Effect of foot rotation on knee kinetics and hamstring activation in older adults with and without signs of knee osteoarthritis

Lynn, Scott K.; Costigan, Patrick A.

doi:10.1016/j.clinbiomech.2008.01.012

Cited by 77 publications

(66 citation statements)

References 23 publications

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“…As seen in Table 1, 14 different modifications were evaluated. Seven studies (29 -35) evaluated the effect of increasing toe-out, 3 of which also evaluated reducing toe-out (31)(32)(33). Alteration of gait speed was also investigated, with 7 studies evaluating increasing speed (36 -42) and 4 studies investigating reduced speed (36,39,40,42).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies evaluated the overall or early-stance peak KAM (Table 2). Twelve studies reported early-stance peak KAM values (27,30 -33,35,43-46,48,49), with late-stance peak KAM values reported in 6 studies (27,30,32,33,35,45). Point estimates and measures of variability were not reported for 1 study and could not be extracted from graphical data (36).…”

Section: Reducing Medial Knee Load Using Gait Modificationsmentioning

confidence: 99%

See 1 more Smart Citation

Gait modification strategies for altering medial knee joint load: A systematic review

Simić¹,

Hinman²,

Wrigley³

et al. 2011

Arthritis Care & Research

221

178

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Objective. To evaluate the effect of gait modification strategies on the external knee adduction moment (KAM), a marker of medial knee joint load; determine potentially adverse effects; assess the methodologic quality; and identify areas of future research. Methods. Five electronic databases were searched. Studies evaluating the effects of gait modifications on the KAM in either healthy individuals or those with knee osteoarthritis (OA) were included. Methodologic quality was evaluated by 2 reviewers using the Downs and Black checklist. Results. Twenty-four studies met the inclusion criteria, exploring 14 different gait modifications of varying sample sizes, age groups, and OA classifications. Contralateral cane use, increased step width, medial knee thrust, increased hip internal rotation, weight transfer to the medial foot, and increased lateral trunk lean demonstrated KAM reductions. Tai Chi gait, ipsilateral cane use, Nordic walking poles, and increased knee flexion exhibited increases in the KAM, demonstrating a potential detriment to their use. The effects of reduced stride length, as well as increases and reductions in either toe-out or gait speed, were inconsistent across the studies and gait cycle. Conclusion. This review demonstrates that some gait modifications have the ability to alter knee load. Future research is required to determine the magnitude of modification required to maximize beneficial effects, the best method of training, long-term patient adherence, and if these biomechanical changes can translate into clinically relevant changes in symptoms or disease progression risk.

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Section: Resultsmentioning

confidence: 99%

Section: Reducing Medial Knee Load Using Gait Modificationsmentioning

confidence: 99%

Gait modification strategies for altering medial knee joint load: A systematic review

Simić¹,

Hinman²,

Wrigley³

et al. 2011

Arthritis Care & Research

221

178

View full text Add to dashboard Cite

show abstract

“…Gait compensations can be described as the tendency of patients to compensate for localized pain and pathology by adopting probable automatic gait modifications (6). 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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“…Studies have reported a reduction in the second (but not the first) peak of KAM in patients with OA when the foot is externally rotated between 10° and 21° beyond the natural foot position during walking [21,24]. Indeed, a negative correlation between the amount of the second peak KAM and the toe out angle has been consistently reported in patients with OA and also healthy subjects.…”

Section: Discussionmentioning

confidence: 88%

“…Changes in the position of the foot during gait can change both external load of knee and hamstring muscle activation patterns. This may unload the knee articular cartilages [24]. Therefore, external rotation occurs at the ankle as a compensatory mechanism.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Knee Osteoarthritis on Excursions of Lower Limb Joints During Gait

Jalalvand

Anbarian

Ahanjan

et al. 2017

PTJ

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Purpose: This study aimed to investigate excursion changes at the hip, knee, and ankle joints during gait in patients with knee osteoarthritis (KOA) of varying severity. Methods:The method of research was causal-comparative (Ex Post Facto). A Vicon motion analysis system with 4 T-Series cameras was used to measure the kinematics variables. Fifteen normal subjects without KOA and thirty patients with KOA participated in this study. According to Kellgren and Lawrence radiologic scale, the patients were divided into three groups of mild (n=10), moderate (n=10), and severe (n=10). Kinematics parameters of gait includes the range of motion (ROM) in all three planes of motion at the hip, knee, and ankle joints during gait, which were calculated by Vicon Nexus 1.8.5 software. All data were extracted by Polygon 3.5.1 and then were analyzed in SPSS20 using 1-way ANOVA test. The level of significance was set at P<0.05.Results: There were no significant differences in all kinematics parameters (joint angles) between the healthy and KOA groups (P>0.05). There were significant differences observed between groups of mild, moderate, and severe KOA with healthy one with respect to foot progress angles in the transverse plane, foot eversion/inversion excursion, knee flexion/extension excursion, knee abduction/adduction excursion, hip internal/external rotation excursion, anterior/posterior pelvic tilt, and lateral pelvic tilt (P<0.05). Conclusion:The results showed that some ROM parameters in all three planes of motion can estimate the severity of osteoarthritis. Some observed changes in kinematics parameters are due to effects of compensatory mechanisms, and some might be considered as the severity of the osteoarthritis. In addition, osteoarthritis in one joint had strong effects on other joints.

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Effect of foot rotation on knee kinetics and hamstring activation in older adults with and without signs of knee osteoarthritis

Cited by 77 publications

References 23 publications

Gait modification strategies for altering medial knee joint load: A systematic review

Gait modification strategies for altering medial knee joint load: A systematic review

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

The Effect of Knee Osteoarthritis on Excursions of Lower Limb Joints During Gait

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