Toe-Out Gait Decreases the Second Peak of the Medial Knee Contact Force

2015 ◽  
Vol 31 (4) ◽  
pp. 275-280 ◽  
Author(s):  
Shinya Ogaya ◽  
Hisashi Naito ◽  
Akira Iwata ◽  
Yumi Higuchi ◽  
Satoshi Fuchioka ◽  
...  
Keyword(s):  
Contact Force ◽  
Simulation Analysis ◽  
Cartilage Damage ◽  
Reaction Force ◽  
Muscle Tension ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Joint Reaction Force ◽  
Medial Knee ◽  
Second Peak

Toe-out angle alternation is a potential tactic for decreasing the knee adduction moment during walking. Published reports have not examined the medial knee contact force during the toe-out gait, although it is a factor affecting knee articular cartilage damage. This study investigated the effects of increased toe-out angle on the medial knee contact force, using musculoskeletal simulation analysis. For normal and toe-out gaits in 18 healthy subjects, the muscle tension forces were simulated based on the joint moments and ground reaction forces with optimization process. The medial knee contact force during stance phase was determined using the sum of the muscle force and joint reaction force components. The first and second peaks of the medial knee contact force were compared between the gaits. The toe-out gait showed a significant decrease in the medial knee contact force at the second peak, compared with the normal gait. In contrast, the medial knee contact forces at the first peak were not significantly different between the gaits. These results suggest that the toe-out gait is beneficial for decreasing the second peak of the medial knee contact force.

CONTRIBUTION OF MUSCLE TENSION FORCE TO MEDIAL KNEE CONTACT FORCE AT FAST WALKING SPEED

2015 ◽  
Vol 15 (01) ◽  
pp. 1550002 ◽  
Author(s):  
S. OGAYA ◽  
H. NAITO ◽  
Y. OKITA ◽  
A. IWATA ◽  
Y. HIGUCHI ◽  
...  
Keyword(s):  
Contact Force ◽  
Muscle Force ◽  
Walking Speed ◽  
Reaction Force ◽  
Muscle Tension ◽  
Moderate Increase ◽  
Joint Reaction Force ◽  
Medial Knee ◽  
Fast Walking ◽  
Second Peak

Fast walking is considered as a factor that causes pain in patients suffering from knee disorders. This study examined the effect of walking speed on the medial knee contact force and identified contributions to the muscle tension on the medial knee contact force during fast walking using musculoskeletal simulation analysis. The muscle contribution to the medial knee contact force was calculated based on the joint angles and ground reaction force for the normal and fast walking experiments of seven subjects. The muscle force and joint reaction force were used to estimate the medial knee contact force. Results showed, in average, 70% increase in medial knee contact force at the first peak and 34% increase at the second peak with a fast walking speed, compared to when they walked at a normal walking speed. The remarkable increase in the first peak was mainly contributed by the increase in the quadriceps force resisting the external knee flexion moment. In contrast, the moderate increase of second peak was contributed by the increase in the gastrocnemius muscle force. These results suggest that the increase in medial knee contact force at fast walking speeds is caused by the increased muscle force.

Intra-Articular Knee Contact Force Estimation During Walking Using Force-Reaction Elements and Subject-Specific Joint Model2

2016 ◽  
Vol 138 (2) ◽  
Author(s):  
Yihwan Jung ◽  
Cong-Bo Phan ◽  
Seungbum Koo
Keyword(s):  
Contact Force ◽  
Inverse Dynamics ◽  
Reaction Force ◽  
Muscle Tension ◽  
Contact Forces ◽  
Contact Model ◽  
Grand Challenge ◽  
Subject Specific ◽  
Mean Square Errors

Joint contact forces measured with instrumented knee implants have not only revealed general patterns of joint loading but also showed individual variations that could be due to differences in anatomy and joint kinematics. Musculoskeletal human models for dynamic simulation have been utilized to understand body kinetics including joint moments, muscle tension, and knee contact forces. The objectives of this study were to develop a knee contact model which can predict knee contact forces using an inverse dynamics-based optimization solver and to investigate the effect of joint constraints on knee contact force prediction. A knee contact model was developed to include 32 reaction force elements on the surface of a tibial insert of a total knee replacement (TKR), which was embedded in a full-body musculoskeletal model. Various external measurements including motion data and external force data during walking trials of a subject with an instrumented knee implant were provided from the Sixth Grand Challenge Competition to Predict in vivo Knee Loads. Knee contact forces in the medial and lateral portions of the instrumented knee implant were also provided for the same walking trials. A knee contact model with a hinge joint and normal alignment could predict knee contact forces with root mean square errors (RMSEs) of 165 N and 288 N for the medial and lateral portions of the knee, respectively, and coefficients of determination (R2) of 0.70 and −0.63. When the degrees-of-freedom (DOF) of the knee and locations of leg markers were adjusted to account for the valgus lower-limb alignment of the subject, RMSE values improved to 144 N and 179 N, and R2 values improved to 0.77 and 0.37, respectively. The proposed knee contact model with subject-specific joint model could predict in vivo knee contact forces with reasonable accuracy. This model may contribute to the development and improvement of knee arthroplasty.

