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.

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.

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 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.

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.

Effects of Medial Thrust Gait on Lower Extremity Kinetics in Patients with Knee Osteoarthritis

2021 ◽  
Vol 23 (2) ◽  
pp. 115-120
Author(s):  
Hamid Reza Bokaeian ◽  
Fateme Esfandiarpour ◽  
Shahla Zahednejad ◽  
Hossein Kouhzad Mohammadi ◽  
Farzam Farahmand
Keyword(s):  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Gait Pattern ◽  
Mean Difference ◽  
Knee Adduction Moment ◽  
Camera Motion ◽  
Normal Gait ◽  
Significant Difference

Background. Medial thrust (MT) gait is a nonsurgical approach for reducing the knee adduction moment (KAM) in patients with knee osteoarthritis. However, its usefulness is indeterminate due to scarcity of research about changes in lower extremity kinetics and the ground reaction force (GRF) which have been investigated in this study. Materials and methods. Twenty patients (6 males, 14 females, age: 56.2±6.2 years) with medial knee osteo­arthritis participated in this cross-sectional study. A 12-camera motion analysis system and two force plates recorded kinematic and GRF data while participants walked barefoot along a 12m path with 1) their regular gait pattern and 2) MT gait pattern. The first peak adduction and flexion moments of the hip, knee, and ankle, and the sagittal and frontal GRF were measured. The center of pressure (CoP) location in the mediolateral direction at first KAM peak was also determined. Results. MT gait significantly reduced the first KAM peak (mean difference= 169.7, p<0.001) and the hip flexion moment (mean difference: 82.6, p= 0.020) compared to normal gait. The mediolateral CoP significantly shifted laterally during MT gait compared to normal gait (mean difference: -12% foot width, p<0.001). There was no significant difference in other kinetics variables between the two gait patterns (p>0.05). Conclusions. 1. Our findings show that MT gait can reduce the KAM with no significant increase in the GRF and other lower extremity moments. 2. The results suggest that the reduced KAM associated with MT gait is caused by a lateral shift of the CoP, resulting in a reduced GRF moment arm.

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 Progressive Changes in Walking Kinematics and Kinetics After Anterior Cruciate Ligament Injury and Reconstruction: A Review and Meta-Analysis

2017 ◽  
Vol 52 (9) ◽  
pp. 847-860 ◽  
Author(s):  
Lindsay V. Slater ◽  
Joseph M. Hart ◽  
Adam R. Kelly ◽  
Christopher M. Kuenze
Keyword(s):  
Lower Extremity ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Flexion Angle ◽  
Knee Adduction Moment ◽  
Control Group ◽  
Knee Flexion Angle ◽  
Peak Knee ◽  
Healthy Control

Context:  Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described. Objective:  To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR. Data Sources:  We searched PubMed and Web of Science from 1970 through 2013. Study Selection and Data Extraction:  We selected only articles that provided peak kinematic and kinetic values during walking in individuals with ACLD or ACLR and comparison with a healthy control group or the contralateral uninjured limb. Data Synthesis:  A total of 27 of 511 identified studies were included. Weighted means, pooled standard deviations, and 95% confidence intervals were calculated for the healthy control, ACLD, and ACLR groups at each reported time since surgery. The magnitude of between-groups (ACLR versus ACLD, control, or contralateral limb) differences at each time point was evaluated using Cohen d effect sizes and associated 95% confidence intervals. Peak knee-flexion angle (Cohen d = −0.41) and external knee-extensor moment (Cohen d = −0.68) were smaller in the ACLD than in the healthy control group. Peak knee-flexion angle (Cohen d range = −0.78 to −1.23) and external knee-extensor moment (Cohen d range = −1.39 to −2.16) were smaller in the ACLR group from 10 to 40 months after ACLR. Reductions in external knee-adduction moment (Cohen d range = −0.50 to −1.23) were present from 9 to 42 months after ACLR. Conclusions:  Reductions in peak knee-flexion angle, external knee-flexion moment, and external knee-adduction moment were present in the ACLD and ACLR groups. This movement profile during the loading phase of gait has been linked to knee-cartilage degeneration and may contribute to the development of osteoarthritis after ACLR.

Single-Leg Drop Jump Biomechanics After Ankle or Knee Joint Cooling in Healthy Young Adults

2021 ◽  
pp. 1-8
Author(s):  
Jihong Park ◽  
Kyeongtak Song ◽  
Sae Yong Lee
Keyword(s):  
Angular Velocity ◽  
Knee Joint ◽  
Lower Extremity ◽  
Knee Flexion ◽  
Reaction Force ◽  
Drop Jump ◽  
Vertical Ground Reaction Force ◽  
Time To Peak ◽  
Peak Knee ◽  
Vertical Ground

