Knee and hip kinetics during normal stair climbing

Abstract

Understanding joint kinetics during activities of daily living furthers our understanding of the factors involved in joint pathology and the effects of treatment. In this study, we examined hip and knee joint kinetics during stair climbing in 35 young healthy subjects using a subject-specific knee model to estimate bone-on-bone tibiofemoral and patello-femoral joint contact forces. The net knee forces were below one body weight while the peak posterior-anterior contact force was close to one body weight. The peak distal-proximal contact force was on average 3 times body weight and could be as high as 6 times body weight. These contact forces occurred at a high degree of knee flexion where there is a smaller joint contact area resulting in high contact stresses. The peak knee adduction moment was 0.42 (0.15) N m/kg while the flexion moment was 1.16 (0.24) N m/kg. Similar peak moment values, but different curve profiles, were found for the hip. The hip and knee posterio-anterior shear forces and the knee flexion moment were higher during stair climbing than during level walking. The most striking difference between stair ascent and level walking was that the peak patello-femoral contact force was 8 times higher during stair ascent. These data can be used as baseline measures in pathology studies, as input to theoretical joint models, and as input to mechanical joint simulators.

Does Interlimb Knee Symmetry Exist After Unicompartmental Knee Arthroplasty?

“…1). Conversely, our knee displacement magnitudes and kinematic patterns for the abduction/adduction and internal/ external rotation axes were greater than those found by Costigan et al [10] for stair ascent of healthy young adults. However, their participants were younger and ascended faster.…”

“…There are several potential explanations for the knee displacement asymmetry. We surmise that several factors such as limb dominance, stair ascent movement technique [26], muscle strength [10,32], implant placement [32], and knee alignment pre-and postoperatively [23,32] could have influenced interlimb symmetry more than having had an UKA. Limb dominance and pre-and postoperative knee alignment may have had minimal influence, however, because there was no clear trend for the limb that displayed greater angular displacement.…”

Vastus Lateralis Fascicle Length Changes During Stair Ascent and Descent

“…4 Physical Therapist, Physiotherapy Associates, West Chester, OH. 5 Physical Therapist, Marietta Memorial Hospital, Marietta, OH. This study was approved by the Ohio University Institutional Review Board.…”

Does a Microprocessor-controlled Prosthetic Knee Affect Stair Ascent Strategies in Persons With Transfemoral Amputation?

“…Stairs are often encountered in daily living and require greater lower-extremity ROM and strength to negotiate, compared to level ground walking [1,6,11,15]. Stair ascent may be challenging for individuals with above-theknee (transfemoral) amputation because of the importance of knee ROM and extensor muscles in stair ascent [10].…”

“…The X2 1 uses activity recognition and variable flexion/ extension resistance during step-over-step stair ascent to allow individuals with transfemoral amputation to load the knee while flexed without collapsing. Body elevation is achieved through prosthetic limb hip extension and contralateral intact ankle plantarflexion [5,6]. Previous microprocessor-controlled knees, such as the C-Leg 1 (Ottobock), do not provide sufficient resistance to prevent the knee from buckling while loaded in a flexed position.…”