Greater Step Widths Reduce Internal Knee Abduction Moments in Medial Compartment Knee Osteoarthritis Patients During Stair Ascent

Increased step widths have been shown to reduce peak internal knee abduction moments in healthy individuals but not in knee osteoarthritis patients during stair descent. This study aimed to assess effects of increased step widths on peak knee abduction moments and associated variables in adults with medial knee osteoarthritis and healthy older adults during stair ascent. Thirteen healthy older adults and 13 medial knee osteoarthritis patients performed stair ascent using preferred, wide, and wider step widths. Three-dimensional kinematics and ground reaction forces (GRFs) using an instrumented staircase were collected. Increased step width reduced first and second peak knee abduction moments, and knee abduction moment impulse. In addition, frontal plane GRF at time of first and second peak knee abduction moment and lateral trunk lean at time of first peak knee abduction moment were reduced with increased step width during stair ascent in both groups. Knee abduction moment variables were not different between knee osteoarthritis patients and healthy controls. Our findings suggest that increasing step width may be an effective simple gait alteration to reduce knee abduction moment variables in both knee osteoarthritis and healthy adults during stair ascent. However, long term effects of increasing step width during stair ascent in knee osteoarthritis and healthy adults remain unknown.

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

Prosthetics and Orthotics International ◽

10.1177/0309364615589537 ◽

2015 ◽

Vol 40 (4) ◽

pp. 447-453 ◽

Cited By ~ 9

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.

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Processing gender stereotypes in dementia patients and older healthy adults: a self-paced reading study

Linguistics Vanguard ◽

10.1515/lingvan-2018-0029 ◽

2019 ◽

Vol 5 (s2) ◽

Cited By ~ 1

Author(s):

Daniel Müller-Feldmeth ◽

Katharina Ahnefeld ◽

Adriana Hanulíková

Keyword(s):

Older Adults ◽

Young Adults ◽

Sentence Processing ◽

Gender Stereotypes ◽

Time Course ◽

Healthy Adults ◽

Control Group ◽

Healthy Older Adults ◽

Dementia Patients ◽

Age Related

AbstractWe used self-paced reading to examine whether stereotypical associations of verbs with women or men as prototypical agents (e.g. the craftsman knits a sweater) are activated during sentence processing in dementia patients and healthy older adults. Effects of stereotypical knowledge on language processing have frequently been observed in young adults, but little is known about age-related changes in the activation and integration of stereotypical information. While syntactic processing may remain intact, semantic capacities are often affected in dementia. Since inferences based on gender stereotypes draw on social and world knowledge, access to stereotype information may also be affected in dementia patients. Results from dementia patients (n = 9, average age 86.6) and healthy older adults (n = 14, average age 79.5) showed slower reading times and less accuracy in comprehension scores for dementia patients compared to the control group. While activation of stereotypical associations of verbs was visible in both groups, they differed with respect to the time-course of processing. The effect of stereotypes on comprehension accuracy was visible for healthy adults only. The evidence from reading times suggests that older adults with and without dementia engage stereotypical inferences during reading, which is in line with research on young adults.

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Biomechanical Effect of 3D-Printed Foot Orthoses in Patients with Knee Osteoarthritis

10.21203/rs.3.rs-90724/v1 ◽

2020 ◽

Author(s):

Kuang-Wei Lin ◽

Li-Wei Chou ◽

Yi-Tien Su ◽

Shun-Hwa Wei ◽

Chen-Sheng Chen

Keyword(s):

