Acute effects of lateral shoe wedges on joint biomechanics of patients with medial compartment knee osteoarthritis during stationary cycling

Gardner, Jacob K.; Klipple, Gary; Stewart, Candice; Asif, Irfan M.; Zhang, Songning

doi:10.1016/j.jbiomech.2016.06.016

Cited by 16 publications

(13 citation statements)

References 37 publications

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“…In clinical practice, stationary cycling exercise is often suggested to be beneficial for improving joint stiffness, as the mode of stationary cycling exercise involves repeated flexion and extension of the knee joint. 28,29 However, results here showed that both the stiffness sub-scale of the Western Ontario and McMaster Universities Osteoarthritis Index and the symptoms sub-scale of the Knee Injury and Osteoarthritis Score gains were less than their respective minimal clinically important difference values, of 16.24 and 5.38. 21,22 Most of the studies included in the review involved trials that incorporated an exercise program with a comprehensive duration, of eight to twelve weeks, where changes in physical function due to neuromuscular adaptation would be achievable.…”

Section: Discussioncontrasting

confidence: 55%

“…14,33,34 (2) The nature of stationary cycling, being a closed chain activity with constraints on the movement produced in the lower limbs, may mean that it does not develop physical function in a way that promotes balance and coordination effectively. 24,29,35 (3) In addition, compared to other outdoor and group exercise activities, stationary cycling may not promote emotional management and engagement with the environment outdoors. [36][37][38] Intervention with stationary cycling exercise did not show effects that were either superior or inferior to those from other exercises used in the management of individuals with knee osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

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Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

Luan¹,

Bousie

Pranata

et al. 2020

Clin Rehabil

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Objective: To evaluate effects of stationary cycling exercise on pain, function and stiffness in individuals with knee osteoarthritis. Data sources: Systematic search conducted in seven databases (PubMed, Embase, Cochrane Library, Web of Science, EBSCO, PEDro, and CNKI) from inception to September 2020. Review methods: Included studies were randomized-controlled trials involving stationary cycling exercise conducted on individuals with knee osteoarthritis. End-trial weighted mean difference (WMD) and 95% confidence interval (CI) were analyzed, and random-effects models were used. Methodological quality and risk bias were assessed by using the Physiotherapy Evidence Database scale and Cochrane Collaboration tool, respectively. Results: Eleven studies with 724 participants were found, of which the final meta-analysis was performed with eight. Compared to a control (no exercise), stationary cycling exercise resulted in reduced pain (WMD 12.86, 95% CI 6.90–18.81) and improved sport performance (WMD 8.06, 95% CI 0.92–15.20); although most of the meta-analysis results were statistically significant, improvements in stiffness (WMD 11.47, 95% CI 4.69–18.25), function (WMD 8.28, 95% CI 2.44–14.11), symptoms (WMD 4.15, 95% CI −1.87 to 10.18), daily living (WMD 6.43, 95% CI 3.19 to 9.66) and quality of life (WMD 0.99, 95% CI −4.27 to 6.25) for individuals with knee osteoarthritis were not greater than the minimal clinically important difference values for each of these outcome measures. Conclusions: Stationary cycling exercise relieves pain and improves sport function in individuals with knee osteoarthritis, but may not be as clinically effective for improving stiffness, daily activity, and quality of life.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

Luan¹,

Bousie

Pranata

et al. 2020

Clin Rehabil

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“…The saddle position is often selected based on comfort. An improper position can lead to knee joint overuse injuries [ 2 , 35 , 37 – 39 ] and inconsistent kinematics. Numerous methods have been proposed to determine the appropriate saddle height configuration [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Stationary cycling is commonly recommended for individuals with various disabilities, such as knee osteoarthritis and compromised function of the joints following surgeries like anterior cruciate ligament (ACL) reconstruction and total hip arthroplasty. Cycling reduces the load on the knee joint [ 2 , 3 ] and ACL [ 4 – 7 ]; the tibiofemoral compressive forces during cycling are between 0.3 and 2 times the body weight, while other full weight-bearing rehabilitative exercises (e.g., walking, stair ascent/descent) generate forces of approximately 2–4 times the body weight [ 4 , 8 – 10 ]. The patellofemoral compressive force [ 9 , 11 ], shear stress [ 12 ], tibiofemoral shear force [ 13 , 14 ], and ACL strain [ 9 , 11 , 15 , 16 ] are low during cycling; nevertheless, the quadriceps and hamstring muscles are strengthened as the knee stability increases [ 7 , 12 , 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Cycling kinematics in healthy adults for musculoskeletal rehabilitation guidance

