Effects of a Knee Extension Constraint Brace on Selected Lower Extremity Motion Patterns during a Stop-Jump Task

2008 ◽  
Vol 24 (2) ◽  
pp. 158-165 ◽  
Author(s):  
Cheng-Feng Lin ◽  
Hui Liu ◽  
William E. Garrett ◽  
Bing Yu
Keyword(s):  
Vertical Velocity ◽  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Knee Extension ◽  
Horizontal Velocity ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Extremity Motion

Small knee flexion angle during landing has been proposed as a potential risk factor for sustaining noncontact ACL injury. A brace that promotes increased knee flexion and decreased posterior ground reaction force during landing may prove to be advantageous for developing prevention strategies. Forty male and forty female recreational athletes were recruited. Three-dimensional videographic and ground reaction force data in a stop-jump task were collected in three conditions. Knee flexion angle at peak posterior ground reaction force, peak posterior ground reaction force, the horizontal velocity of approach run, the vertical velocity at takeoff, and the knee flexion angle at takeoff were compared among conditions: knee extension constraint brace, nonconstraint brace, and no brace. The knee extension constraint brace significantly increased knee flexion angle at peak posterior ground reaction force. Both knee extension constraint brace and nonconstraint brace significantly decreased peak posterior ground reaction force during landing. The brace and knee extension constraint did not significantly affect the horizontal velocity of approach run, the vertical velocity at takeoff, and the knee flexion angle at takeoff. A knee extension constraint brace exhibits the ability to modify the knee flexion angle at peak posterior ground reaction force and peak posterior ground reaction force during landing.

Effects of Knee Extension Constraint Training on Knee Flexion Angle and Peak Impact Ground-Reaction Force

2014 ◽  
Vol 42 (4) ◽  
pp. 979-986 ◽  
Author(s):  
Hui Liu ◽  
Will Wu ◽  
Wanxiang Yao ◽  
Jeffrey T. Spang ◽  
R. Alexander Creighton ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Knee Extension ◽  
Flexion Angle ◽  
Knee Flexion Angle

Effects of an Intervention Program on Lower Extremity Biomechanics in Stop-Jump and Side-Cutting Tasks

2018 ◽  
Vol 46 (12) ◽  
pp. 3014-3022 ◽  
Author(s):  
Chen Yang ◽  
Wanxiang Yao ◽  
William E. Garrett ◽  
Deborah L. Givens ◽  
Jonathon Hacke ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Knee Flexion ◽  
Intervention Program ◽  
Reaction Force ◽  
Intervention Group ◽  
Collegiate Athletes ◽  
Flexion Angle ◽  
Control Group ◽  
Knee Flexion Angle ◽  
Intervention Effects

Background: Anterior cruciate ligament (ACL) injury is one of the most common injuries in sport. To reduce the risk of noncontact ACL injury, it is critical to understand the effects of an intervention program on neuromuscular control–related biomechanical risk factors. Hypothesis: A newly developed 4-week intervention program would significantly increase the knee flexion angle at peak impact posterior ground-reaction force and would significantly decrease the peak impact posterior and vertical ground-reaction forces in the stop-jump and side-cutting tasks, while the intervention effects would be retained after the training was completed. Study Design: Controlled laboratory study. Methods: A total of 22 male and 18 female collegiate basketball and volleyball players with biomechanical characteristics associated with increased risk of ACL injury were recruited and randomly assigned to either the intervention group or the control group. The intervention group executed a program to improve landing techniques through strength and plyometric training 3 times a week for 4 weeks while participating in their regular training. The control group participated in only their regular training for 4 weeks. Three-dimensional kinematic and kinetic data in the stop-jump and side-cutting tasks were collected at week 0 (the beginning of the study) and at the ends of weeks 4, 8, 16, and 20. Knee flexion angle and ground-reaction forces were calculated. Analyses of variance with a mixed design were performed to determine the intervention effects and the retention of intervention effects for each sex. Results: Male participants in the intervention group significantly increased the knee flexion angle at peak impact posterior ground-reaction force in the stop-jump task at weeks 8, 12, and 20 when compared with that at week 0 and with the male control group ( P ≤ .002). No significant intervention effects on knee flexion angle and ground-reaction force were found in the side-cutting task for male participants. No significant interaction effects on takeoff velocities were detected in any task for male participants. No significant intervention effects on knee flexion angle and ground-reaction force were found in any task for female participants. Vertical takeoff velocity in the stop-jump task was significantly lower in the intervention group at week 20 compared with the control group ( P = .011). Conclusion: A 4-week intervention program significantly increased the knee flexion angle at peak impact posterior ground-reaction force of male collegiate athletes in the stop-jump task without significant effect on the performance of the task. This intervention effect was retained for at least 16 weeks after the training was completed. The intervention program, however, did not affect knee flexion angle and ground-reaction force in any task for female collegiate athletes. A reduction in vertical takeoff velocity of the stop-jump task was observed for female collegiate athletes 16 weeks after the intervention. Clinical Relevance: The intervention program with strength conditioning and plyometric exercises could modify landing biomechanics of male collegiate athletes in a stop-jump task. The intervention program may be a useful tool for preventing noncontact ACL injury for male collegiate athletes.

