Knee adduction moment and medial knee contact force during gait in older people

Ogaya, Shinya; Naito, Hisashi; Iwata, Atsushi; Higuchi, Yoshio; Fuchioka, Satoshi; Tanaka, Masao

doi:10.1016/j.gaitpost.2014.04.205

Cited by 37 publications

(24 citation statements)

References 26 publications

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“…representing true MCF and LCFs. This is of great importance considering so many studies stray beyond simple linear scaling (Fregly 2007;Shull et al 2013a;Ogaya et al 2014;Miller et al 2015;van Den Noort et al 2015;Liu et al 2016;Richards et al 2017). Two of the main limitations of this study were the small sample size and not randomizing the order of gait alterations, although beyond the scope of this study, this restricted detection of meaningful clinical results.…”

Section: Discussionmentioning

confidence: 96%

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Dzialo

Mannisi

Halonen

et al. 2019

International Biomechanics

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Gait modifications and laterally wedged insoles are non-invasive approaches used to treat medial compartment knee osteoarthritis. However, the outcome of these alterations is still a controversial topic. This study investigates how gait alteration techniques may have a unique effect on individual patients; and furthermore, the way we scale our musculoskeletal models to estimate the medial joint contact force may influence knee loading conditions. Five patients with clinical evidence of medial knee osteoarthritis were asked to walk at a normal walking speed over force plates and simultaneously 3D motion was captured during seven conditions (0°-, 5°-, 10°-insoles, shod, toe-in, toe-out, and wide stance). We developed patient-specific musculoskeletal models, using segmentations from magnetic resonance imaging to morph a generic model to patientspecific bone geometries and applied this morphing to estimate muscle insertion sites. Additionally, models were created of these patients using a simple linear scaling method. When examining the patients' medial compartment contact force (peak and impulse) during stance phase, a 'one-size-fits-all' gait alteration aimed to reduce medial knee loading did not exist. Moreover, the different scaling methods lead to differences in medial contact forces; highlighting the importance of further investigation of musculoskeletal modeling methods prior to use in the clinical setting. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 96%

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Dzialo

Mannisi

Halonen

et al. 2019

International Biomechanics

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“…Estimation of KCF is possible through computational musculoskeletal modeling systems, such as the AnyBody Modeling System (AMS, AnyBody Technology, Aalborg, Denmark) or OpenSim 10,11 . Studies based on musculoskeletal modeling investigating associations between KAM and KCF have reported R 2 values from 0.36 (in young healthy subjects) 12 , 0.52 (in older adults) 13 to 0.6 (in young subjects post-ACL reconstruction) 8 . These values suggest only moderate association between the measured KAM and estimated KCF.…”

Section: Introductionmentioning

confidence: 99%

Relationship between knee joint contact forces and external knee joint moments in patients with medial knee osteoarthritis: effects of gait modifications

Richards

Andersen

Harlaar

et al. 2018

Osteoarthritis and Cartilage

121

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At the first peak, KAM is a reasonable substitute for the medial contact force, but not at the second peak. First peak KFM is also a significant contributor to the medial KCF. At the first peak, walking with a modified gait reduced the ratio of the medial to total KCF but not the medial KCF itself. To determine the effects of gait modifications on cartilage loading and disease progression, longitudinal studies and individualized modeling, accounting for motion control, would be required.

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“…Finally, by design, our study focusses on sagittal plane knee joint kinematics, mechanics, and quadriceps muscle action; as well as the risk of cartilage degeneration due to loading below physiological values. However, individuals with knee joint pathology and those at risk of OA also frequently exhibit larger peak external knee adduction moments than controls (Butler, Minick et al 2009, Alnahdi, Zeni et al 2011, an indirect surrogate for medial compressive forces (Ogaya, Naito et al 2014). Together, the collective literature thus suggests that changes in articular cartilage loading magnitude that occur faster than cartilage adaptation may contribute to PTOA (Andriacchi, Mundermann et al 2004) -underscoring future opportunities for real-time biofeedback to optimize knee joint loading.…”

Section: Discussionmentioning

confidence: 99%

Peer Review #2 of "The effects of knee extensor moment biofeedback on gait biomechanics and quadriceps contractile behavior (v0.1)"

Stock¹

2020

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Individuals with knee joint pathologies exhibit quadriceps dysfunction that, during walking, manifests as smaller peak knee extensor moment (pKEM) and reduced knee flexion excursion. These changes persist despite muscle strengthening and may alter stance phase knee joint loading considered relevant to osteoarthritis risk. Novel rehabilitation strategies that more directly augment quadriceps mechanical output during functional movements are needed to reduce this risk. As an important first step, we tested the efficacy of real-time biofeedback during walking to prescribe changes of ±20% and ±40% of normal walking pKEM values in 11 uninjured young adults. We simultaneously recorded knee joint kinematics, ground reaction forces, and, via ultrasound, vastus lateralis (VL) fascicle length change behavior. Participants successfully responded to real-time biofeedback and averaged up to 55% larger and 51% smaller than normal pKEM values with concomitant and potentially favorable changes in knee flexion excursion. While the VL muscle-tendon unit (MTU) lengthened, VL fascicles accommodated weight acceptance during walking largely through isometric, or even slight concentric, rather than eccentric action as is commonly presumed. Targeted pKEM biofeedback may be a useful rehabilitative and/or scientific tool to elicit desirable changes in knee joint biomechanics considered relevant to the development of osteoarthritis.

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Knee adduction moment and medial knee contact force during gait in older people

Cited by 37 publications

References 26 publications

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Gait alteration strategies for knee osteoarthritis: a comparison of joint loading via generic and patient-specific musculoskeletal model scaling techniques

Relationship between knee joint contact forces and external knee joint moments in patients with medial knee osteoarthritis: effects of gait modifications

Peer Review #2 of "The effects of knee extensor moment biofeedback on gait biomechanics and quadriceps contractile behavior (v0.1)"

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