Yum

Kim

Lee

et al. 2021

BMC Musculoskelet Disord

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Background Stationary cycling is commonly used for postoperative rehabilitation of physical disabilities; however, few studies have focused on the three-dimensional (3D) kinematics of rehabilitation. This study aimed to elucidate the three-dimensional lower limb kinematics of people with healthy musculoskeletal function and the effect of sex and age on kinematics using a controlled bicycle configuration. Methods Thirty-one healthy adults participated in the study. The position of the stationary cycle was standardized using the LeMond method by setting the saddle height to 85.5% of the participant’s inseam. The participants maintained a pedaling rate of 10–12 km/h, and the average value of three successive cycles of the right leg was used for analysis. The pelvis, hip, knee, and ankle joint motions during cycling were evaluated in the sagittal, coronal, and transverse planes. Kinematic data were normalized to 0–100% of the cycling cycle. The Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, and k-fold cross-validation were used to analyze the data. Results In the sagittal plane, the cycling ranges of motion (ROMs) were 1.6° (pelvis), 43.9° (hip), 75.2° (knee), and 26.9° (ankle). The coronal plane movement was observed in all joints, and the specific ROMs were 6.6° (knee) and 5.8° (ankle). There was significant internal and external rotation of the hip (ROM: 11.6°), knee (ROM: 6.6°), and ankle (ROM: 10.3°) during cycling. There was no difference in kinematic data of the pelvis, hip, knee, and ankle between the sexes (p = 0.12 to 0.95) and between different age groups (p = 0.11 to 0.96) in all anatomical planes. Conclusions The kinematic results support the view that cycling is highly beneficial for comprehensive musculoskeletal rehabilitation. These results might help clinicians set a target of recovery ROM based on healthy and non-elite individuals and issue suitable guidelines to patients.

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“…Marker position data were filtered at 4 Hz using a 4th order Butterworth filter (Elmer et al 2011;Gardner et al 2016;Shen et al 2018). For the no spacer experimental condition, we first cropped the trial to include 4 cycles of data.…”

Section: Discussionmentioning

confidence: 99%

Effect of Q-factor manipulation via pedal spacers on lower limb frontal plane kinematics during cycling

Fife¹,

Buddhadev

Suprak³

et al. 2020

J Sci Cycling

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Anecdotal evidence suggests that frontal plane kinematics of the lower extremity are an important aspect of bicycle fit, however, frontal plane adjustments are often overlooked during common fitting procedures. The purpose of this study was to manipulate Q-factor width via pedal spacers to determine their influence on frontal plane kinematics of the hip, knee, and ankle during cycling. Twenty-four young healthy recreational cyclists (12 female) completed five minutes of pedaling at their preferred cadence and power output under three stance widths conditions: no spacer, 20 mm spacer, and 30 mm spacer. For each participant, the pedaling cadence and power output were kept identical for all experimental conditions. Lower extremity marker position data were captured at 250 Hz for the last two minutes of each condition. Sixty consecutive crank cycles were analyzed to identify maximum and minimum hip, knee, and ankle angles in the frontal plane. With an increase in Q-factor, hip and knee maximum abduction angles increased and maximum adduction angles decreased. With increase in Q-factor from no spacer to 20 mm spacer condition, hip abduction increased by 0.8o (∆10%; p<0.001) whereas hip abduction decreased by 0.9o (∆23%; p<0.001) and similarly, knee abduction increased by 1.2o (∆60%; p=0.002) whereas knee abduction decreased by 1.1o (∆18%; p=0.003). And with increase in Q-factor from no spacer to 30 mm spacer condition, hip abduction increased by 1.4o (∆18%; p<0.001) and hip adduction decreased by 1.6o (∆40%; p<0.001) and similarly, knee abduction increased by 1.8o (∆86%; p<0.001) and knee adduction decreased by 2.1o (∆35%; p<0.001). Maximum and minimum ankle angles were not affected by the stance width conditions (p>0.05). Pedal spacers are an effective way of manipulating Q-factor and frontal plane kinematics of the hip and knee and could help cyclists experiencing medial or lateral knee pain.

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Acute effects of lateral shoe wedges on joint biomechanics of patients with medial compartment knee osteoarthritis during stationary cycling

Cited by 16 publications

References 37 publications

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

Cycling kinematics in healthy adults for musculoskeletal rehabilitation guidance

Effect of Q-factor manipulation via pedal spacers on lower limb frontal plane kinematics during cycling

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