scholarly journals Gait Disorders In Patients After Polytrauma

2015 ◽  
Vol 69 (1-2) ◽  
pp. 27-32
Author(s):  
Ruta Jakušonoka ◽  
Zane Pavāre ◽  
Andris Jumtiņš ◽  
Aleksejs Smolovs ◽  
Tatjana Anaņjeva
Keyword(s):  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Step Length ◽  
Vertical Load ◽  
Lower Limb Injuries ◽  
Limb Injuries ◽  
Stance Time ◽  
Polytrauma Patients

Abstract Evaluation of the gait of patients after polytrauma is important, as it indicates the ability of patients to the previous activities and work. The aim of our study was to evaluate the gait of patients with lower limb injuries in the medium-term after polytrauma. Three-dimensional instrumental gait analysis was performed in 26 polytrauma patients (16 women and 10 men; mean age 38.6 years), 14 to 41 months after the trauma. Spatio-temporal parameters, motions in pelvis and lower extremities joints in sagittal plane and vertical load ground reaction force were analysed. Gait parameters in polytrauma patients were compared with a healthy control group. Polytrauma patients in the injured side had decreased step length, cadence, hip extension, maximum knee flexion, vertical load ground reaction force, and increased stance time and pelvic anterior tilt; in the uninjured side they had decreased step length, cadence, maximum knee flexion, vertical load ground reaction force and increased stance time (p < 0.05). The use of the three-dimensional instrumental gait analysis in the evaluation of polytrauma patients with lower limb injuries consequences makes it possible to identify the gait disorders not only in the injured, but also in the uninjured side.

scholarly journals The Kinematics and Kinetics Analysis of the Lower Extremity in the Landing Phase of a Stop-jump Task

2015 ◽  
Vol 9 (1) ◽  
pp. 103-107 ◽  
Author(s):  
L Yin ◽  
D Sun ◽  
Q.C Mei ◽  
Y.D Gu ◽  
J.S Baker ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Flexion Angle ◽  
Contact Phase ◽  
Peak Knee ◽  
Significant Difference ◽  
The Impact ◽  
Kinematics And Kinetics

Large number of studies showed that landing with great impact forces may be a risk factor for knee injuries. The purpose of this study was to illustrate the different landing loads to lower extremity of both genders and examine the relationships among selected lower extremity kinematics and kinetics during the landing of a stop-jump task. A total of 35 male and 35 female healthy subjects were recruited in this study. Each subject executed five experiment actions. Lower extremity kinematics and kinetics were synchronously acquired. The comparison of lower extremity kinematics for different genders showed significant difference. The knee and hip maximum flexion angle, peak ground reaction force and peak knee extension moment have significantly decreased during the landing of the stop-jump task among the female subjects. The hip flexion angle at the initial foot contact phase showed significant correlation with peak ground reaction force during landing of the stop-jump task (r=-0.927, p<0.001). The knee flexion angle at the initial foot contact phase had significant correlation with peak ground reaction force and vertical ground reaction forces during landing of the stop-jump task (r=-0.908, p<0.001; r=0.812, P=0.002). A large hip and knee flexion angles at the initial foot contact with the ground did not necessarily reduce the impact force during landing, but active hip and knee flexion motions did. The hip and knee flexion motion of landing was an important technical factor that affects anterior cruciate ligament (ACL) loading during the landing of the stop-jump task.