Center Of Pressure ◽

Medial Knee ◽

Knee Oa ◽

Ankle Inversion ◽

Ankle Eversion ◽

Peak Knee ◽

Flexion Moment ◽

3D Printed ◽

Lateral Wedges ◽

Second Peak

Abstract Background: Lateral wedges comprise a common conservative treatment for medial knee osteoarthritis (OA). However, use of lateral wedges might increases the ankle eversion moment. To minimize the risk of ankle joint, lateral wedges with custom arch support are suggested. However, the manufacturing process of a custom foot orthosis (FO) is complicated, labor intensive, and time consuming. The technology of 3D printing is an ideal method for mass customization. Therefore. the purpose of this study was to develop custom FOs using 3D printing techniques and to evaluate the biomechanical effects of 3D-printed FOs in patients with medial knee OA.Methods: Fifteen patients with medial knee OA were enrolled into this study. Kinematic and kinetic data were collected during walking by using an optical motion capture system. A paired-sample t-test was conducted to compare biomechanical variables under two conditions: walking in standard shoes (Shoe) and walking in shoes embedded with 3D-printed FOs (Shoe + FO).Results: Under the Shoe + FO condition, the center of pressure at the peak knee adduction moment significantly shifted laterally by 2.71 mm compared with the Shoe condition. No significant difference in the peak knee flexion moment was observed between the two conditions. In addition, both the first and second peak knee adduction moments were significantly reduced by 4.08% and 9.09% under the Shoe + FO condition. The 3D-printed FOs did not affect the ankle eversion moment but caused a decrease in the peak ankle inversion moment.Conclusions: The 3D-printed FOs caused a decrease in the ankle inversion moment, the first and second peak knee adduction moments by changing the center of pressure path laterally. Although the decrease in the knee flexion moment from the use of 3D-printed FOs was nonsignificant, such FOs engender biomechanical changes and positively influence the biomechanics of patients with knee OA.

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Development of a Dementia-Focused End-of-Life Planning Tool: The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia)

Innovation in Aging ◽

10.1093/geroni/igz024 ◽

2019 ◽

Vol 3 (3) ◽

Cited By ~ 3

Author(s):

Kara Dassel ◽

Rebecca Utz ◽

Katherine Supiano ◽

Sara Bybee ◽

Eli Iacob

Keyword(s):

Older Adults ◽

Clinical Practice ◽

Focus Groups ◽

End Of Life ◽

Family Caregivers ◽

Early Stage ◽

Healthy Adults ◽

Planning Tool ◽

Healthy Older Adults ◽

Life Planning

Abstract Background and Objectives To address the unique characteristics of Alzheimer’s disease and related dementias (ADRD) that complicate end-of-life (EOL), we created, refined, and validated a dementia-focused EOL planning instrument for use by healthy adults, those with early-stage dementia, family caregivers, and clinicians to document EOL care preferences and values within the current or future context of cognitive impairment. Research Design and Methods A mixed-method design with four phases guided the development and refinement of the instrument: (1) focus groups with early-stage ADRD and family caregivers developed and confirmed the tool content and comprehensiveness; (2) evaluation by content experts verified its utility in clinical practice; (3) a sample of healthy older adults (n = 153) and adults with early-stage ADRD (n = 38) completed the tool, whose quantitative data were used to describe the psychometrics of the instrument; and (4) focus groups with healthy older adults, family caregivers, and adults with early-stage ADRD informed how the guide should be used by families and in clinical practice. Results Qualitative data supported the utility and feasibility of a dementia-focused EOL planning tool; the six scales have high internal consistency (α = 0.66–0.89) and high test–rest reliability (r = .60–.90). On average, both participant groups reported relatively high concern for being a burden to their families, a greater preference for quality over length of life, a desire for collaborative decision-making process, limited interest in pursuing life-prolonging measures, and were mixed in their preference to control the timing of their death. Across disease progression, preferences for location of care changed, whereas preferences for prolonging life remained stable. Discussion and Implications The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) has the potential to facilitate discussion and documentation of EOL values and care preferences prior to loss of decisional capacity, and has utility for healthy adults, patients, families, providers, and researchers.

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Effects of step width modifications on the ambulatory kinetics in patients with medial knee osteoarthritis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2021.05.020 ◽

2021 ◽

Vol 29 ◽

pp. S11

Author(s):

L.C. Pereira ◽

B. Ulrich ◽

J. Runhaar ◽

S. Bierma-Zeinstra ◽

B.M. Jolles ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Step Width ◽

Medial Knee ◽

Medial Knee Osteoarthritis

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

Journal of Applied Biomechanics ◽

10.1123/jab.2014-0039 ◽

2014 ◽

Vol 30 (5) ◽

pp. 632-636 ◽

Cited By ~ 11

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.