Context: It is unclear if lower-extremity joint cooling alters biomechanics during a functional movement. Objective: To investigate the effects of unilateral lower-extremity cryotherapy on movement alterations during a single-leg drop jump. Design: A crossover design. Setting: Laboratory. Patients: Twenty healthy subjects (10 males and 10 females; 23 y, 169 cm, 66 kg). Intervention(s): Subjects completed a single-leg drop jump before and after a 20-minute ankle or knee joint cooling on the right leg, or control (seated without cooling) on 3 separate days. Main Outcome Measures: Time to peak knee flexion, vertical ground reaction force, lower-extremity joint angular velocity (sagittal plane only), and angle and moment (sagittal and frontal planes) in the involved leg over the entire ground contact (GC; from initial contact to jump-off) during the first landing. Time to peak knee flexion was compared using an analysis of variance; the rest of the outcome measures were analyzed using functional analyses of variance (P < .05). Results: Neither joint cooling condition changed the time to peak knee flexion (F2,95 = 0.73, P = .49). Ankle joint cooling reduced vertical ground reaction force (55 N at 4% of GC), knee joint angular velocity (44°/s during 5%–9% of GC), and knee varus moment (181 N·m during 18%–20% of GC). Knee joint cooling resulted in a reduction in knee joint angular velocity (24°/s during 37%–40% of GC) and hip adduction moment (151 N·m during 46%–48% of GC), and an increase in hip joint angular velocity (16°/s during 49%–53% of GC) and plantarflexion angle (1.5° during 11%–29% of GC). Conclusion: Resuming activity immediately after lower-extremity joint cooling does not seem to predispose an individual to injury during landing because altered mechanics are neither overlapping with the injury time period nor of sufficient magnitude to lead to an injury.

7. Frontal Plane Knee Loading during Bodyweight Squat Performance: Effects of Stance Width and Foot Rotation

2016 ◽  
Author(s):  
David Kingston
Keyword(s):  
Body Weight ◽  
Knee Joint ◽  
Repeated Measures ◽  
Inverse Dynamics ◽  
Exercise Prescription ◽  
Reaction Force ◽  
Frontal Plane ◽  
The Body ◽  
Knee Adduction Moment ◽  
Squat Exercise

The bodyweight squat is routinely used for conditioning of the knee musculature. In the performance of this exercise, modifications in the initial standing position may result in altered frontal plane kneel loading, and hence may potentially be used for targeted exercise prescription. The purpose of this study is to quantify the frontal plane mechanical loading on the knee joint whilst performing the bodyweight squat exercise, and to examine the effects of varying stance width and foot rotation angle. Twenty-four participants (14 males) performed 4 randomized sets of 8 repetitions of the body weight resistant squat exercise in the following conditions: 1) Shoulder width (SW) stance with parallel feet; 2) SW stance with feet externally rotated 30°; 3) 140% SW stance with parallel feet, and; 4) 140% SW stance with the feet externally rotated by 30°. The adduction/abduction knee joint moment experienced across conditions was calculated using inverse dynamics procedures. Moment waveforms were subjected to Principal Component (PC) analysis, with 3 PC’s retained based on a 90% trace criteria. Following, a 1-way repeated measures ANOVA and pair wise comparisons were used to discern differences between conditions. Omnibus test results indicate significant differences across conditions for PC1 and PC2 (p<0.01), Post hoc comparisons and waveform interpretation of PC1 extreme scores showed that the magnitude of the adduction moment was higher throughout the movement in the foot rotated conditions vs. the parallel feet conditions in both stance widths (mean Z scores .69 & .65 vs. -.88 & -.45, p<0.01, respectively). For PC2, significant differences were found between the 2 parallel feet conditions and the 2 foot rotated conditions, as well as between the foot conditions in the wide stance squats. PC2 differences were interpreted as phase shift operators. We found that modification of foot rotation slightly alters the magnitude and timing of knee adduction moment component during performance of the body weight squat. The observed magnitude differences are presumably a consequence of alteration in the location of the point of application of the ground reaction force during the initial standing posture. The findings may assist clinicians in exercise prescription decision making.

Effect of Different Insole Materials on Kinetic and Kinematic Variables of the Walking Gait in Healthy People

2018 ◽  
Vol 108 (5) ◽  
pp. 390-396 ◽  
Author(s):  
Ramadan Özmanevra ◽  
Salih Angin ◽  
İzge H. Günal ◽  
Ata Elvan
Keyword(s):  
Repeated Measures ◽  
Knee Flexion ◽  
Reaction Force ◽  
Three Dimensional ◽  
Ankle Dorsiflexion ◽  
Healthy People ◽  
Walking Gait ◽  
System A ◽  
Significant Difference ◽  
Analysis System

Background: There is a lack of data that could address the effects of off-the-shelf insoles on gait variables in healthy people. Methods: Thirty-three healthy volunteers ranging in age from 18 to 35 years were included to this study. Kinematic and kinetic data were obtained in barefoot, shoe-only, steel insole, silicone insole, and polyurethane insole conditions using an optoelectronic three-dimensional motion analysis system. A repeated measures analysis of variance test was used to identify statistically significant differences between insole conditions. The alpha level was set at P &lt; .05 Results: Maximum knee flexion was higher in the steel insole condition (P &lt; .0001) compared with the silicone insole (P = .001) and shoe-only conditions (P = .032). Reduced maximum knee flexion was recorded in the polyurethane insole condition compared with the shoe-only condition (P = .031). Maximum knee flexion measured in the steel insole condition was higher compared to the barefoot condition (P = .020). Higher maximum ankle dorsiflexion was observed in the barefoot condition, and there were significant differences between the polyurethane insole (P &lt; .0001), silicone insole (P = .001), steel insole (P = .002), and shoe conditions (P = .004). Least and highest maximum ankle plantarflexion were detected in the steel insole and silicone insole conditions, respectively. Maximum ankle plantarflexion in the barefoot and steel insole conditions (P = .014) and the barefoot and polyurethane insole conditions (P = .035) were significant. There was no significant difference between conditions for ground reaction force or joint moments. Conclusions: Insoles made by different materials affect maximum knee flexion, maximum ankle dorsiflexion, and maximum ankle plantarflexion. This may be helpful during the decision-making process when selecting the insole material for any pathological conditions that require insole prescription.

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