scholarly journals Weight-Bearing Knee Flexion Angle Better Correlates with Patient-Reported Outcome Measures Than Non-Weight-Bearing Condition in Total Knee Arthroplasty: A Three-Dimensional Analysis Study

2021 ◽  
Author(s):  
Tomofumi Kage ◽  
Hiroshi Inui ◽  
Tetsuya Tomita ◽  
Takaharu Yamazaki ◽  
Shuji Taketomi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Weight Bearing ◽  
Three Dimensional ◽  
Patient Reported Outcome Measures ◽  
Flexion Angle ◽  
3D Analysis ◽  
Knee Flexion Angle ◽  
Angular Difference ◽  
Functional Activities ◽  
Patient Reported

Abstract Background: This study aims to elucidate and compare the relationship between the knee flexion angle and patient-reported outcome measures (PROM) in both non-weight-bearing (NWB) and weight-bearing (WB) conditions. Methods: This retrospective cohort study included 61 knees (47 patients) who underwent total knee arthroplasty. The knee flexion angle was measured by three conditions: NWB in manual goniometer, NWB in fluoroscopic three-dimensional (3D) analysis and WB in the fluoroscopic 3D analysis. The PROM was evaluated by postoperative 2011 Knee Society Score (2011 KSS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Correlations between the knee flexion angle and PROM was analyzed using Spearman’s correlation coefficient. Additionally, whether the angular difference between NWB and WB correlated with the PROM or not was evaluated. Results: The NWB knee flexion angle in a goniometer, NWB in 3D analysis, and WB in 3D analysis were 124.6° ± 8.4°, 118.0° ± 10.5°, and 109.5° ± 13.3°, respectively. The angular difference was 8.5° ± 12.8°. No PROM correlation existed in NWB using a goniometer. Moreover, significant positive correlations in 2011 KSS symptoms (r = 0.35) and 2011 KSS functional activities (r = 0.27) were noted in NWB using 3D analysis. Significant positive correlations existed in 2011 KSS symptoms (r = 0.32), 2011 KSS functional activities (r = 0.57), KOOS pain (r = 0.37), KOOS activity of daily living (ADL; r = 0.45), KOOS sports (r = 0.42), and KOOS quality of life (r = 0.36) in WB using 3D analysis. Significant negative correlations were noted in 2011 KSS functional activities (r = −0.45), KOOS ADL (r = −0.30), and KOOS sports (r = −0.38) in angular difference. Conclusions: The WB knee flexion angle better correlated with PROM compared with NWB by evaluation of 3D analysis. The larger the angular difference existed between NWB and WB, the lower the PROM score.

Patellofemoral Joint Stress during Running with Added Load in Females

2020 ◽  
Vol 41 (06) ◽  
pp. 412-418
Author(s):  
Molly Kujawa ◽  
Aleyna Goerlitz ◽  
Drew Rutherford ◽  
Thomas W. Kernozek
Keyword(s):  
Knee Flexion ◽  
Patellofemoral Joint ◽  
Reaction Force ◽  
Step Length ◽  
Force Platform ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Peak Knee ◽  
Foot Strike ◽  
Quadriceps Force

AbstractPatellofemoral joint (PFJ) pain syndrome is a commonly reported form of pain in female runners and military personnel. Increased PFJ stress may be a contributing factor. Few studies have examined PFJ stress running with added load. Our purpose was to analyze PFJ stress, PFJ reaction force, quadriceps force, knee flexion angle, and other kinematic and temporospatial variables running with and without a 9 kg load. Nineteen females ran across a force platform with no added load and 9.0 kg weight vest. Kinematic data were collected using 3D motion capture and kinetic data with a force platform. Muscle forces were estimated using a musculoskeletal model, and peak PFJ loading variables were calculated during stance. Multivariate analyses were run on PFJ loading variables and on cadence, step length and foot strike index. Differences were shown in PFJ stress, PFJ reaction force, peak knee flexion angle and quadriceps force. Joint specific kinetic variables increased between 5–16% with added load. PFJ loading variables increased with 9 kg of added load without changes in cadence, step length, or foot strike index compared to no load. Added load appears to increase the PFJ loading variables associated with PFJ pain in running.

