Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

Sotelo, Michael; Eichelberger, Patric; Furrer, Martina; Baur, Heiner; Schmid, Stefan

doi:10.1016/j.gaitpost.2018.07.177

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…Kinetic changes during walking with a restricted extension of the knee joint have been analysed in previous studies where knee joint force was bilaterally increased during loading response depending on the degree of restriction of the knee joint [11][12][13]. Knee extension restriction also increases the vertical component of ground reaction force and the external knee flexion moment, which increases the demand for muscle activity in the lower extremities [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Effect of Unilateral Knee Extension Restriction on the Lumbar Region during Gait

Nakatsuji

Kawada

Takeshita

et al. 2022

Journal of Healthcare Engineering

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Unilateral knee extension restriction might change trunk alignment and increase mechanical load on the lumbar region during walking. We aimed to clarify lumbar region mechanical load during walking with restricted knee extension using a musculoskeletal model simulation. Seventeen healthy adult males were enrolled in this study. Participants walked 10 m at a comfortable velocity with and without restricted right knee extension of 15° and 30° using a knee brace. L4–5 joint moment, joint reaction force, and muscle forces around the lumbar region during walking were calculated for each condition. Peaks of kinetic data were compared among three gait conditions during 0%–30% and 50%–80% of the right gait cycle. Lumbar extension moment at early stance of the bilateral lower limbs was significantly increased in the 30° restricted condition ( p ≤ 0.021 ). Muscle force of the multifidus showed peaks at stance phase of the contralateral side during walking, and the erector spinae showed force peaks at early stance of the bilateral lower limb. Muscle force of the multifidus and erector spinae increased with increasing degree of knee flexion ( p ≤ 0.010 ), with a large eﬀect size (η2 = 0.273–0.486). The joint force acting on L4–5 showed two peaks at early stance of the bilateral lower limbs during the walking cycle. The anterior and vertical joint force on L4–5 increased by 14.2%–36.5% and 10.0%–23.0% in walking with restricted knee extension, respectively ( p ≤ 0.010 ), with a large effect size (η2 = 0.149–0.425). Restricted knee joint extension changed trunk alignment and increased the muscle force and the vertical and anterior joint force on the L4–5 joint during walking; this tendency became more obvious with increased restriction angle. Our results provide important information for therapists engaged in the rehabilitation of patients with knee contracture.

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Section: Introductionmentioning

confidence: 99%

Effect of Unilateral Knee Extension Restriction on the Lumbar Region during Gait

Nakatsuji

Kawada

Takeshita

et al. 2022

Journal of Healthcare Engineering

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“…In humans, the short-term effects (immediate to a few minutes following application) of artificial joint constraints have been studied using external devices. For example, to mimic the knee flexion contracture gait pattern typical for people with cerebral palsy and people with knee arthropathy and to mimic full knee extension following knee arthrodesis surgery (44)(45)(46)(47)(48)(49)(50)(51)(52). A simulated knee flexion contracture results in an increased forefoot weight bearing and flexion posture during stance, increasing the knee extensor torque (46,48,51).…”

Section: Introductionmentioning

confidence: 99%

Modular reorganization of gait in chronic but not in artificial knee joint constraint

Cruz‐Montecinos

Pérez‐Alenda

Cerda

et al. 2021

Journal of Neurophysiology

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It is currently unknown if modular reorganization does occur if not the central nervous system, but the musculoskeletal system is affected. The aims of this study were to investigate (I) the effects of an artificial knee joint constraint on the modular organization of gait in healthy subjects; (II) the differences in modular organization between healthy subjects with an artificial knee joint constraint and people with a similar but chronic knee joint constraint. Eleven healthy subjects and eight people with a chronic knee joint constraint walked overground at 1 m/s. The healthy subjects also walked with a constraint limiting knee joint movement to 20°. The total variance accounted (tVAF) for one to four synergies and modular organization were assessed using surface electromyography from eleven leg muscles. The distribution of number of synergies were not significantly different between groups. The tVAF and the motor modules were not significantly affected by the artificial knee constraint. A higher tVAF for one and two synergies, as well as merging of motor modules were observed in the chronic knee constraint group. We conclude that in the short-term a knee constraint does not affect the modular organization of gait, but in the long-term a knee constraint results in modular reorganization. These results indicate that merging of motor modules may also occur when changes in the mechanics of the musculoskeletal system is the primary cause of the motor impairment.

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The Telemedicine Functional Assessment

Herrera

Beaufort

Wilkey

2023

Telemedicine for the Musculoskeletal Physical Exam

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Walking with an induced unilateral knee extension restriction affects lower but not upper body biomechanics in healthy adults

Cited by 6 publications

References 22 publications

Effect of Unilateral Knee Extension Restriction on the Lumbar Region during Gait

Effect of Unilateral Knee Extension Restriction on the Lumbar Region during Gait

Modular reorganization of gait in chronic but not in artificial knee joint constraint

The Telemedicine Functional Assessment

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