Characteristics of trunk lean motion during walking in patients with symptomatic knee osteoarthritis

Tanaka, Kosuke; Miyashita, Koji; Urabe, Yukio; Ijiri, Tomohito; Takemoto, Yumi; Ishii, Yoshimasa; Ochi, Mitsuo

doi:10.1016/j.knee.2007.12.009

Cited by 22 publications

(20 citation statements)

References 13 publications

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“…Gait patterns that alter knee joint loads or are related to pain have recently engendered particular interest, especially toe-out angle (7)(8)(9)(10)(11)(12)(13), trunk lean toward the stance leg (14 -19), and associated pelvic obliquity (15,16,20). These gait patterns are correlated with the external knee adduction moment about the knee (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Bechard

Birmingham

Zečević

et al. 2012

Arthritis Care & Research

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Objective. To compare the time-varying behavior of maximum toe-out angle, lateral trunk lean (over the stance leg), and pelvic obliquity (rise and drop on the swing leg) during prolonged walking in participants with and without medial compartment knee osteoarthritis (OA), and to explore correlations between these gait characteristics and pain. Methods. Twenty patients with knee OA and 20 healthy controls completed 30 minutes of treadmill walking. Toe-out, trunk lean, pelvic obliquity, and pain were measured at 5-minute intervals. Results. The mean ؎ SD toe-out angle was significantly smaller (P ‫؍‬ 0.04) in patients with knee OA (6.7 ؎ 2.5 degrees) than in controls (10.3 ؎ 2.2 degrees). Toe-out changed significantly over time (P ‫؍‬ 0.002), but not in a systematic way, and there was no interaction between group and time. The mean ؎ SD trunk lean was higher (P ‫؍‬ 0.03) in patients with knee OA (2.0 ؎ 1.0 degrees) than in controls (0.7 ؎ 0.5 degrees). Trunk lean did not change over time and there was no interaction between group and time. There were no differences for pelvic drop. The mean ؎ SD pelvic rise was higher (P ‫؍‬ 0.01) in patients with knee OA (2.8 ؎ 0.9 degrees) than in controls (1.2 ؎ 0.8 degrees), but did not change over time and there was no interaction. Patients experienced a small increase in pain (P < 0.001). Trunk lean and pelvic drop were correlated with pain (r ‫؍‬ 0.49, P ‫؍‬ 0.03 and r ‫؍‬ 0.47, P ‫؍‬ 0.04, respectively). Conclusion. Toe-out and trunk lean are consistently different between individuals with and without medial compartment knee OA during prolonged walking, and patients with greater pain have greater trunk lean. However, over 30 minutes of walking, these gait characteristics remain quite stable, suggesting they are not acute compensatory mechanisms in response to repetitive loading with subtle increases in pain.

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Section: Introductionmentioning

confidence: 99%

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Bechard

Birmingham

Zečević

et al. 2012

Arthritis Care & Research

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“…The results showed that 10 degrees of trunk inclination reduced on average 65% external adductor moment of the knee. In the study by Tanaka et al (16) there was no signi icant difference in trunk inclination between asymptomatic individuals with medial knee OA. This result could be explained by the limitations of the study, as cited by the authors, for example, the small number of individuals studied (OA group 12 individuals and 5 in the control group).…”

Section: Kinetic Parametersmentioning

confidence: 80%

“…Increased foot external rotation angle and lateral inclination of the trunk towards the stance limb are kinematic parameters that reduce the external knee adductor moment consequently decrease pain and slow progression of OA medial knee (16,24).…”

Section: Angular Displacement Of the Foot And Trunkmentioning

confidence: 99%

“…Previous studies had indicated that some spatial-temporal, kinematic and kinetic gait parameters might reduce the external adductor moment of the knee (11,16,24,25). Thus, this review aims to identify these biomechanical strategies and discuss how clinicians could work with their patients to reduce the pain and consequences of the medial knee OA.…”

Section: Introductionmentioning

confidence: 99%

“…Studies quantifying articular loads in subjects with knee OA have received attention in recent years (13,(15)(16)(17). The overload joint can be estimated by calculating the external adductor moment of the knee, obtained through the assessment of gait kinematics and kinetics (11,18).…”

Section: Introductionmentioning

confidence: 99%

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Strategies to reduce joint load in the medial compartment of the knee during gait in individuals with osteoarthritis: a review of the literature

Magalhães

Kirkwood

2016

Fisioter. mov.

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Introduction: Increased joint load on the medial compartment of the knee during gait is a mechanical factor responsible for pain and progression of medial knee osteoarthritis. The knee external adductor moment of force is a kinetic parameter that correlates with the joint load in the medial compartment. Objective: The aim of this study was to conduct a narrative review of the biomechanics strategies during gait of individuals with medial knee osteoarthritis that reduce external adductor moment of force of the knee. Methods: The review of the literature was conducted in the databases MEDLINE, PUBMED and PEDro and included articles published between 2000 and 2011. It was selected transversal, theoretical, correlational and longitudinal studies as well as controlled clinical trials. Results: Decreased gait velocity, increased external rotation of the foot, increased internal abductor moment force of the hip and lateral trunk inclination to the side of the support limb are compensatory strategies used to reduce the external adductor moment of force of the knee during gait of individuals with medial knee osteoarthritis. The lateral trunk inclination may be beneficial in a short term, however it decreases the activity of the abductors muscles of the hip during the support phase of the gait favoring compensation that could result in the progression of medial knee osteoarthritis. Conclusion: Strengthening of the abductors muscles of the hip reduces pain, improves the function and prevents compensations that in a long term could possibly accelerate the progression of the medial knee osteoarthritis.

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A biomechanical analysis of trunk and pelvis motion during gait in subjects with knee osteoarthritis compared to control subjects

Linley

Sled

Culham

et al. 2010

Clinical Biomechanics

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Characteristics of trunk lean motion during walking in patients with symptomatic knee osteoarthritis

Cited by 22 publications

References 13 publications

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Toe‐out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls

Strategies to reduce joint load in the medial compartment of the knee during gait in individuals with osteoarthritis: a review of the literature

A biomechanical analysis of trunk and pelvis motion during gait in subjects with knee osteoarthritis compared to control subjects

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