scholarly journals Effects of Toe-Out and Toe-In Gaits on Lower-Extremity Kinematics, Dynamics, and Electromyography

2019 ◽  
Vol 9 (23) ◽  
pp. 5245
Author(s):  
Weiling Cui ◽  
Changjiang Wang ◽  
Weiyi Chen ◽  
Yuan Guo ◽  
Yi Jia ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Contact Force ◽  
Repeated Measures ◽  
Joint Pain ◽  
Knee Flexion ◽  
Reaction Force ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Positive Effects ◽  
Lateral Contact

Toe-in and toe-out gait modifications have received increasing attention as an effective, conservative treatment for individuals without severe osteoarthritis because of its potential for improving knee adduction moment (KAM) and knee flexion moment (KFM). Although toe-in and toe-out gaits have positive effects on tibiofemoral (TF) joint pain in the short term, negative impacts on other joints of the lower extremity may arise. The main purpose of this study was to quantitatively compare the effects of foot progression angle (FPA) gait modification with normal walking speeds in healthy individuals on lower-extremity joint, ground reaction force (GRF), muscle electromyography, joint moment, and TF contact force. Experimental measurements using the Vicon system and multi-body dynamics musculoskeletal modelling using OpenSim were conducted in this study. Gait analysis of 12 subjects (n = 12) was conducted with natural gait, toe-in gait, and toe-out gait. One-way repeated measures of ANOVA (p < 0.05) with Tukey’s test was used for statistical analysis. Results showed that the toe-in and toe-out gait modifications decreased the max angle of knee flexion by 8.8 and 12.18 degrees respectively (p < 0.05) and the max angle of hip adduction by 1.28 and 0.99 degrees respectively (p < 0.05) compared to the natural gait. Changes of TF contact forces caused by FPA gait modifications were not statistically significant; however, the effect on KAM and KFM were significant (p < 0.05). KAM or combination of KAM and KFM can be used as surrogate measures for TF medial contact force. Toe-in and toe-out gait modifications could relieve knee joint pain probably due to redistribution of TF contact forces on medial and lateral condylar through changing lateral contact centers and shifting bilateral contact locations.

scholarly journals Immediate Effects of Medially Posted Insoles on Lower Limb Joint Contact Forces in Adult Acquired Flatfoot: A Pilot Study

2020 ◽  
Vol 17 (7) ◽  
pp. 2226 ◽  
Author(s):  
Yinghu Peng ◽  
Duo Wai-Chi Wong ◽  
Yan Wang ◽  
Tony Lin-Wei Chen ◽  
Qitao Tan ◽  
...  
Keyword(s):  
Contact Force ◽  
Lower Limb ◽  
Random Order ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Joint Mechanics ◽  
Joint Force ◽  
Ankle Eversion ◽  
Peak Knee ◽  
Joint Contact

Flatfoot is linked to secondary lower limb joint problems, such as patellofemoral pain. This study aimed to investigate the influence of medial posting insoles on the joint mechanics of the lower extremity in adults with flatfoot. Gait analysis was performed on fifteen young adults with flatfoot under two conditions: walking with shoes and foot orthoses (WSFO), and walking with shoes (WS) in random order. The data collected by a vicon system were used to drive the musculoskeletal model to estimate the hip, patellofemoral, ankle, medial and lateral tibiofemoral joint contact forces. The joint contact forces in WSFO and WS conditions were compared. Compared to the WS group, the second peak patellofemoral contact force (p < 0.05) and the peak ankle contact force (p < 0.05) were significantly lower in the WSFO group by 10.2% and 6.8%, respectively. The foot orthosis significantly reduced the peak ankle eversion angle (p < 0.05) and ankle eversion moment (p < 0.05); however, the peak knee adduction moment increased (p < 0.05). The reduction in the patellofemoral joint force and ankle contact force could potentially inhibit flatfoot-induced lower limb joint problems, despite a greater knee adduction moment.

scholarly journals Estimation of the Knee Adduction Moment and Joint Contact Force during Daily Living Activities Using Inertial Motion Capture

Sensors ◽  
2019 ◽  
Vol 19 (7) ◽  
pp. 1681 ◽  
Author(s):  
Jason Konrath ◽  
Angelos Karatsidis ◽  
H. Schepers ◽  
Giovanni Bellusci ◽  
Mark de Zee ◽  
...  
Keyword(s):  
Motion Capture ◽  
Contact Force ◽  
Daily Living ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Inertial Motion ◽  
Daily Living Activities ◽  
Tibiofemoral Joint ◽  
Joint Contact Force ◽  
Joint Contact

