Patients With Medial Knee Osteoarthritis Reduce Medial Knee Contact Forces by Altering Trunk Kinematics, Progression Speed, and Stepping Strategy During Stair Ascent and Descent: A Pilot Study

Meireles, Susana; Reeves, Neil D.; Jones, Richard; Cr, Smith; Thelen, Darryl G.; Jonkers, Ilse

doi:10.1123/jab.2017-0159

Cited by 14 publications

(17 citation statements)

References 46 publications

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“…Musculoskeletal simulations are commonly applied to estimate joint contact forces in groups of healthy and pathologic subjects and to investigate the role of joint loading in pathologies. 4,20,29,34,35,40,47,49 However, musculoskeletal models have traditionally overestimated the absolute magnitude of joint loading, 41,43 our results indicate that the capacity of traditional musculoskeletal modeling techniques to relatively differentitate the order of knee joint loading between subjects is also limited. Advances in modeling techniques such as the inclusion of EMG driven simulations, 17 or detailed six DOF knee models, 29 may improve the capacity of musculoskeletal simulations perform such studies.…”

Section: Biomedical Engineering Societymentioning

confidence: 81%

The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets

et al. 2020

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Musculoskeletal models enable non-invasive estimation of knee contact forces (KCFs) during functional movements. However, the redundant nature of the musculoskeletal system and uncertainty in model parameters necessitates that model predictions are critically evaluated. This study compared KCF and muscle activation patterns predicted using a scaled generic model and OpenSim static optimization tool against in vivo measurements from six patients in the CAMS-knee datasets during level walking and squatting. Generally, the total KCFs were under-predicted (RMS: 47.55%BW, R 2 : 0.92) throughout the gait cycle, but substiantially over-predicted (RMS: 105.7%BW, R 2 : 0.81) during squatting. To understand the underlying etiology of the errors, muscle activations were compared to electromyography (EMG) signals, and showed good agreement during level walking. For squatting, however, the muscle activations showed large descrepancies especially for the biceps femoris long head. Errors in the predicted KCF and muscle activation patterns were greatest during deep squat. Hence suggesting that the errors mainly originate from muscle represented at the hip and an associated muscle co-contraction at the knee. Furthermore, there were substaintial differences in the ranking of subjects and activities based on peak KCFs in the simulations versus measurements. Thus, future simulation study designs must account for subject-specific uncertainties in musculoskeletal predictions.

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Section: Biomedical Engineering Societymentioning

confidence: 81%

The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets

et al. 2020

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“…Sit-to-stand and stair negotiation require high knee extensor moments and generate great knee loading [ 59 , 123 – 125 ]. Since the increase in trunk flexion can reduce knee loading [ 126 ], these findings possibly represent a compensatory strategy to reduce knee loading and avoid or control knee pain [ 53 , 68 ]. However, the persistent use of this strategy may lead to chronic disuse of knee extensors and subsequent muscle weakness [ 127 ].…”

Section: Discussionmentioning

confidence: 99%

Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis

et al. 2022

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Background The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls. Methods Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. Results A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58–1.18) and stepping tasks (SMD 0.56, 95% CI 0.13–.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60–2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90–2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01–1.12) or ACLR (SMD 0.48; 95% CI 0.21–.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33–1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders. Conclusion Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies. Trial registration: PROSPERO registration number: CRD42019129257.

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“…One of the strategies which may have helped reduced TFJ loading during early stance is reducing the speed of performing stair ascent. Those with both mild 6,21,22 and severe 23 OA have reportedly performed stair ascent slower than their aged‐matched controls. Indeed, slowing down stair ambulation would allow more time during the stance phase, where the initial loading during early stance can be done more gradually.…”

Section: Discussionmentioning

confidence: 99%

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

Price

Gissane

Cleather

2020

Engineering Reports

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This study investigated the tibiofemoral joint (TFJ) forces and supporting muscle forces displayed by knee osteoarthritis (OA) patients during stair ascent, and if these forces were influenced by the presence of pain. Fifteen knee OA patients partitioned into two groups based on pain experienced during stair ascent trails using a Visual Analogue Scale (VAS) (OA-pain = 10; OA-no pain = 5) and 14 healthy aged-matched controls took part in this study. Kinematic and kinetic data were collected during three stair ascent trials, which provided the inputs for the musculoskeletal model FreeBody. TFJ contact forces and muscles forces were predicted by the model at early, mid-and late stance. These variables were compared between groups using a one-way analysis of variance. The results show the OA-pain (P < .05; d = 2.4) and OA-no pain (P < .05; d = 1.1) groups displayed reduced medial TFJ contact forces and altered muscle forces in comparison to healthy controls during early stance. This suggests pain and the anticipation of pain results in knee OA patients deliberately offloading the front limb during stair ascent, which alters supporting muscle forces. This study provides valuable information on knee OA mechanics during stair ascent for clinicians developing rehabilitation programs. K E Y W O R D S muscle forces, musculoskeletal model, osteoarthritis, stair ascent, tibiofemoral joint forces 1 INTRODUCTION Stair ascent is a challenging everyday activity for those who suffer with knee osteoarthritis (OA). Many studies have reported stair ascent being one of the main activities which elicits knee pain for those with knee OA, 1,2 greatly affecting quality of life. 3 The increased susceptibility of knee pain during stair ascent likely comes from weight-bearing at higher knee flexion angles. 4 Because of this, knee OA patients have been reported to compensate while walking upstairs to offload the OA knee as a strategy to avoid pain. 5 Asay et al 4 reported that during stair ascent those with knee OA increased trunk flexion angle during the weight-acceptance phase of stance to reduce the quadriceps moment in comparison to healthy controls. Further, Meireles et al 6 found that, in comparison to healthy controls, knee OA patients altered their stair ascent This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Patients With Medial Knee Osteoarthritis Reduce Medial Knee Contact Forces by Altering Trunk Kinematics, Progression Speed, and Stepping Strategy During Stair Ascent and Descent: A Pilot Study

Cited by 14 publications

References 46 publications

The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets

The Capacity of Generic Musculoskeletal Simulations to Predict Knee Joint Loading Using the CAMS-Knee Datasets

Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

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