Does decrease of the thoracic kyphosis influence decrease knee adduction moment during gait? A preliminary study of a healthy population

Ota, Susumu; Kano, Rika; Fukuta, Shoya; Miyai, Ryo; Masaoka, Nao; Yoshida, Akihiro

doi:10.1589/jpts.27.3077

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…The Nanba gait might decrease pelvic excursion, although this was not examined in the present study. The high trunk muscle activation might be similar to the draw-in maneuver gait, a gait that also reduces the KAM [ 34 ]. Regarding Gmed activation, Chang et al [ 35 ] reported that hip abduction weakness in the stance limb shifts the center of the body mass toward the swing limb, and this shift increases the KAM due to an increase in the lever arm length.…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults

et al. 2017

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The knee adduction moment (KAM) relates to medial knee osteoarthritis (OA). Several gait modifications to reduce the KAM for the prevention of knee OA have been studied. Most of the modifications, however, involve voluntary changes in leg alignment. Here we investigated the biomechanical effects for reducing the KAM of a walking style with a small trunk rotation and arm swing gait, which is a natural walking style used while wearing a kimono (Nanba walk) that shifts the ground reaction force toward the stance leg (reduced lever arm). Twenty-nine healthy adults (21.5 ± 0.6 years) participated in the present study. A three-dimensional analysis system with 10 cameras and 1 force plate was used to obtain the KAM and other biomechanical data. Surface electromyography (EMG) of the hip and trunk muscles (internal obliquus abdominal muscle: IO, external obliquus abdominal muscle: EO, multifidus muscle: MF, and gluteus medius muscle: Gmed) was also assessed, and integrated EMG (iEMG) of the four muscles was assessed in the first and second halves of the stance phase. The 1st and 2nd peak KAMs were significantly decreased during Nanba walking (0.40±0.09 and 0.37±0.13 Nm/kg) compared with normal walking (0.45±0.09 and 0.45±0.13 Nm/kg; P = 0.002, P<0.001, respectively). The lever arm lengths at the 1st and 2nd peak KAMs were also significantly decreased during Nanba walking compared with normal walking (p = 0.023 and p<0.001, respectively). The iEMGs of IO, EO and Gmed muscles during the first half, and the iEMGs of EO and GM during the second half of the stance phase were significantly increased during Nanba walking compared with normal walking. The Nanba gait modification could be a useful strategy for reducing the KAM with high activation of the trunk and hip joint muscles for the prevention and/or treatment of medial knee OA.

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Section: Discussionmentioning

confidence: 99%

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults

et al. 2017

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“…A gait modification that requires no voluntary alignment change is the draw-in maneuver (DI), which is reported to improve thoracic kyphosis and reduce the KAM 17) . In the DI maneuver, participants are asked to bring their belly button up and toward the spine as they exhale, thereby contracting the abdominal muscles and increasing stability 18) .…”

Section: Introductionmentioning

confidence: 99%

“…In the DI maneuver, participants are asked to bring their belly button up and toward the spine as they exhale, thereby contracting the abdominal muscles and increasing stability 18) . Ota et al 17) reported that the KAM in a healthy population was significantly reduced by walking with a DI maneuver (DI gait) in which the thoracic kyphosis angle is decreased as measured in a standing position while performing the DI maneuver. The authors considered that insufficient instruction for the DI gait, i.e., a simple verbal command to "decrease the abdominal circumference", was a limitation of previous studies 17) .…”

Section: Introductionmentioning

confidence: 99%

“…Ota et al 17) reported that the KAM in a healthy population was significantly reduced by walking with a DI maneuver (DI gait) in which the thoracic kyphosis angle is decreased as measured in a standing position while performing the DI maneuver. The authors considered that insufficient instruction for the DI gait, i.e., a simple verbal command to "decrease the abdominal circumference", was a limitation of previous studies 17) . Therefore, proper instruction regarding the DI maneuver and confirmation of the activities of the abdominal and paravertebral muscles are necessary for studying the effects of the DI gait 19) .…”

Section: Introductionmentioning

confidence: 99%

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Effects of walking with a “draw-in maneuver” on the knee adduction moment and hip muscle activity

et al. 2021

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To investigate the effect of performing a draw-in maneuver (DI) on knee adduction moment (KAM) and hip and trunk muscle activities while walking. [Participants and Methods] We included 30 healthy young adults (21.5 ± 0.6 years, 16 males and 14 females) in this study. We measured the KAM and lever arm while participants walked with either a normal gait or a DI gait. We also performed surface electromyography (EMG) of the hip and trunk muscles (i.e., internal oblique abdominal muscle [IO], external oblique abdominal muscle [EO], multifidus muscle [MF], and gluteus medius muscle [GM]). [Results] The 1st peak of the KAM was significantly lower when walking with a DI gait compared to when walking with a normal gait. The integrated EMG activity of the IO, EO, and GM during the 1st half of the stance phase, and of the IO and EO during the 2nd half of the stance phase was significantly higher during the DI than during normal gait. [Conclusion] Compared with a normal gait, a DI gait leads to a decrease in the 1st peak of the KAM as a result of the shorter lever arm, and an increase in the muscular activity of the GM, IO, and EO.

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“…The external knee adduction moment (KAM) during walking is used as a surrogate for load on the knee joint 1 ) , and its association with knee osteoarthritis (OA) has been discussed in many previous studies 2 , 3 , 4 , 5 , 6 ) . Miyazaki et al examined the relationship between KAM at baseline and the progression of knee OA at a 6 year follow up in patients with medial compartment knee OA, and concluded that KAM could predict radiographic OA progression 7 ) .…”

Section: Introductionmentioning

confidence: 99%

The relationship between the load on the knee joint during walking and the biomechanical characteristics of single-leg standing

et al. 2016

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[Purpose] The purpose of the present study was to investigate the relationship between the external knee adduction moment (KAM) during walking and the biomechanical characteristics of single-leg standing in healthy subjects. [Subjects and Methods] Twenty-eight healthy subjects were recruited for this study. Data were collected while the subjects performed walking and single-leg standing using a motion analysis system with six digital video cameras and two force plates. Pearson’s correlation coefficient was used to quantify the relationship between peak KAM during walking and single-leg standing. To determine whether the kinematic behavior of the pelvis and trunk during single-leg standing are associated with peak KAM during walking, Pearson’s correlation coefficients were calculated and stepwise linear regression was performed. [Results] The peak KAM during single-leg standing was significantly correlated with that during walking. The peak KAM during walking was significantly correlated with the peak lateral lean of the trunk and the peak lateral tilt of the pelvis during single-leg standing. The results of stepwise linear regression analysis show the peak KAM during walking was partially explained by the peak lateral lean of the trunk during single-leg standing. [Conclusion] Our findings suggest that single-leg standing might be a useful method for predicting the peak KAM during walking.

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Does decrease of the thoracic kyphosis influence decrease knee adduction moment during gait? A preliminary study of a healthy population

Cited by 8 publications

References 17 publications

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults

Effects of walking with a “draw-in maneuver” on the knee adduction moment and hip muscle activity

The relationship between the load on the knee joint during walking and the biomechanical characteristics of single-leg standing

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