The effect of exercise therapy on knee adduction moment in individuals with knee osteoarthritis: A systematic review

Ferreira, Giovanni E; Robinson, Caroline Cabral; Wiebusch, Matheus; Viero, Carolina Cabral de Mello; Rosa, Luís Henrique Telles da; Silva, Marcelo Faria

doi:10.1016/j.clinbiomech.2015.03.028

Cited by 31 publications

(15 citation statements)

References 60 publications

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“…34 However, hip abductor strength only explained 10% of the variability in knee load, suggesting that other factors may be more important in knee OA development and that hip abductor weakness may be a result of knee OA, not a cause. 15,30 Nevertheless, this remains speculation, without evidence from prospective trials that include a measure of hip muscle strength.…”

Section: Discussionmentioning

confidence: 99%

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Deasy¹,

Leahy²,

Semciw³

2016

Journal of Orthopaedic & Sports Physical Therapy

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Standardized mean differences (SMDs; Hedges' g) were calculated from means and standard deviations (mean difference/pooled SD) of muscle strength data using Review Manager software (Version 5.2; The Cochrane Collaboration, London, UK). The SMDs of 0.2, 0.5, and 0.8 were considered small, moderate, and large, respectively. 9 The percentage difference in strength was also calculated to provide a further indication of the relative difference in strength between OA and control participants [(OA strength -control strength)/control strength × 100]. Results were grouped according to the type of strength measurement (eg, isometric or isokinetic) or hip action performed (eg, hip flexion or extension). Data were pooled for multiple studies in a meta-analysis within each group using a random-effects model. When studies reported on multiple grades of OA classification (eg, Kellgren-Lawrence grade 2 or 3) without reporting on muscle strength of the whole sample combined, only the more established OA grading was used in the meta-analysis, to avoid repeated assessment of control-group data. When studies measured isokinetic strength at multiple speeds, the slower speed was used, as slower speeds are considered more reliable.35,41 When a study reported results of left and right knees of participants with bilateral knee OA, only the side with the most conservative SMD was presented, to avoid repeated inclusion of control-group data.10 Statistical heterogeneity across pooled studies was assessed using the I 2 statistic, in which a value of 25%, 50%, or 75% was considered a low, moderate, or high level of heterogeneity, respectively. 23 Assessment of Quality of Body of EvidenceA modified version of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence in each meta-analysis. 20,35,43 The GRADE tool has been modified to apply to observational, nonexperimental data. 35,43 Each meta-analysis was graded using the following predefined criteria: (1) inconsistency (downgraded if I 2 was 50% or greater), (2) Screened by title and abstract, n = 1737Screened by title and abstract, n = 1737Full-text articles assessed for eligibility, n = 102Full-text articles assessed for eligibility, n = 102Hip strength in knee OA compared to control, n = 5Hip strength in knee OA compared to control, n = 5Hip strength as a risk factor for knee OA development, n = 0Hip strength as a risk factor for knee OA development, n = 0

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Section: Discussionmentioning

confidence: 99%

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Deasy¹,

Leahy²,

Semciw³

2016

Journal of Orthopaedic & Sports Physical Therapy

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“…The KAM significantly correlates with medial compartment force (5,6), medial to lateral cartilage thickness ratio in both the femur and the tibia (8), severity of knee OA (9,10), and the risk factors of OA such as age, sex, and obesity (11)(12)(13). These findings support a hypothesis that treatment interventions, which can reduce the KAM, may detain the progression of knee OA, and improve patients' symptoms (14). range of motion, joint proprioception, balance, and cardiovascular function in patients with knee OA (16)(17)(18).…”

Section: Introductionmentioning

confidence: 52%

“…Exercise therapy is an essential element for the treatment of knee OA (15). However, research showed only short-term improvement of clinical symptoms using routine exercise therapy regimens (14). For a more efficient treatment of knee OA, physiotherapists should explore exercise therapy protocols, which may reduce the progression rate of the disease by targeting potential predictive factors to OA.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is a lack of evidence to support the superior efficacy of any of these practices over others (18,19). In addition, there is no study to suggest that these exercise therapy regimens may reduce the KAM in patients with knee OA (14). For instance, Foroughi et al, and Bennell et al, showed that strengthening and neuromuscular exercises could not reduce the KAM in patients with knee OA (20,21).…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Yoga and Medial Thrust Gait Training and Conventional Physiotherapy on Gait Biomechanics, Pain, and Function in Individuals with Knee Osteoarthritis: A Randomized Clinical Trial Protocol