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Changes in foot progression angle during gait reduce the knee adduction moment and do not increase hip moments in individuals with knee osteoarthritis

10.1101/2022.01.10.22268858 ◽

2022 ◽

Author(s):

Kirsten Seagers ◽

Scott D Uhlrich ◽

Julie A Kolesar ◽

Madeleine Berkson ◽

Janelle M Janeda ◽

...

Keyword(s):

Experimental Data ◽

Knee Osteoarthritis ◽

Musculoskeletal Modeling ◽

Knee Adduction Moment ◽

Foot Progression Angle ◽

Peak Knee ◽

Hip Abduction ◽

Surrogate Measure ◽

Surrogate Measures ◽

Second Peak

People with knee osteoarthritis who adopt a modified foot progression angle (FPA) during gait often benefit from a reduction in the knee adduction moment and knee pain. It is unknown, however, whether changes in the FPA increase hip moments, a surrogate measure of hip loading, which may increase the risk of hip pain or osteoarthritis. This study examined how altering the FPA affects hip moments. Individuals with knee osteoarthritis walked on an instrumented treadmill with their baseline gait, 10° toe-in gait, and 10° toe-out gait. A musculoskeletal modeling package was used to compute joint moments from the experimental data. Fifty participants were selected from a larger study who reduced their peak knee adduction moment with a modified FPA. In this group, participants reduced the first peak of the knee adduction moment by 7.6% with 10° toe-in gait and reduced the second peak by 11.0% with 10 ° toe-out gait. Modifying the FPA reduced the early-stance hip abduction moment, at the time of peak hip contact force, by 4.3% ± 1.3% for 10° toe-in gait (p=0.005) and by 4.6% ± 1.1% for 10° toe-out gait (p<0.001) without increasing the flexion and internal rotation moments (p>0.15). In summary, when adopting a FPA modification that reduced the knee adduction moment, participants did not increase surrogate measures of hip loading.

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RADIOLOGICAL ASSESSMENT OF KNEE JOINT WIDTH DIFFERENCES IN OLDER ADULTS WITH SYMPTOMATIC MEDIAL KNEE OSTEOARTHRITIS

Journal of Mechanics in Medicine and Biology ◽

10.1142/s0219519421400534 ◽

2021 ◽

Author(s):

SAMWON YOON ◽

YOUNGJOO CHA ◽

HYUNSIK YOON ◽

KYOUNGTAE KIM ◽

ILBONG PARK ◽

...

Keyword(s):

Older Adults ◽

Knee Joint ◽

Knee Osteoarthritis ◽

Joint Space Width ◽

Lower Limbs ◽

Unaffected Side ◽

Medial Knee ◽

Knee Oa ◽

Affected Side ◽

Significant Difference

Knee osteoarthritis (OA) is a degenerative articular disease. The knee joint space width (JSW) is used for grading the severity of knee OA. However, there is a lack of research on differences in the widths of knee joints between both lower limbs in unilateral OA. The purpose of this research was to examine the radiological difference in the affected knee joint and contralateral knee joint by analyzing unilateral older adults with medial knee OA using both knees’ JSW differences. Twenty-five subjects with unilateral medial knee OA participated. X-ray radiographs were used to assess knee JSW, and the paired [Formula: see text]-test was performed to assess the knee joint gap width between the affected side and the unaffected side in the respective medial and lateral sides. The independent [Formula: see text]-test compared the differences between the lateral and medial knee JSWs on the affected side and unaffected side. The paired [Formula: see text]-test did not show a significant difference in the medial and lateral knee JSW on the affected side compared to the unaffected side ([Formula: see text]; 0.11). Meanwhile, the independent [Formula: see text]-test revealed a significant difference between the affected and unaffected sides ([Formula: see text]). This study showed no significant changes in affected knee JSWs compared to unaffected sides, but the difference between the lateral and medial JSWs was significant between the knees affected and unaffected by OA in the older adults with medial knee OA.

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