoperatively compared with preoperative stages. Preoperatively, the peak anterior trunk tilt during the stance phase was significantly larger in osteoarthritis patients than in controls. The peak anterior trunk tilt during the stance phase was significantly smaller postoperatively than at preoperative stages. CONCLUSIONS: These results suggest that after TKA, the trunk movements of knee osteoarthritis patients were approximately equal to those of controls, with improvement in clinical outcomes such as knee extension limitation and pain.

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RELATIONSHIPS BETWEEN KINETIC VARIABLES AND SMOOTHNESS OF KNEE JOINT MOVEMENT IN THE STANCE PHASE

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519414500791 ◽

2014 ◽

Vol 14 (05) ◽

pp. 1450079 ◽

Cited By ~ 1

Author(s):

TAKASHI FUKAYA ◽

HIROTAKA MUTSUZAKI ◽

HAJIME ITO ◽

YASUYOSHI WADANO

Keyword(s):

Knee Joint ◽

Ground Reaction Force ◽

Stance Phase ◽

Reaction Force ◽

Vertical Component ◽

Correlation Coefficients ◽

The Other ◽

Joint Movement ◽

Important Index ◽

Three Phases

The purposes of this study were to clarify which period of the stance phase shows the greatest decrease in the smoothness of the knee joint movement and to analyze the relationships between kinetic variables and the smoothness of the knee joint movement during the stance phase using the angular jerk cost (AJC). The study subjects were 11 healthy adults. To clarify the relationships between the kinetic variables and the AJC, Pearson's product correlation coefficients were calculated for the AJC and three kinetic variables. The AJC in the early stance phase was significantly larger than those in the other three phases, and it was confirmed that the early stance phase showed the greatest decrease in smoothness of the knee joint movement. Furthermore, there was a positive correlation between the AJC and the vertical component of the ground reaction force in the early stance phase. Correlations between the AJC and the kinetic variables were also found in the other three phases. Regarding evaluation of the smoothness of the knee joint movement using the AJC based on the present results, the AJC may be an important index for understanding the dynamics of the knee joint in the early stance phase.

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Interrater Reproducibility of Knee Movement Analyses during the Stance Phase: Use of Anatomical Landmark Calibration with a Rigid Marker Set

Rehabilitation Research and Practice ◽

10.1155/2013/692624 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Takashi Fukaya ◽

Hirotaka Mutsuzaki ◽

Yasuyoshi Wadano

Keyword(s):

Knee Joint ◽

Measurement Method ◽

Stance Phase ◽

Physical Therapists ◽

Maximum Error ◽

Anatomical Landmarks ◽

Joint Movement ◽

Knee Movement ◽

Measurement Results ◽

Standard Error Of Measurement

Objective.Measurements of knee joint movement in gait analysis may result in large errors caused by misplacement of reflective markers by the testers. To properly understand the measurement results, it is important to guarantee the reliability of the measurement method used for the purpose. The aim of this study was to confirm the interrater reproducibility of a measurement method with a rigid marker set (RMS).Methods.The study subjects were four healthy adults, and the testers were three physical therapists. The interrater reproducibility of the measurements was verified by using the coefficient of multiple correlations (CMCs) and the standard error of measurement (SEM).Results.The average CMCs values of 4 subjects in knee joint movement at the stance phase were greater than 0.8, and the average SEM values of 4 subjects in knee joint movement at the stance phase were also relatively good (maximum error: 2.42°).Conclusion.Based on these results, the measurement method with estimation of anatomical landmarks using the RMS can prevent misplacement during attachment of the reflective markers, as long as the testers have sufficient experience in attaching reflective markers.

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SMOOTHNESS USING ANGULAR JERK COST OF THE KNEE JOINT MOVEMENT AFTER A REDUCTION IN WALKING SPEED

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519413500371 ◽

2013 ◽

Vol 13 (03) ◽

pp. 1350037 ◽

Cited By ~ 1

Author(s):

TAKASHI FUKAYA ◽

HIROTAKA MUTSUZAKI ◽

YASUYOSHI WADANO

Keyword(s):

Knee Joint ◽

Ground Reaction Force ◽

Stance Phase ◽

Walking Speed ◽

Reaction Force ◽

Angular Acceleration ◽

Time Dependent ◽

Initial Contact ◽

Joint Movement ◽

Important Index

The angular jerk cost (AJC) was proposed to objectively represent the smoothness of joint movement by calculating the time-dependent changes in acceleration during motion. There are currently no reports focusing on smoothness using AJC measurements of the knee joint movement during the stance phase of gait. The purpose of this study was to verify whether a reduced walking speed affects the smoothness of the knee joint movement during the stance phase of gait. The gaits of 12 healthy adults were assessed. A slower walker showed a significant reduction in the AJC value in the period between the initial contact and the loading response, as compared with someone walking at a comfortable speed. The maximum ground reaction force of the stance phase at a comfortable walking speed was significantly larger than that at a slower walking speed. Thus, although the smoothness of the knee joint was impaired by a rapid load in the early stance phase, a slower walking speed reduced the ground reaction force and angular acceleration of the knee joint and created a smoother movement. The AJC can be an important index for understanding the smoothness of the knee joint in the early stance phase.