scholarly journals Quadriceps Neuromuscular Function and Jump-Landing Sagittal-Plane Knee Biomechanics After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 53 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Sarah H. Ward ◽  
J. Troy Blackburn ◽  
Darin A. Padua ◽  
Laura E. Stanley ◽  
Matthew S. Harkey ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Sagittal Plane ◽  
Neuromuscular Function ◽  
Knee Extension ◽  
Spinal Reflex ◽  
Flexion Angle ◽  
Voluntary Activation ◽  
Knee Flexion Angle ◽  
Jump Landing ◽  
Peak Knee

Context:  Aberrant biomechanics may affect force attenuation at the knee during dynamic activities, potentially increasing the risk of sustaining a knee injury or hastening the development of osteoarthritis after anterior cruciate ligament reconstruction (ACLR). Impaired quadriceps neuromuscular function has been hypothesized to influence the development of aberrant biomechanics. Objective:  To determine the association between quadriceps neuromuscular function (strength, voluntary activation, and spinal-reflex and corticomotor excitability) and sagittal-plane knee biomechanics during jump landings in individuals with ACLR. Design:  Cross-sectional study. Setting:  Research laboratory. Patients or Other Participants:  Twenty-eight individuals with unilateral ACLR (7 men, 21 women; age = 22.4 ± 3.7 years, height = 1.69 ± 0.10 m, mass = 69.4 ± 10.1 kg, time postsurgery = 52 ± 42 months). Main Outcome Measure(s):  We quantified quadriceps spinal-reflex excitability via the Hoffmann reflex normalized to maximal muscle response (H : M ratio), corticomotor excitability via active motor threshold, strength as knee-extension maximal voluntary isometric contraction (MVIC), and voluntary activation using the central activation ratio (CAR). In a separate session, sagittal-plane kinetics (peak vertical ground reaction force [vGRF] and peak internal knee-extension moment) and kinematics (knee-flexion angle at initial contact, peak knee-flexion angle, and knee-flexion excursion) were collected during the loading phase of a jump-landing task. Separate bivariate associations were performed between the neuromuscular and biomechanical variables. Results:  In the ACLR limb, greater MVIC was associated with greater peak knee-flexion angle (r = 0.38, P = .045) and less peak vGRF (r = −0.41, P = .03). Greater CAR was associated with greater peak internal knee-extension moment (ρ = −0.38, P = .045), and greater H : M ratios were associated with greater peak vGRF (r = 0.45, P = .02). Conclusions:  Greater quadriceps MVIC and CAR may provide better energy attenuation during a jump-landing task. Individuals with greater peak vGRF in the ACLR limb possibly require greater spinal-reflex excitability to attenuate greater loading during dynamic movements.

scholarly journals Gait Training Using a Hip-Wearable Robotic Exoskeleton After Total Knee Arthroplasty: A Case Report

2020 ◽  
Vol 11 ◽  
pp. 215145932096648
Author(s):  
Kazunori Koseki ◽  
Hirotaka Mutsuzaki ◽  
Kenichi Yoshikawa ◽  
Yusuke Endo ◽  
Atsushi Kanazawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Walking Speed ◽  
Gait Training ◽  
Gait Pattern ◽  
Knee Extension ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Total Knee

The Honda Walking Assist® (HWA) is a light and easy wearable robot device for gait training, which assists patients’ hip flexion and extension movements to guide hip joint movements during gait. However, the safety and feasibility of gait training with HWA after total knee arthroplasty (TKA) remains unclear. Thus, we aimed to evaluate the safety and feasibility of this gait training intervention using HWA for a patient who underwent TKA. The patient was a 76-year-old female who underwent a left TKA. Gait training using HWA was conducted for 18 sessions in total, from 1 to 5 weeks after TKA. To verify the recovery process after TKA surgery, knee function parameters and walking ability were measured at pre-TKA and 1, 2, 4, and 8 weeks after TKA. The gait patterns at self-selected walking speed (SWS) without HWA at pre- and 5 weeks after TKA were measured by using 3-dimensional (3D) gait analysis. The patient completed a total of 18 gait training interventions with HWA without any adverse complications such as knee pain and skin injury. The postoperative knee extension range of motion (ROM), knee extension torque, SWS, and maximum walking speed were remarkably improved. Regarding gait kinematic parameters, though this patient had a characteristic gait pattern with decreased knee ROM (called stiff knee gait) preoperatively, the knee flexion angle at 5 weeks after TKA showed knee flexion movement at loading response phase (LR; called double knee action), increased knee ROM during gait, and increased knee flexion angle at swing phase. In this case, the gait training using HWA was safe and feasible, and could be effective for the early improvement of gait ability, hip function, and gait pattern after TKA.

