A Kinetic and Kinematic Analysis of the Effect of Stochastic Resonance Electrical Stimulation and Knee Sleeve During Gait in Osteoarthritis of the Knee

2014 ◽  
Vol 30 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Amber Collins ◽  
Troy Blackburn ◽  
Chris Olcott ◽  
Joanne M. Jordan ◽  
Bing Yu ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Stochastic Resonance ◽  
Sagittal Plane ◽  
Knee Kinematics ◽  
Osteoarthritis Of The Knee ◽  
Initial Contact ◽  
Current Configuration ◽  
Knee Mechanics ◽  
Populations At Risk

Extended use of knee sleeves in populations at risk for knee osteoarthritis progression has shown functional and quality of life benefits; however, additional comprehensive kinematic and kinetic analyses are needed to determine possible physical mechanisms of these benefits which may be due to the sleeve’s ability to enhance knee proprioception. A novel means of extending these enhancements may be through stochastic resonance stimulation. Our goal was to determine whether the use of a knee sleeve alone or combined with stochastic resonance electrical stimulation improves knee mechanics in knee osteoarthritis. Gait kinetics and kinematics were assessed in subjects with medial knee osteoarthritis when presented with four conditions: control1, no electrical stimulation/sleeve, 75% threshold stimulation/sleeve, and control2. An increase in knee flexion angle throughout stance and a decrease in flexion moment occurring immediately after initial contact were seen in the stimulation/sleeve and sleeve alone conditions; however, these treatment conditions did not affect the knee adduction angle and internal knee abduction moment during weight acceptance. No differences were found between the sleeve alone and the stochastic resonance with sleeve conditions. A knee sleeve can improve sagittal-plane knee kinematics and kinetics, although adding the current configuration of stochastic resonance did not enhance these effects.

Knee Flexion Angle at Initial Contact During Jump Landing in Individuals With and Without Chronic Ankle Instability: A Critically-Appraised Topic

2019 ◽  
Vol 24 (4) ◽  
pp. 151-155
Author(s):  
Jacob T. Hartzell ◽  
Kyle B. Kosik ◽  
Matthew C. Hoch ◽  
Phillip A. Gribble
Keyword(s):  
Knee Flexion ◽  
Sagittal Plane ◽  
Ankle Instability ◽  
Knee Kinematics ◽  
Chronic Ankle Instability ◽  
Flexion Angle ◽  
Initial Contact ◽  
Knee Flexion Angle ◽  
Bottom Line ◽  
Jump Landing

Clinical Scenario: Chronic ankle instability (CAI) is characterized by the residual symptoms and feelings of instability that persist after an acute ankle sprain. Current literature has identified several neuromuscular impairments associated with CAI that may negatively impact sagittal plane knee kinematics during dynamic activities. This has led researchers to begin examining sagittal plane knee kinematics during jump landing tasks. Understanding changes in movement patterns at the knee may assist clinicians in designing rehabilitation plans that target both the ankle and more proximal joints, such as the knee. Clinical Question: What is the evidence to support the notion that patients with CAI have decreased sagittal plane knee flexion angle at initial contact during a jump-landing task compared to healthy individuals? Summary of Key Findings: The literature was systematically searched for level 4 evidence or higher. The search yielded two case-control studies which met the inclusion criteria. Based on limited evidence, there are mixed results for whether sagittal plane knee kinematic at initial contact differ between those with and without CAI. Clinical Bottom Line: There is weak evidence to support changes in sagittal plane knee kinematics at initial contact during a jump landing in individuals with CAI compared to healthy controls. Strength of Recommendation: In accordance with the Centre for Evidence-Based Medicine, a grade of C for level 4 evidence is recommended due to variable findings.

scholarly journals The Relationships Between the Center of Mass Position and the Trunk, Hip, and Knee Kinematics in the Sagittal Plane: A Pilot Study on Field-Based Video Analysis for Female Soccer Players

2015 ◽  
Vol 45 (1) ◽  
pp. 71-80 ◽  
Author(s):  
Shogo Sasaki ◽  
Yasuharu Nagano ◽  
Satoshi Kaneko ◽  
Shoichiro Imamura ◽  
Takuma Koabayshi ◽  
...  
Keyword(s):  
Video Analysis ◽  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Center Of Mass ◽  
Negative Relationship ◽  
Knee Kinematics ◽  
Initial Contact ◽  
Linear Regression Models ◽  
Anterior Cruciate ◽  
Base Of Support

