Journal article
Modifying Stride Length in Isolation and Combination with Foot Progression Angle and Step Width Modifications to Alter Knee Kinetics for Osteoarthritis-Related Gait Retraining.
- Edd S Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland.
- Bennour S Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland; Mechanical Laboratory of Sousse, National Engineering School of Sousse, University of Sousse, Tunisia.
- Ulrich B Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland.
- Jolles B Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland; Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
- Favre J Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Department of Musculoskeletal Medicine, Swiss BioMotion Lab, Lausanne, Switzerland.
- 2020-03-24
Published in:
- Journal of biomechanical engineering. - 2020
English
PURPOSE
To determine the effects of modifying stride length (SL) on knee adduction and flexion moments, two markers of knee loading associated with medial-compartment knee osteoarthritis progression. This study also tested if SL modifications, in addition to foot progression angle (FP) and step width (SW) modifications, provide solutions in more subjects for reducing knee adduction moment without increasing knee flexion moment (potentially protecting the joint).
METHODS
Fourteen healthy subjects (6 female) were enrolled in this preliminary study. Walking trials were collected first without instructions, and then following foot placement instructions for 50 combinations of SL, FP, and SW modifications. Repeated measures analysis of variance was used to detect group-average effects of footprint modifications on maximum knee adduction and flexion moments and on knee adduction moment impulse. Subject-specific dose-responses between footprint modifications and kinetics changes were modeled with linear regressions, and the models were used to identify modification solutions, per subject, for various kinetics change conditions.
RESULTS
Shorter SL significantly decreased the three kinetics measures (p<0.01). Potential solutions for 10% reductions in knee adduction moment maximum and impulse without increasing maximum knee flexion moment were identified for 5 subjects with FP and SW modifications. A significantly higher proportion of subjects had solutions when adding SL modifications (11 subjects, p=0.04).
CONCLUSIONS
SL is a valuable parameter to modify, especially in combination with FP and SW modifications, to reduce markers of medial knee loading. Future work is needed to extend these findings to osteoarthritic knees.
To determine the effects of modifying stride length (SL) on knee adduction and flexion moments, two markers of knee loading associated with medial-compartment knee osteoarthritis progression. This study also tested if SL modifications, in addition to foot progression angle (FP) and step width (SW) modifications, provide solutions in more subjects for reducing knee adduction moment without increasing knee flexion moment (potentially protecting the joint).
METHODS
Fourteen healthy subjects (6 female) were enrolled in this preliminary study. Walking trials were collected first without instructions, and then following foot placement instructions for 50 combinations of SL, FP, and SW modifications. Repeated measures analysis of variance was used to detect group-average effects of footprint modifications on maximum knee adduction and flexion moments and on knee adduction moment impulse. Subject-specific dose-responses between footprint modifications and kinetics changes were modeled with linear regressions, and the models were used to identify modification solutions, per subject, for various kinetics change conditions.
RESULTS
Shorter SL significantly decreased the three kinetics measures (p<0.01). Potential solutions for 10% reductions in knee adduction moment maximum and impulse without increasing maximum knee flexion moment were identified for 5 subjects with FP and SW modifications. A significantly higher proportion of subjects had solutions when adding SL modifications (11 subjects, p=0.04).
CONCLUSIONS
SL is a valuable parameter to modify, especially in combination with FP and SW modifications, to reduce markers of medial knee loading. Future work is needed to extend these findings to osteoarthritic knees.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1115/1.4046713
- PMID 32203585
- Persistent URL
- https://sonar.ch/global/documents/19247
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