Stability and variability of knee kinematics during gait in knee osteoarthritis before and after replacement surgery

Yakhdani, Hamid Reza F.; Bafghi, Hamid Abbasi; Meijer, Onno G.; Bruijn, Sjoerd M.; Dikkenberg, N. van den; Stibbe, A.; Royen, Barend J. van; Dieën, Jaap H. van

doi:10.1016/j.clinbiomech.2009.12.003

Cited by 88 publications

(59 citation statements)

References 33 publications

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“…The negative regression between affected side variability and unaffected side co-contraction time appears to confirm our hypothesis that co-contraction decreases variability (Fallah-Yakhdani et al, 2010). Leg kinematics just after heel strike are co-determined by the kinematics of the other leg, which may explain how unaffected side co-contraction can decrease affected side variability.…”

Section: Variability Of Sagittal Plane Knee Movementssupporting

confidence: 81%

“…Reduced variability may be harmful to the joint (Lewek et al, 2006), but increased variability suggests a lack of control, and coincides with a higher risk of falling (e.g., Hausdorff, 2007;Leitner et al, 2007;Maki, 1997). Earlier, we hypothesised that subjects with knee osteoarthritis co-contract in order to reduce variability (Fallah-Yakhdani et al, 2010), which may enhance the control over knee motion (e.g., Benedetti et al, 2003;Kean et al, 2009;Schmitt and Rudolph, 2008;Van Dieën et al, 2003). Some authors see co-contraction as a strategy to compensate for quadriceps weakness (e.g., Hortobágyi et al, 2005).…”

Section: Introductionmentioning

confidence: 91%

“…The angular velocity of sagittal knee movements was used for objective local dynamic stability (Bruijn et al, 2009a,b;Fallah-Yakhdani et al, 2010). Per subject per speed condition, a 5-dimensional state space was constructed from the original kinematic signal during the first 30 strides, and four copies with time delays of 10, 20, 30, and 40 samples.…”

Section: Calculationsmentioning

confidence: 99%

“…Moreover, the present study does not exclude other mechanisms to decrease variability, such as paying more attention (cf. Fallah-Yakhdani et al, 2010).…”

Section: Variability Of Sagittal Plane Knee Movementsmentioning

confidence: 99%

“…In knee osteoarthritis, reduced variability of knee movements has been reported (Fallah-Yakhdani et al, 2010;Lewek et al, 2006). Reduced variability may be harmful to the joint (Lewek et al, 2006), but increased variability suggests a lack of control, and coincides with a higher risk of falling (e.g., Hausdorff, 2007;Leitner et al, 2007;Maki, 1997).…”

Section: Introductionmentioning

confidence: 99%

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Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Fallah-Yakhdani¹,

Bafghi²,

Meijer³

et al. 2012

Clinical Biomechanics

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Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and cocontraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Preoperatively, multivariate regressions on co-contraction time were used to identify determinants of cocontraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of cocontraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability.

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Section: Variability Of Sagittal Plane Knee Movementssupporting

confidence: 81%

Section: Introductionmentioning

confidence: 91%

Section: Calculationsmentioning

confidence: 99%

“…Moreover, the present study does not exclude other mechanisms to decrease variability, such as paying more attention (cf. Fallah-Yakhdani et al, 2010).…”

Section: Variability Of Sagittal Plane Knee Movementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Fallah-Yakhdani¹,

Bafghi²,

Meijer³

et al. 2012

Clinical Biomechanics

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Association between postoperative fall history and toe grip strength in patients after total knee arthroplasty: A prospective observational study

Mawarikado,

Inagaki,

Fujii

et al. 2024

Journal of Foot and Ankle Research

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BackgroundFactors associated with falls after total knee arthroplasty (TKA) have been rarely reported. The aim of this study was to identify factors that influence the incidence of falls after TKA, focusing on toe grip strength (TGS) in particular, which has been associated with falls in older adults.Methods217 patients who underwent TKA were included and followed up for 1 year. Main study outcome measures were the presence or absence of falls within 1 year after TKA. Multiple logistic regression analysis was used with postoperative falls as the dependent variable and preoperative falls and postoperative TGS on the affected sides as independent variables.Results170 (43 and 127 in the fall and non‐fall groups) patients were included in the analysis. The presence of a preoperative falls history before TKA and a weak postoperative affected TGS indicated an increased susceptibility of the patient to fall postoperatively.ConclusionsResults of the current study revealed the association between postoperative TGS and postoperative falls. We highlight the importance of preoperative fall monitoring and postoperative TGS evaluation to prevent falls after TKA.

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Entropy analysis of tri‐axial leg acceleration signal waveforms for measurement of decrease of physiological variability in human gait

Tochigi

Segal

Vaseenon

et al. 2011

Journal Orthopaedic Research

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Disease-related and senescent decrease of physiological variability in biological time-series outputs (e.g., heart rate) has drawn increasing attention as a potential new type of biomarker. In this paradigm, measurement of variability in periodic motion may enable quantitative evaluation of functional limitation in people with musculoskeletal disorders. A novel technique to measure variability of leg motion patterns during level walking was used to study 52 adults with symptomatic knee osteoarthritis (OA), and 57 asymptomatic control subjects over a wide range of age (20 to 79 years). The hypothesis was that cycle-to-cycle variability in leg motion patterns, indexed by tri-axial acceleration signal entropy, would be lower in those with greater age or with knee symptoms. Leg motions were assessed using portable inertial monitors attached bilaterally just above each ankle. The tri-axial acceleration data were analyzed using a non-linear variability measurement tool designated as Sample Entropy (SampEn). SampEn data for asymptomatic subjects exhibited a significant negative correlation (r = -0.287, p = 0.0306) with greater age. OA subjects had significantly lower SampEn values (p = 0.0002) than did age-matched asymptomatic subjects who walked at equivalent velocity. This approach holds promise as a basis for valid, inexpensive, and convenient objective evaluation of limitations in human gait function.

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Stability and variability of knee kinematics during gait in knee osteoarthritis before and after replacement surgery

Cited by 88 publications

References 33 publications

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Association between postoperative fall history and toe grip strength in patients after total knee arthroplasty: A prospective observational study

Entropy analysis of tri‐axial leg acceleration signal waveforms for measurement of decrease of physiological variability in human gait

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