Foot progression angle and the knee adduction moment: a cross-sectional investigation in knee osteoarthritis

Rutherford, Derek; Hubley‐Kozey, Cheryl L.; Deluzio, Kevin J.; Stanish, William D.; Dunbar, Michael J.

doi:10.1016/j.joca.2007.11.012

Cited by 93 publications

(85 citation statements)

References 44 publications

(80 reference statements)

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“…So far solely gait analysis studies considered the FPA, but no studies dealing with dynamic movements such as jumps, have focused on the FPA as a central parameter inXuencing joint and motor control. During walking the FPA eVects lower extremity's joint moments (Guo et al 2007;Lynn and Costigan 2008;Rutherford et al 2008), ankle joint angles (Ho et al 2000), and muscle activation patterns (Lynn and Costigan 2008). In those studies dealing with gait analysis the FPA has primarily been observed as a parameter inXuencing knee joint moments, whereas a more exorotated foot reduces frontal knee peak joint moments, and thus minimizes knee loading compared to an internal rotated FPA (Andrews et al 1996;Guo et al 2007, Lynn andCostigan 2008;Rutherford et al 2008).…”

Section: The Fpa a Central Parameter Regulating Lateral Stretch Loadsmentioning

confidence: 99%

Load-dependent movement regulation of lateral stretch shortening cycle jumps

et al. 2010

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The classical stretch shortening cycle (SSC) describes sagittal joint flexion-extensions in motions like running or hopping. However, lateral movements are integral components of team sports and are associated with frontal plane joint displacements. The purpose of this study is to identify neuromuscular and kinematical mechanisms determining motor control and performance of reactive laterally conducted SSCs. Lateral jumps were performed from four distances in order to investigate the influence of lateral stretch loads on the lower extremity. Electromyographic (EMG) data of nine lower extremity muscles were collected. Foot, ankle, knee, and hip kinematics were recorded by 3-D motion analysis. High stretch loads were characterized by a greater foot exorotation during the initial phase of contact. In the sagittal plane knee and hip joint, displacements increased, whereas in the frontal plane only the hip joint displacement was significantly raised. In particular, frontal peak joint moments increased with stretch load. Thigh muscles' mean pre-activity amplitude was enhanced. It was possible to detect stretch reflexes in the thigh muscles, whereas in particular the short-latency reflex (SLR) was stretch load-dependently modulated. The results of the present study suggest that the foot exorotation seems to play a decisive role in the movement control of lateral jumps. The association between exorotation and increased sagittal joint displacements may be seen as a compensation strategy to shift load from the frontal to the sagittal plane. Lateral load compensation seems to strongly depend on upper leg's kinematic and neuromuscular adjustments, rather than on the ankle joint complex.

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Section: The Fpa a Central Parameter Regulating Lateral Stretch Loadsmentioning

confidence: 99%

Load-dependent movement regulation of lateral stretch shortening cycle jumps

et al. 2010

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“…Gait compensations can be described as the tendency of patients to compensate for localized pain and pathology by adopting probable automatic gait modifications (6). Gait patterns that alter knee joint loads or are related to pain have recently engendered particular interest, especially toe-out angle (7)(8)(9)(10)(11)(12)(13), trunk lean toward the stance leg (14 -19), and associated pelvic obliquity (15,16,20). These gait patterns are correlated with the external knee adduction moment about the knee (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Bechard

Birmingham

Zečević

et al. 2012

Arthritis Care & Research

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Objective. To compare the time-varying behavior of maximum toe-out angle, lateral trunk lean (over the stance leg), and pelvic obliquity (rise and drop on the swing leg) during prolonged walking in participants with and without medial compartment knee osteoarthritis (OA), and to explore correlations between these gait characteristics and pain. Methods. Twenty patients with knee OA and 20 healthy controls completed 30 minutes of treadmill walking. Toe-out, trunk lean, pelvic obliquity, and pain were measured at 5-minute intervals. Results. The mean ؎ SD toe-out angle was significantly smaller (P ‫؍‬ 0.04) in patients with knee OA (6.7 ؎ 2.5 degrees) than in controls (10.3 ؎ 2.2 degrees). Toe-out changed significantly over time (P ‫؍‬ 0.002), but not in a systematic way, and there was no interaction between group and time. The mean ؎ SD trunk lean was higher (P ‫؍‬ 0.03) in patients with knee OA (2.0 ؎ 1.0 degrees) than in controls (0.7 ؎ 0.5 degrees). Trunk lean did not change over time and there was no interaction between group and time. There were no differences for pelvic drop. The mean ؎ SD pelvic rise was higher (P ‫؍‬ 0.01) in patients with knee OA (2.8 ؎ 0.9 degrees) than in controls (1.2 ؎ 0.8 degrees), but did not change over time and there was no interaction. Patients experienced a small increase in pain (P < 0.001). Trunk lean and pelvic drop were correlated with pain (r ‫؍‬ 0.49, P ‫؍‬ 0.03 and r ‫؍‬ 0.47, P ‫؍‬ 0.04, respectively). Conclusion. Toe-out and trunk lean are consistently different between individuals with and without medial compartment knee OA during prolonged walking, and patients with greater pain have greater trunk lean. However, over 30 minutes of walking, these gait characteristics remain quite stable, suggesting they are not acute compensatory mechanisms in response to repetitive loading with subtle increases in pain.

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“…The KAdM reflects the distribution of load transferred through the medial versus the lateral compartment of the tibiofemoral joint [5,12]. In studies identifying the severity of knee OA and evaluating progression and therapy, the KAdM has often been used as an outcome measure [5,17,26,34,40,41,43].…”

mentioning

confidence: 99%

Influence of the instrumented force shoe on gait pattern in patients with osteoarthritis of the knee

Noort

Esch

Steultjens

et al. 2011

Med Biol Eng Comput

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Osteoarthritis (OA) of the knee is associated with alterations in gait. As an alternative to force plates, instrumented force shoes (IFSs) can be used to measure ground reaction forces. This study evaluated the influence of IFS on gait pattern in patients with knee OA. Twenty patients with knee OA walked in a gait laboratory on IFS and control shoes (CSs). An optoelectronic system and force plate were used to perform 3D gait analyses. A comparison of temporalspatial gait parameters, kinematics, and kinetics was made between IFS and CS. Patients wearing IFS showed a decrease in walking velocity and cadence (8%), unchanged stride length, an increase in stance time (13%), stride time (11%) and step width (14%). No differences were found in knee adduction moment or knee kinematics. Small differences were found in foot and ankle kinematics (2-5°), knee transverse moments (5%), ankle frontal (3%) and sagittal moments (1%) and ground reaction force (1-6%). The gait of patients with knee OA was only mildly influenced by the IFS, due to increased shoe height and weight and a change in sole stiffness. The changes were small compared to normal variation and clinically relevant differences. Importantly, in OA patients no effect was found on the knee adduction moment.

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Foot progression angle and the knee adduction moment: a cross-sectional investigation in knee osteoarthritis

Cited by 93 publications

References 44 publications

Load-dependent movement regulation of lateral stretch shortening cycle jumps

Load-dependent movement regulation of lateral stretch shortening cycle jumps

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Influence of the instrumented force shoe on gait pattern in patients with osteoarthritis of the knee

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