Abstract Athletes with non-contact anterior cruciate ligament tears have common features in the sagittal plane; namely, the body’s center of mass (COM) is located posterior to the base of support, the trunk and knee joints are extended, and the hip angle is flexed. However, the relationships among these variables have not been assessed in field-based movements. This study sought to determine relationships between distances from the COM to the base of support and the trunk, hip, and knee positions in women while playing soccer. Sixty events (29 single-leg landing and 31 single-leg stopping events) were analyzed using two-dimensional video analysis. The relationships among the measurement variables were determined using the Pearson’s product-moment correlation coefficient, and stepwise multiple linear regression models were used to explore the relationships between the COM position and the kinematic variables. The distance from the COM to the base of support displayed a moderate negative relationship with the trunk angle (r = - 0.623, p < .0001, r2 = 0.388) and a strong positive relationship with the limb angle (r = 0.869, p < .0001, r2 = 0.755). The limb, knee, and trunk angles were selected in the best regression model (adjusted r2 = 0.953, p < .0001, f2 = 20.277). These findings suggest that an increased trunk angle and a decreased limb angle at initial contact are associated with a safer COM position. Neuromuscular training may be useful for controlling the trunk and lower limb positions during dynamic activities.

Day-to-Day Reliability of Two Different Models to Quantify Knee Kinematics in Subjects With Knee Osteoarthritis and Healthy Controls

2012 ◽  
Vol 28 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Inga Krauss ◽  
Thomas Ukelo ◽  
Christoph Ziegler ◽  
Detlef Axmann ◽  
Stefan Grau ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Gait Analysis ◽  
Repeated Measures ◽  
Sagittal Plane ◽  
Knee Kinematics ◽  
Biomechanical Model ◽  
Population Group ◽  
Healthy Controls ◽  
Applied Model ◽  
Transversal Plane

Results from instrumented gait analysis vary between test situations. Subject characteristics and the biomechanical model can influence the total amount of variability. The purpose of this study was to quantify reliability of gait data in general, and with respect to the applied model, and investigated population group. Reliability was compared between a functional and a predictive gait model in subjects with knee osteoarthritis and healthy controls. Day-to-day consistency for sagittal plane variables was comparable between models and population groups. Transversal plane variables relative to joint excursion showed larger inconsistency for repeated measures, even for a more sophisticated biomechanical approach. In conclusion, the presented reliability data of sagittal plane kinematics should be used for a reasonable interpretation of results derived in clinical gait analysis. Variables of the transversal plane should not be used as long as sources of error are not sufficiently minimized.

scholarly journals The Effect of Electroacupuncture on Dynamic Balance during Stair Climbing for Elderly Patients with Knee Osteoarthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Meijin Hou ◽  
Xiangbin Wang ◽  
Jiao Yu ◽  
Shengxing Fu ◽  
Fengjiao Yang ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Dynamic Balance ◽  
Stair Climbing ◽  
Initial Contact ◽  
Significant Difference ◽  
Stair Negotiation ◽  
Hip Kinematics ◽  
Risk Factors For Falls ◽  
Kinematics And Kinetics

Background. Poor balance is one of the risk factors for falls in patients with knee osteoarthritis (KOA), which is related to the symptoms. Electroacupuncture (EA) is one of the traditional Chinese conservative methods commonly used to improve the symptoms in patients with KOA. Objective. To assess whether EA increases the dynamic balance during stair negotiation among patients with KOA. Methods. A total of 40 KOA patients were assigned to two groups randomly (true electroacupuncture vs. mock electroacupuncture). Acupoints around the knee were selected in the true electroacupuncture (TEA) group with electrical stimulation (2 Hz). In the mock electroacupuncture (MEA) group, about 2 cm next to the above acupoints, the needles were inserted superficially without electrical stimulation. All the participants received 11 sessions of stimulation treatment in three weeks. The primary outcome was margin of stability (MOS). Secondary outcomes included hip kinematics and kinetics as well as pain. Results. There was no significant difference between the two groups for self-reported pain (p=0.585). During ascent, there was no difference between groups in MOS value in both directions, which was the anterior-posterior (A/P) direction and medial-lateral (M/L) direction at initial contact and toe-off as well as the midstance in the gait cycle, and no difference for the hip kinematics and kinetics between the groups was detected (p>0.05). For descent, at the toe-off event, the TEA group was more unstable as compared to the MEA group in the A/P direction (p=0.029) but not in the M/L direction, and the hip showed a larger internal rotator moment (p=0.049); at the midstance, the TEA group showed a lower abductor moment than the MEA group (p=0.003). Conclusions. Based on the assessment results from the chosen patients with KOA, the TEA did not demonstrate a significant effect in improving the dynamic balance during stair negotiation in comparison with the MEA. This finding does not support EA as a conservative treatment to improve the dynamic balance in such patients.