scholarly journals Progression of Fatigue Modifies Primary Contributors to Ground Reaction Forces During Drop Landing

2021 ◽  
Vol 76 (1) ◽  
pp. 161-173
Author(s):  
Qiang Zhang ◽  
Mianfang Ruan ◽  
Navrag B. Singh ◽  
Lingyan Huang ◽  
Xin Zhang ◽  
...  
Keyword(s):  
Knee Joint ◽  
Ground Reaction Force ◽  
Knee Flexion ◽  
Reaction Force ◽  
Joint Stiffness ◽  
Knee Flexion Angle ◽  
Vertical Ground Reaction Force ◽  
Severe Fatigue ◽  
Peak Knee ◽  
Vertical Ground

Abstract Few studies have focused on the effect of fatigue severity on landing strategy. This study aimed to investigate the effect of fatigue progression on ground reaction force during landing. Eighteen participants performed a fatigue exercise protocol. Then participants performed drop landings at three levels of fatigue: no fatigue, medium fatigue, and severe fatigue. Multiple linear regression was conducted to identify the predictors of the peak vertical ground reaction force at each level of fatigue. Two-way ANOVAs were conducted to test the effect of fatigue on the vertical ground reaction force and the predictors. For the vertical ground reaction force, the knee joint stiffness and the knee angle at initial contact were the main predictors at no fatigue. The peak knee flexion angle and knee power were the main predictors at medium fatigue. However, the peak ankle plantarflexion moments became the main predictor at severe fatigue. The vertical ground reaction force decreased from no to medium fatigue (p = 0.001), and then increased from medium to severe fatigue (p = 0.034). The knee joint stiffness decreased from no to medium fatigue (p = 0.049), and then remained unchanged from medium to severe fatigue. The peak knee flexion angle increased from no to medium fatigue (p = 0.001), and then slightly decreased from medium to severe fatigue (p = 0.051). The results indicate that fatigue progression causes a transition from stiff to soft landing, and then to stiff landing. Participants used ankle joints more to control the landing intensity at severe fatigue.

scholarly journals Subclinical gait disturbance and postoperative gait improvement in patients with degenerative cervical myelopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dong-Ho Lee ◽  
Jong Yoon Yoo ◽  
Jae Hwan Cho ◽  
Chang Ju Hwang ◽  
Choon Sung Lee ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Cervical Myelopathy ◽  
Knee Flexion ◽  
Three Dimensional ◽  
Gait Disturbance ◽  
Flexion Angle ◽  
Assistive Device ◽  
Knee Flexion Angle ◽  
Gait Abnormalities ◽  
Degenerative Cervical Myelopathy

AbstractThis study aimed to evaluate the subclinical gait abnormalities and the postoperative gait improvements in patients with degenerative cervical myelopathy using three-dimensional gait analysis. We reviewed the gait analysis of 62 patients who underwent surgical treatment for degenerative cervical myelopathy. The asymptomatic gait group included 30 patients and the gait disturbance group included 32 patients who can walk on their own slowly or need assistive device on stairs. The step width (17.2 cm vs. 15.9 cm, P = 0.003), stride length (105.2 cm vs. 109.1 cm, P = 0.015), and double-limb support duration (13.4% vs. 11.7%, P = 0.027) improved only in the asymptomatic gait group. Preoperatively, the asymptomatic gait group exhibited better maximum knee flexion angle (60.5° vs. 54.8°, P = 0.001) and ankle plantarflexion angle at push-off (− 12.2° vs. − 6.5°, P = 0.001) compared to the gait disturbance group. Postoperatively, maximum knee flexion angle (62.3° vs. 58.2°, P = 0.004) and ankle plantarflexion angle at push-off (− 12.8° vs. − 8.3°, P = 0.002) were still better in the asymptomatic gait group, although both parameters improved in the gait disturbance group (P = 0.005, 0.039, respectively). Kinematic parameters could improve in patients with gait disturbance. However, temporospatial parameters improvement may be expected when the operative treatment is performed before apparent gait disturbance.

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