A Sex Comparison of Ambulatory Mechanics Relevant to Osteoarthritis in Individuals With and Without Asymptomatic Varus Knee Alignment

2014 ◽  
Vol 30 (5) ◽  
pp. 632-636 ◽  
Author(s):  
Joaquin A. Barrios ◽  
Danielle E. Strotman
Keyword(s):  
Knee Osteoarthritis ◽  
Varus Knee ◽  
Knee Alignment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Gait Parameters ◽  
Peak Knee ◽  
Gait Mechanics ◽  
Reaction Forces ◽  
Asymptomatic Individuals

The prevalence of medial knee osteoarthritis is greater in females and is associated with varus knee alignment. During gait, medial knee osteoarthritis has been linked to numerous alterations. Interestingly, there has been no research exploring sex differences during walking in healthy individuals with and without varus alignment. Therefore, the gait mechanics of 30 asymptomatic individuals with varus knees (15 females) and 30 normally-aligned controls (15 females) were recorded. Gait parameters associated with medial knee osteoarthritis were analyzed with two-factor analyses of variance. In result, varus males exhibited the greatest peak knee adduction moments, while normal females showed the greatest peak hip adduction angles and pelvic drop excursions. By sex, females exhibited greater peak hip adduction angles and moments and greater pelvic drop excursion, but lesser peak knee adduction angles. By alignment type, varus subjects exhibited greater peak knee adduction angles and moments, midstance knee flexion angles and excursion, and eversion angles and lateral ground reaction forces, but lesser peak hip adduction angles. In conclusion, females generally presented with proximal mechanics related to greater hip adduction, whereas males presented with more knee adduction. Varus subjects demonstrated a number of alterations associated with medial knee osteoarthritis. The differential sex effects were far less conclusive.

scholarly journals Effect of real-time biofeedback on peak knee adduction moment in patients with medial knee osteoarthritis: Is direct feedback effective?

2018 ◽  
Vol 57 ◽  
pp. 150-158 ◽  
Author(s):  
Rosie E. Richards ◽  
Josien C. van den Noort ◽  
Martin van der Esch ◽  
Marjolein J. Booij ◽  
Jaap Harlaar
Keyword(s):  
Knee Osteoarthritis ◽  
Real Time ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Direct Feedback

scholarly journals Effect of Laterally Wedged Foot Orthoses on Rearfoot and Hip Mechanics in Patients with Medial Knee Osteoarthritis

2009 ◽  
Vol 33 (2) ◽  
pp. 107-116 ◽  
Author(s):  
Robert J. Butler ◽  
Joaquin A. Barrios ◽  
Todd Royer ◽  
Irene S. Davis
Keyword(s):  
Knee Osteoarthritis ◽  
Three Dimensional ◽  
Frontal Plane ◽  
Knee Adduction Moment ◽  
Orthotic Devices ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Wedge Condition ◽  
Foot Orthotic

The purpose of this study was to examine the effects of laterally wedged foot orthotic devices, used to treat knee osteoarthritis, on frontal plane mechanics at the rearfoot and hip during walking. Thirty individuals with diagnosed medial knee osteoarthritis were recruited for this study. Three dimensional kinematics and kinetics were recorded as the subjects walked in the laboratory at an intentional walking speed. Peak eversion, eversion excursion and peak eversion moment were increased while the peak knee adduction moment was reduced in the laterally wedged orthotic condition compared to the no wedge condition. In contrast, no changes were observed in the variables of interest at the hip. There was no significant relationship between the change in the peak frontal plane moment at the rearfoot and change in the peak frontal plane moment at the knee or hip as a result of the lateral wedge. Laterally wedged foot orthotic devices, used to treat knee osteoarthritis, do not influence hip mechanics. However, they do result in increased rearfoot eversion and inversion moment. Therefore, a full medical screen of the foot should occur before laterally wedged foot orthotic devices are prescribed as a treatment for knee osteoarthritis.

scholarly journals The 2- and 8-week effects of decompressive brace use in people with medial compartment knee osteoarthritis

2015 ◽  
Vol 40 (4) ◽  
pp. 447-453 ◽  
Author(s):  
Eric M Lamberg ◽  
Robert Streb ◽  
Marc Werner ◽  
Ian Kremenic ◽  
James Penna
Keyword(s):  
Knee Osteoarthritis ◽  
Repeated Measures ◽  
Knee Adduction Moment ◽  
Knee Brace ◽  
Knee Motion ◽  
Noninvasive Treatment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Peak Knee ◽  
Second Peak

