Differences in causes of stiff knee gait in knee extensor activity or ankle kinematics: A cross-sectional study

Fujita, Kazuki; Tsushima, Yuichi; Hayashi, Kôji; Kawabata, Kaori; Sato, Mahito; Kobayashi, Yasutaka

doi:10.1016/j.gaitpost.2022.09.078

Cited by 7 publications

(4 citation statements)

References 31 publications

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“…hip circumduction), a frequently observed gait deviation during the swing phase, could be the direct effect of impaired motor control of knee extensors [36], but could also be a secondary compensation for reduced push-off power of ankle muscles [37]. In this population observed co-activation during the isolated leg-swinging task would indicate that this co-activation is inherent to their impairments rather than a compensatory strategy.…”

Section: Discussionmentioning

confidence: 72%

Quadriceps-hamstrings muscle co-activation during the swing phase of walking is modulated by task constraints in healthy adults

Van Can,

Houdijk,

Buurke

2024

Preprint

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Background: Muscle co-activation, the simultaneous activation of muscle groups, is a common strategy to stabilize walking. However, co-activation can also be the consequence of underlying neurological impairments. This complicates differentiation between functional and pathological co-activation during walking. To better understand and discern functional co-activation during walking, this study investigated the difference between quadriceps-hamstrings co-activation during the swing phase of walking and isolated leg-swinging in healthy adults. Methods: Twelve healthy young adults performed walking and isolated leg-swinging at slow (0.6 m/s) and comfortable speed. Electromyography signals from m. vastus lateralis, m. rectus femoris, m. biceps femoris, and m. semitendinosus were recorded. Co-activation index (CI) was calculated using Pearson correlation coefficient and area under the curve (AUC) and averaged to one quadriceps-hamstrings CI per metric. Results: The results showed a higher Pearson-CI during walking compared to isolated leg-swinging, specifically during mid- and terminal-swing at both speeds. AUC-CI, but not Pearson-CI was significantly different between the two speeds. Conclusion: Quadriceps-hamstrings co-activation towards the end of the swing phase during walking reflects preparation for heel-strike, which is not present in isolated leg-swinging. Therefore, an isolated leg-swinging task could serve as a feasible method to distinguish pathological from functional muscle co-activation during walking.

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Section: Discussionmentioning

confidence: 72%

Quadriceps-hamstrings muscle co-activation during the swing phase of walking is modulated by task constraints in healthy adults

Van Can,

Houdijk,

Buurke

2024

Preprint

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“…These changes included pelvis drop to the non-operated side coupled with lumber bending to the operated side during operated side single leg support (Figure 4), which is consistent with impaired hip abductor function (Supplementary Table S1) and a significantly reduced hip abduction moment in the operated leg following surgery (Figure 5). Fourth, the participant also exhibited post-surgery compensatory gait changes consistent with stiff knee gait (Fujita et al, 2022). The participant exhibited a hyperextended knee from mid to late stance phase (Figure 3A), producing a knee flexion moment rather than the expected knee extension moment.…”

Section: Discussionmentioning

confidence: 88%

Changes in walking function and neural control following pelvic cancer surgery with reconstruction

Li,

Ao,

Vega

et al. 2024

Front. Bioeng. Biotechnol.