Two- and Three-Dimensional Relationships Between Knee and Hip Kinematic Motion Analysis: Single-Leg Drop-Jump Landings

2015 ◽  
Vol 24 (4) ◽  
pp. 363-372 ◽  
Author(s):  
Bryan Sorenson ◽  
Thomas W. Kernozek ◽  
John David Willson ◽  
Robert Ragan ◽  
Jordan Hove
Keyword(s):  
Motion Analysis ◽  
Sagittal Plane ◽  
Strong Association ◽  
Knee Kinematics ◽  
Frontal Plane ◽  
Strong Relationship ◽  
Transverse Plane ◽  
Lower Extremity Injury ◽  
Initial Contact ◽  
Drop Landings

Context:Hip- and knee-joint kinematics during drop landings are relevant to lower-extremity injury mechanisms. In clinical research the “gold standard” for joint kinematic assessment is 3-dimensional (3D) motion analysis. However, 2-dimensional (2D) kinematic analysis is an objective and feasible alternative.Objective:To quantify the relationship between 2D and 3D hip and knee kinematics in single-leg drop landings and test for a set of 3D hip and knee kinematics that best predicts 2D kinematic measures during single-leg drop landings Design: Descriptive, comparative laboratory study.Participants:31 healthy college-age women (65.5 kg [SD 12.3], 168.1 cm [SD 6.7]).Methods:Participants performed five 40-cm single-leg landings during motion capture at 240 Hz. Multiple regressions were used to predict relationships for knee and hip between 2D frontal-plane projection angles (FPPA) and 3D measurements.Results:2D knee FPPA had a strong relationship with 3D frontal-plane knee kinematics at initial contact (IC) (r2 = .72), which was only minimally improved with the addition of knee sagittal-plane and hip transverse-plane positions at IC (r2 = .77). In contrast, 2D knee FPPA had a low relationship with 3D knee-abduction excursion (r2 = .06). The addition of knee sagittal-plane and hip transverse-plane motions did not improve this relationship (r2 = .14). 2D hip FPPA had a moderate relationship with 3D frontal-plane hip position at IC (r2 = .52), which was strengthened with the addition of hip sagittal-plane position (r2 = .60). In addition, hip 2D FPPA into adduction excursion had a strong association with 3D hip-adduction excursion (r2 = .70).Conclusion:2D kinematics can predict 3D frontal-plane hip and knee position at IC during a single-leg landing but predict 3D frontal-plane knee excursion with far less accuracy.

Stochastic resonance electrical stimulation to improve proprioception in knee osteoarthritis

The Knee ◽  
2011 ◽  
Vol 18 (5) ◽  
pp. 317-322 ◽  
Author(s):  
Amber T. Collins ◽  
J. Troy Blackburn ◽  
Chris W. Olcott ◽  
Jodie Miles ◽  
Joanne Jordan ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Stochastic Resonance

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

Functional Evaluation of a Personalized Orthosis for Knee Osteoarthritis - A Motion Capture Analysis

2021 ◽  
Author(s):  
Martin Huber ◽  
Matthew Eschbach ◽  
Kazem Kazerounian ◽  
Horea T. Ilies
Keyword(s):  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Motion Capture ◽  
Inverse Dynamics ◽  
Statistical Significance ◽  
Knee Kinematics ◽  
Contact Forces ◽  
Patient Specific ◽  
Functional Evaluation ◽  
Shock Absorption

Abstract Knee osteoarthritis (OA) is a disease that compromises the cartilage inside the knee joint, resulting in pain and impaired mobility. Bracing is a common treatment, however currently prescribed braces cannot treat bicompartmental knee OA, fail to consider the muscle weakness that typically accompanies the disease, and utilize hinges that restrict the knee's natural biomechanics. We have developed and evaluated a brace which addresses these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the muscles in shock absorption, and interfering minimally with gait kinematics. Load reduction is achieved via the compression of medial and lateral leaf springs, and magnetorheological dampers provide the supportive moment during knee loading. A novel, personalized joint mechanism replaces a traditional hinge to reduce interference with knee kinematics. Using motion capture gait analysis, we evaluated the basic functionality of a prototype device. We calculated, via inverse dynamics analysis, the reaction forces at the knee joint and the moments generated by the leg muscles during gait. Comparing these values between braced and unbraced trials allowed us to evaluate the system's effectiveness. Kinematic measurements showed the extent to which the brace interfered with natural gait characteristics. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. The techniques presented in this paper could lead to improved OA treatment through patient-specific braces.

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