Hip, knee, and ankle kinematics of high range of motion activities of daily living

Abstract

Treatment of joint disease that results in limited flexion is often rejected by patients in non-Western cultures whose activities of daily living require a higher range of motion at the hip, knee, or ankle. However, limited information is available about the joint kinematics required for high range of motion activities, such as squatting, kneeling, and sitting cross-legged, making it difficult to design prosthetic implants that will meet the needs of these populations. Therefore, the objective of this work was to generate three-dimensional kinematics at the hip, knee, and ankle joints of Indian subjects while performing activities of daily living. Thirty healthy Indian subjects (average age: 48.2 AE 7.6 years) were asked to perform six trials of the following activities: squatting, kneeling, and sitting cross-legged. Floating axis angles were calculated at the joints using the kinematic data collected by an electromagnetic motion tracking device with receivers located on the subject's foot, shank, thigh, and sacrum. A mean maximum flexion of 1578 AE 68 at the knee joint was required for squatting with heels up. Mean maximum hip flexion angles reached up to 958 AE 278 for squatting with heels flat. The high standard deviation associated with this activity underscored the large range in maximum hip flexion angles required by different subjects. Mean ankle range of flexion reached 588 AE 148 for the sitting cross-legged activity. The ranges of motion required to perform the activities studied are greater than that provided by most currently available joint prostheses, demonstrating the need for high range of motion implant design. ß

Kinematics of hip, knee, ankle of the young and elderly Chinese people during kneeling activity

“…Although some studies have examined joint motion in kneeling activity (Mulholland and Wyss, 2001), there have been few studies which have assessed kinematics of the knee, hip, and ankle joints simultaneously, and even fewer studies looking at the kinematics of kneeling activity at these joints in the three axial planes (Hemmerich et al, 2006). To our knowledge, most studies have solely focused on kneeling activity at the knee joint (Ahlberg et al, 1988;Baltzopoulos, 1995;Hefzy et al, 1998;Nakagawa et al, 2000;Kanekasu et al, 2004;Moro-Oka et al, 2008), and the kinematics of knee having total knee arthroplasty (Coughlin et al, 2007;Hamai et al, 2008;Nakamura et al, 2010).…”

Total knees designed for normal kinematics evaluated in an up‐and‐down crouching machine

“…[27][28][29] The provision of varus-valgus rotation at the ankle was indicated in a study of crouching in high flexion. 23 The reduced forces in our tests represent about 20% of actual forces, based on in vivo data from an instrumented TKR. 30 High flexion activities are performed less frequently than walking and with the most difficulty, but are important to many patients.…”

“…The distal tibia was hinged at the ankle joint, but the ankle was attached to the machine's frame by flexible polyurethane blocks to allow for a few degrees of varus-valgus rotations as in everyday activities. 23 The hip joint was simulated with a spherical bearing attached to a plate that was allowed to slide vertically along a smooth rail so the knee could flex to 135 8. The total vertical force at the hip was 73.4N.…”

Lumbopelvic motion during seated hip flexion in subjects with low-back pain accompanying limited hip flexion

“…Although the possible range of motion of flexion in the supine position has been stated to be 120° [14,15], there is no reported study of the hip flexion range in a sitting posture for performing functional activities. Previous kinematic studies have demonstrated that high hip flexion, i.e., 95-114°, occurs in daily activities such as sitting with legs crossed, squatting, and putting on socks, in asymptomatic subjects [16,27,28]. Thus, we selected a target bar position of 20°hip flexion from a sitting posture.…”

“…The normal angle of hip flexion is 120°in healthy people performing functional activities [14,15], and hip flexion flexibility is required to perform many daily activities, such as squatting, putting on shoes and socks, and riding a bicycle [16][17][18][19]. Since the hip joint and lumbar spine are both adjacent to the pelvis, the hip joint moves in cooperation with the lumbar spine to provide functional movement [20][21][22].…”