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Introduction: Surgical planning and custom prosthesis design for pelvic cancer patients are challenging due to the unique clinical characteristics of each patient and the significant amount of pelvic bone and hip musculature often removed. Limb-sparing internal hemipelvectomy surgery with custom prosthesis reconstruction has become a viable option for this patient population. However, little is known about how post-surgery walking function and neural control change from pre-surgery conditions.Methods: This case study combined comprehensive walking data (video motion capture, ground reaction, and electromyography) with personalized neuromusculoskeletal computer models to provide a thorough assessment of pre- to post-surgery changes in walking function (ground reactions, joint motions, and joint moments) and neural control (muscle synergies) for a single pelvic sarcoma patient who received internal hemipelvectomy surgery with custom prosthesis reconstruction. Pre- and post-surgery walking function and neural control were quantified using pre- and post-surgery neuromusculoskeletal models, respectively, whose pelvic anatomy, joint functional axes, muscle-tendon properties, and muscle synergy controls were personalized using the participant’s pre-and post-surgery walking and imaging data. For the post-surgery model, virtual surgery was performed to emulate the implemented surgical decisions, including removal of hip muscles and implantation of a custom prosthesis with total hip replacement.Results: The participant’s post-surgery walking function was marked by a slower self-selected walking speed coupled with several compensatory mechanisms necessitated by lost or impaired hip muscle function, while the participant’s post-surgery neural control demonstrated a dramatic change in coordination strategy (as evidenced by modified time-invariant synergy vectors) with little change in recruitment timing (as evidenced by conserved time-varying synergy activations). Furthermore, the participant’s post-surgery muscle activations were fitted accurately using his pre-surgery synergy activations but fitted poorly using his pre-surgery synergy vectors.Discussion: These results provide valuable information about which aspects of post-surgery walking function could potentially be improved through modifications to surgical decisions, custom prosthesis design, or rehabilitation protocol, as well as how computational simulations could be formulated to predict post-surgery walking function reliably given a patient’s pre-surgery walking data and the planned surgical decisions and custom prosthesis design.

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“…5). Fourth, the subject also exhibited post-surgery compensatory gait changes consistent with stiff knee gait (Fujita et al, 2022). The subject exhibited a hyperextended knee from mid to late stance phase (Fig.…”

Section: Discussionmentioning

confidence: 99%

Changes in Walking Function and Neural Control following Pelvic Cancer Surgery with Reconstruction

Li,

Ao,

Vega

et al. 2024

Preprint

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Surgical planning and custom prosthesis design for pelvic cancer patients is challenging due to the unique clinical characteristics of each patient and the significant amount of pelvic bone and hip musculature often removed. Limb-sparing internal hemipelvectomy surgery with custom prosthesis reconstruction has become a viable option for this patient population. However, little is known about how post-surgery walking function and neural control change from pre-surgery conditions. This case study combined comprehensive human movement data collection with personalized neuromusculoskeletal computer modeling to provide a thorough assessment of pre-to post-surgery changes in walking function and neural control for a single pelvic sarcoma patient who received internal hemipelvectomy surgery with custom prosthesis reconstruction. Extensive walking data (video motion capture, ground reaction, and EMG) were collected from the patient before surgery and after plateau in recovery after surgery. Pre- and post-surgery personalized neuromusculoskeletal computer models of the patient were then constructed using the patient’s pre- and post-surgery walking data. These models were used to calculate the patient’s pre- and post-surgery joint motions, joint moments, and muscle synergies. The calculated muscle synergies were described by time-invariant synergy vectors and time-varying synergy activations, were consistent with the patient’s experimental EMG data, and produced the patient’s experimental joint moments found via inverse dynamics. The patient’s post-surgery walking function was marked by a slower self-selected walking speed coupled with several compensatory mechanisms necessitated by lost or impaired hip muscle function, while the patient’s post-surgery neural control demonstrated a dramatic change in coordination strategy (as evidenced by modified synergy vectors) with little change in recruitment timing (as evidenced by conserved synergy activations). Furthermore, the patient’s post-surgery muscle activations were fitted accurately using the patient’s pre-surgery synergy activations but poorly using the patient’s pre-surgery synergy vectors. These results provide valuable information about which aspects of post-surgery walking function could potentially be improved through modifications to surgical decisions, custom prosthesis design, or rehabilitation protocol, as well as how computational simulations could be formulated to predict post-surgery walking function reliably given a patient’s pre-surgery walking data and the planned surgical decisions and custom prosthesis design.

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Differences in causes of stiff knee gait in knee extensor activity or ankle kinematics: A cross-sectional study

Cited by 7 publications

References 31 publications

Quadriceps-hamstrings muscle co-activation during the swing phase of walking is modulated by task constraints in healthy adults

Quadriceps-hamstrings muscle co-activation during the swing phase of walking is modulated by task constraints in healthy adults

Changes in walking function and neural control following pelvic cancer surgery with reconstruction

Changes in Walking Function and Neural Control following Pelvic Cancer Surgery with Reconstruction

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