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Effects of knee osteoarthritis severity on inter-joint coordination and gait variability as measured by hip-knee cyclograms

Scientific Reports ◽

10.1038/s41598-020-80237-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jae Hyeon Park ◽

Hyojin Lee ◽

Jae-sung Cho ◽

Inyoung Kim ◽

Jongshill Lee ◽

...

Keyword(s):

Knee Joint ◽

Knee Osteoarthritis ◽

Range Of Motion ◽

Stance Phase ◽

Center Of Mass ◽

Swing Phase ◽

Gait Variability ◽

Joint Coordination ◽

The Relationship

AbstractInter-joint coordination and gait variability in knee osteoarthritis (KOA) has not been well investigated. Hip-knee cyclograms can visualize the relationship between the hip and knee joint simultaneously. The aim of this study was to elucidate differences in inter-joint coordination and gait variability with respect to KOA severity using hip-knee cyclograms. Fifty participants with KOA (early KOA, n = 20; advanced KOA, n = 30) and 26 participants (≥ 50 years) without KOA were recruited. We analyzed inter-joint coordination by hip-knee cyclogram parameters including range of motion (RoM), center of mass (CoM), perimeter, and area. Gait variability was assessed by the coefficient of variance (CV) of hip-knee cyclogram parameters. Knee RoM was significantly reduced and total perimeter tended to be decreased with KOA progression. KOA patients (both early and advanced) had reduced stance phase perimeter, swing phase area, and total area than controls. Reduced knee CoM and swing phase perimeter were observed only in advanced KOA. Both KOA groups had a greater CV for CoM, knee RoM, perimeter (stance phase, swing phase and total) and swing phase area than the controls. Increased CV of hip RoM was only observed in advanced KOA. These results demonstrate that hip-knee cyclograms can provide insights into KOA patient gait.

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Compliant orthoses for repositioning of knee joint based on super-elasticity of shape memory alloys

Journal of Intelligent Material Systems and Structures ◽

10.1177/1045389x18783085 ◽

2018 ◽

Vol 29 (15) ◽

pp. 3136-3150 ◽

Cited By ~ 4

Author(s):

Farshid Sadeghian ◽

Mohammad Reza Zakerzadeh ◽

Morad Karimpour ◽

Mostafa Baghani

Keyword(s):

Knee Joint ◽

Shape Memory Alloys ◽

Shape Memory ◽

Muscle Weakness ◽

Stance Phase ◽

Quadriceps Muscle ◽

Patient Specific ◽

Initial Contact ◽

Joint Movement ◽

Distinct Level

People suffering from neuromuscular diseases may also face certain abnormalities in their walking pattern. Patients with quadriceps muscle weakness suffer from flexion contracture as well as flexion instability during the gait cycle. In this article, a knee-ankle-foot orthosis design is proposed with two different mechanisms for the stance and swing phases, addressing the needs of patients with quadriceps muscle weakness. The stance phase mechanism locks the knee joint movement from the initial contact until the end of mid-swing and after mid-stance phase, the knee joint can flex freely. OpenSim was utilized to simulate patients with muscle weakness as well as calculating the required moment to mimic the stiffness of a normal knee joint. The super-elasticity of shape memory alloys was then used to reproduce the calculated moment for different levels of muscle weakness. It is shown that by designing patient-specific orthosis, the stiffness profile of normal joint for each patient with distinct level of muscle weakness can be reproduced.

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A Novel Hybrid Approach Based on Deep CNN Features to Detect Knee Osteoarthritis

Sensors ◽

10.3390/s21186189 ◽

2021 ◽

Vol 21 (18) ◽

pp. 6189

Author(s):

Rabbia Mahum ◽

Saeed Ur Rehman ◽

Talha Meraj ◽

Hafiz Tayyab Rauf ◽

Aun Irtaza ◽

...

Keyword(s):

Knee Joint ◽

Knee Osteoarthritis ◽

Hybrid Approach ◽

Joint Space Width ◽

Local Binary Patterns ◽

Bone Diseases ◽

Support Vector ◽

Joint Movement ◽

X Ray

In the recent era, various diseases have severely affected the lifestyle of individuals, especially adults. Among these, bone diseases, including Knee Osteoarthritis (KOA), have a great impact on quality of life. KOA is a knee joint problem mainly produced due to decreased Articular Cartilage between femur and tibia bones, producing severe joint pain, effusion, joint movement constraints and gait anomalies. To address these issues, this study presents a novel KOA detection at early stages using deep learning-based feature extraction and classification. Firstly, the input X-ray images are preprocessed, and then the Region of Interest (ROI) is extracted through segmentation. Secondly, features are extracted from preprocessed X-ray images containing knee joint space width using hybrid feature descriptors such as Convolutional Neural Network (CNN) through Local Binary Patterns (LBP) and CNN using Histogram of oriented gradient (HOG). Low-level features are computed by HOG, while texture features are computed employing the LBP descriptor. Lastly, multi-class classifiers, that is, Support Vector Machine (SVM), Random Forest (RF), and K-Nearest Neighbour (KNN), are used for the classification of KOA according to the Kellgren–Lawrence (KL) system. The Kellgren–Lawrence system consists of Grade I, Grade II, Grade III, and Grade IV. Experimental evaluation is performed on various combinations of the proposed framework. The experimental results show that the HOG features descriptor provides approximately 97% accuracy for the early detection and classification of KOA for all four grades of KL.

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