Knee osteoarthritis is a major cause of pain and disability in the elderly population with many daily living activities being difficult to perform as a result of this disease. The present study aimed to estimate the knee adduction moment and tibiofemoral joint contact force during daily living activities using a musculoskeletal model with inertial motion capture derived kinematics in an elderly population. Eight elderly participants were instrumented with 17 inertial measurement units, as well as 53 opto-reflective markers affixed to anatomical landmarks. Participants performed stair ascent, stair descent, and sit-to-stand movements while both motion capture methods were synchronously recorded. A musculoskeletal model containing 39 degrees-of-freedom was used to estimate the knee adduction moment and tibiofemoral joint contact force. Strong to excellent Pearson correlation coefficients were found for the IMC-derived kinematics across the daily living tasks with root mean square errors (RMSE) between 3° and 7°. Furthermore, moderate to strong Pearson correlation coefficients were found in the knee adduction moment and tibiofemoral joint contact forces with RMSE between 0.006–0.014 body weight × body height and 0.4 to 1 body weights, respectively. These findings demonstrate that inertial motion capture may be used to estimate knee adduction moments and tibiofemoral contact forces with comparable accuracy to optical motion capture.

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 Positive Correlation Between the Hip Adduction Moment Impulse During the Stance Phase and the Hip Joint Contact Force Impulse

2020 ◽  
Author(s):  
Takuma Inai ◽  
Tomoya Takabayashi ◽  
Mutsuaki Edama ◽  
Masayoshi Kubo
Keyword(s):  
Contact Force ◽  
Hip Joint ◽  
Stance Phase ◽  
Hip Osteoarthritis ◽  
Contact Forces ◽  
Joint Contact Force ◽  
Joint Contact ◽  
Hip Joint Contact Force ◽  
The Relationship ◽  
Second Peak

Abstract Background: Excessive mechanical loading, in the form of the joint contact force, has been reported to promote osteoarthritis in vitro and vivo in mice. However, it has also been reported that an excessive hip adduction moment impulse during the stance phase likely contributes to the progression of hip osteoarthritis. The relationship between the hip adduction moment impulse and hip joint contact force (impulse, and first and second peaks) during the stance phase is unclear. The objective of the present study was to clarify this relationship. Methods: A public dataset pertaining to the overground walking of 84 healthy adults, in which the participants walked at a self-selected speed, was considered. The data of three trials for each participant were analyzed. The relationship between the hip adduction moment and hip joint contact force, in terms of the impulse and first and second peaks, during the stance phase was evaluated using correlation coefficients.Results: The hip adduction moment impulse during the stance phase was positively correlated with the hip joint contact force impulse and not correlated with the first and second peak hip joint contact forces. Furthermore, the first and second peak hip adduction moments during the stance phase were positively correlated with the first and second peak hip joint contact forces, respectively. Conclusions: These findings indicate that the hip joint contact force impulse during the stance phase can be used as an index to determine the risk factors for the progression of hip osteoarthritis.

Changes in Medial Knee Contact Force Through Gait Modification

2012 ◽  
Author(s):  
Allison L. Hall ◽  
Thor F. Besier ◽  
Amy Silder ◽  
Scott L. Delp ◽  
Darryl D. D’Lima ◽  
...  
Keyword(s):  
Contact Force ◽  
Treatment Strategies ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Non Invasive ◽  
Trunk Sway ◽  
Invasive Method ◽  
Gait Modification ◽  
External Knee Adduction Moment

The development of medial knee osteoarthritis (OA) has been attributed to overloading of the medial compartment articular cartilage [1]. Therefore, treatment strategies are often focused on reducing medial compartment loads. Gait modification represents a non-invasive method for achieving this goal. Previous studies have shown that a variety of gait modifications (e.g., toeing out, increased medial-lateral trunk sway, walking with medialized knees (i.e., medial thrust gait)) are effective in reducing the external knee adduction moment [e.g., 2–4]. Although the external knee adduction moment is often used as a surrogate measure of medial compartment force, a recent study showed that reductions in the external knee adduction moment do not guarantee reductions in medial compartment force [5]. Therefore, direct measurements of changes in medial contact force are important for determining the effectiveness of gait modifications.

Knee adduction moment and medial knee contact force during gait in older people

2014 ◽  
Vol 40 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Shinya Ogaya ◽  
Hisashi Naito ◽  
Akira Iwata ◽  
Yumi Higuchi ◽  
Satoshi Fuchioka ◽  
...  
Keyword(s):  
Older People ◽  
Contact Force ◽  
Knee Adduction Moment ◽  
Medial Knee
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