Bokaeian

Esfandiarpour

Zahednejad

et al. 2019

Middle East J Rehabil Health Stud

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Background: Literatures indicate a strong association between biomechanical factors, i.e., increased knee adduction moment (KAM) and knee osteoarthritis. Laboratory studies showed that yoga exercises and medial thrust (MT) gait pattern could reduce the KAM. However, there is a lack of clinical evidence to support their efficacy compared to current exercise therapy regimens. Objectives: This randomized control trial will compare the effects of combined yoga and the MT gait training and conventional knee exercises on gait biomechanics, pain, and function in people with knee OA. Methods: Forty patients with knee OA will be randomly allocated to two treatment groups: (1) the yoga and MT gait group (YogaMT), and (2) the conventional physiotherapy group. Exercise therapy for the YogaMT group includes the MT gait training, and the yoga exercises, and for the conventional physiotherapy group, conventional knee strengthening exercises. The amount of KAM during gait, pain severity, and the functional score will be assessed at baseline, two days and one month after 12 sessions of treatment. Conclusions: Physiotherapists should explore etiology-based interventions targeting the contributing factors to the development and progression of OA. The results of this RCT may help suggest a more effective treatment for patients with knee OA.

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“…Было также выдвинуто предположение, что снижение аддукционного момента может быть достигнуто за счет физической реабилитации и тренировки мышц, однако анализ проведенных исследований с участием 233 пациентов не нашел подтвержде-ния данной гипотезы [15]. Но значительные из-менения величины медиального момента были достигнуты за счет использования различных ор-топедических изделий [14,[16][17][18].…”

Section: Introductionunclassified

Video-analysis of the effect of different types of adapted shoes on knee adduction moment

Aksenov

Юрьевич²,

Klishkovskaya

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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Санкт-Петербургский государственный электротехнический университет «ЛЭТИ» им. В. И. Улья-нова (Ленина), Санкт-Петербург Введение. Для повышения эффективности лечения и реабилитации пациентов, страдающих остеоартрозом, часто рекомендуется использовать ортопедические стельки. Лечебный эффект в этом случае достигается за счет уменьшения аддукционного момента, воздействующего на биомеханическую ось нижней конечности, бла-годаря особой конструкции обуви, параметры которой определяются с учетом биомеханических параметров локомоции пациента. Однако к настоящему времени в научных источниках отсутствует достаточно убедитель-ная информация о том, как влияют различные параметры конструкции обуви на нагрузку коленного сустава. Методология: видеоанализ ходьбы при использовании обуви с различной высотой каблука, уровнем переката носка и пятки. Результаты. В исследовании принимали участие 15 здоровых мужчин. Исследование показало, что аддукци-онный момент возрос при ходьбе в обуви с каблуком 5,5 см, а также с увеличенным перекатом пятки и углом носка p < 0,05. Ортопедическая обувь 3CR, которая включает все вышеупомянутые факторы, в значительной степени повысила суммарный медиальный момент и аддукционный момент колена p < 0,05. Заключение: использование неправильно подобранной обуви и ортопедических средств в течение длительного времени может существенно способствовать развитию остеоартроза коленного сустава.Ключевые слова: остеоартроз коленного сустава, аддукционный момент, видеоанализ, кинетика, конструкция обуви. VIDEO-ANALYSIS OF THE EFFECT OF DIFFERENT TYPES OF ADAPTED SHOES ON KNEE ADDUCTION MOMENT © A.Yu. Aksenov, T.A. Klishkovskaya Saint Petersburg Electrotechnical University LETI Faculty of Information Measurement and Biotechnical Systems Department of Bioengineering Systems, Saint Petersburg, RussiaBackground. The effect of different footwear profiles on knee adduction moment have not been fully studied. Methods. Fifteen healthy volunteer subjects, age 25.3 (±2.73), undertook a series of gait laboratory trials with adapted shoes. Kinematic and kinetic data were collect using 16 Oqus 3+ cameras and the walking speed was controlled using timing gates. High street shoes were adapted to include five different heel heights (varying from a 1.5 cm to 5.5 cm heels), two heel profile conditions (curved and semi-curved heels), three varying apex angles (10, 15, and 20 degrees), and barefoot and 3CR footwear conditions. The baseline shoe had no heel curve, a heel height of 3.5cm, an apex position of 62.5% of the shoe length, an apex angle of 15 deg, and a rigid forepart of the shoe. Results. The shoe with 5.5 cm heel height significantly increased the mean knee adduction moment during 50%-100% of the stance phase compared to the 1.5 cm heel (p = 0.008). The high heel shoe also significantly increased knee adduction impulse (area under the curve) versus the 1.5, 2.5, and 3.5 cm heels, and the 10° toe angle and barefoot condition. Ten degrees of toe angle reduced mean knee adduction moment during 0%-50% of the stance phase versus

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The effect of exercise therapy on knee adduction moment in individuals with knee osteoarthritis: A systematic review

Cited by 31 publications

References 60 publications

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

The Effects of Yoga and Medial Thrust Gait Training and Conventional Physiotherapy on Gait Biomechanics, Pain, and Function in Individuals with Knee Osteoarthritis: A Randomized Clinical Trial Protocol

Video-analysis of the effect of different types of adapted shoes on knee adduction moment

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