Background: Knee osteoarthritis is a prevalent disease. Unloading the affected compartment using a brace is a treatment option. Objectives: To determine whether a decompressive knee brace alters loading in medial knee osteoarthritis following 2 and 8 weeks of use. Study design: Within subjects; pre- and post-testing. Methods: A total of 15 individuals with medial knee osteoarthritis attended four sessions: baseline, fitting, 2 weeks after fitting (post), and 8 weeks after fitting (final). A gait analysis was performed at baseline (without knee brace), post and final. Knee adduction impulse, first and second peak knee adduction moment, knee motion, and walking velocity were calculated. Participants also recorded hours and steps taken while wearing the brace. Results: On average, the brace was worn for more than 6 h/day. Through use of repeated-measures analysis of variance, it was determined that the knee adduction impulse and second peak knee adduction moment were reduced ( p < 0.05) at post and final compared to baseline (36% and 34% reduction in knee adduction impulse, 26% reduction in second peak knee adduction moment for post and final, respectively). Furthermore, participants walked faster with increased knee motion during stance. Conclusion: The studied decompressive brace was effective in reducing potentially detrimental forces at the knee—knee adduction impulse and second peak knee adduction moment during the stance phase of gait. Clinical relevance The data from this study suggest that use of a medial unloading brace can reduce potentially detrimental adduction moments at the knee. Clinicians should use this evidence to advocate for use of this noninvasive treatment for people presenting with medial knee osteoarthritis.

scholarly journals Effects of Backward Gait Training on Ground Reaction Forces in Patients with Medial Knee Osteoarthritis

2020 ◽  
Author(s):  
Ali Jalalvand ◽  
Mehrdad Anbarian
Keyword(s):  
Knee Osteoarthritis ◽  
Gait Training ◽  
Ground Reaction Forces ◽  
Propulsive Force ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Significant Difference ◽  
Reaction Forces ◽  
Experimental Group ◽  
Training Protocol

Introduction: The aim of this study was to investigate the effects of backward gait training protocol on ground reaction forces in Patients with medial knee Osteoarthritis. Methods: This quasi-experimental study was performed with a pretest-posttest design in two groups of healthy and unhealthy and the experimental group (participants with medial knee osteoarthritis). The participants were 21 healthy and 42 unhealthy men with knee osteoarthritis who were divided into two experimental and control groups according to the Kellgren and Lawrence radiologic scale and the visual analogue scale. The experimental group performed backward gait training for six weeks. Two Kistler force plates (1000Hz) were used to measure parameters by Vicon Nexus 1.8.5, Polygon 4.1.2 software. For statistical analysis One-Way ANOVA test was used through SPSS, version 20 (p≤0.05). Results: Before training, there was a significant difference between the groups of the patients and healthy participants for the first peak of vertical (Fz1) and vertical valley (valley), braking force (AP1), propulsive force (AP2) of ground reaction forces (P<0.05). The training protocol had a significant effect on increasing propulsive force (PPre=0.021, Ppost=0.068) and braking force (PPre=0.022, Ppost=0.077) in the experimental group compared to the healthy group; and there was no significant difference between the groups after training compared to pre-exercise (baseline). Exercise did not affect on the components of vertical force. Conclusion: Loss of braking-pushing forces and first peak of vertical ground reaction force (Fz1) could reflect limb pain or poor performance. Backward gait training protocol had a significant effect on braking-pushing forces.

scholarly journals Personalization improves the biomechanical efficacy of foot progression angle modifications in individuals with medial knee osteoarthritis

2020 ◽  
Author(s):  
Scott D Uhlrich ◽  
Julie A Kolesar ◽  
Łukasz Kidziński ◽  
Melissa A Boswell ◽  
Amy Silder ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Center Of Pressure ◽  
Knee Adduction Moment ◽  
Abduction Angle ◽  
Valgus Knee ◽  
Lasso Regression ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Foot Progression Angle ◽  
Peak Knee

Abstract Objectives The goal of this study was to evaluate the importance of personalization when selecting foot progression angle modifications that aim to reduce the peak knee adduction moment in individuals with medial knee osteoarthritis. Design One hundred seven individuals with medial knee osteoarthritis walked on an instrumented treadmill with biofeedback instructing them to toe-in and toe-out by 5° and 10° relative to their self-selected foot progression angle. We selected individuals’ personalized foot progression angle as the modification that maximally reduced their larger knee adduction moment peak. Additionally, we used lasso regression to identify which secondary changes in kinematics made a 10° toe-in gait modification more effective at reducing the first knee adduction moment peak. Results Sixty-six percent of individuals reduced their larger knee adduction moment peak by at least 5% with a personalized foot progression angle modification, which is more than (p<0.001) the 54% and 23% of individuals who reduced it with a uniformly-assigned 10° toe-in or toe-out modification, respectively. When toeing-in, greater reductions in the first knee adduction moment peak were related to an increased frontal-plane tibia angle (knee more medial than ankle), a more valgus knee abduction angle, reduced contralateral pelvic drop, and a more medialized center of pressure in the foot reference frame. Conclusions Personalization increases the proportion of individuals with medial knee osteoarthritis who may benefit from modification of their foot progression angle.

Size of Medial Knee Osteophytes Correlates With Knee Alignment But Not With Coronal Laxity in Patients With Medial Knee Osteoarthritis

2019 ◽  
Vol 38 (3) ◽  
pp. 639-644
Author(s):  
Yoshinori Ishii ◽  
Hideo Noguchi ◽  
Junko Sato ◽  
Hana Ishii ◽  
Ryo Ishii ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Alignment ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Coronal Laxity
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