Relationship between lower limb dynamics and knee joint pain

Abstract

To test the hypothesis that appropriate and timely neuromuscular control of limb motions plays an important role in the preservation of joint health, we kinematically and kinetically examined the behavior of the legs of young adult subjects at heel strike during natural walking. We compared a group of 18 volunteers, who, we presumed, were preosteoarthrotic because of mild, intermittent, activity-related knee joint pain, with 14 age-matched asymptomatic normal subjects. The two groups of subjects exhibited similar gait patterns with equivalent cadences, walking speeds, terminal stance phase knee flexion, maximum (peak) swing angular velocity, and overall shape of the vertical ground reaction. However, our instrumentation detected statistically significant differences between the two groups within a few milliseconds of heel strike. In the knee pain group, the heel hit the floor with a stronger impact in this brief interval. Just before heel strike, there was a faster downward velocity of the ankle with a larger angular velocity of the shank. The follow-through of the leg immediately after heel strike was more violent with larger peak axial and angular accelerations of the leg echoed by a more rapid rise of the ground reaction force. This sequence of events represents repetitive impulsive loading, which consistently provoked osteoarthrosis in animal experiments. We refer to this micro-incoordination of neuromuscular control not visible to the naked eye as "microklutziness."

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

“…Also, although these time points were chosen to group individuals according to duration of ambulation with a prosthesis, it is not presently clear if or how these outcomes would differ at other (longer) durations. Other literature that have observed these changes assessed gait mechanics in individuals further removed from their time of limb loss [22,25]. Therefore, future work could prospectively track these individuals during postlimb loss ambulation, allowing for within-subject comparisons and improving the support for causality.…”

The influence of orthotic devices and vastus medialis strength and timing on patellofemoral loads during running

“…3(b)). The im pact peak force is suggested to be a leading cause of overuse injuries during repetitive movement tasks [40].…”

Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis

“…The inability to adequately attenuate large compressive forces at the knee can result in impulsive loading, which has been attributed to quadriceps weakness [18] and inactivity [12], and may be responsible for osteoarthritic changes [23].…”