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Kawaji H1,2, Kojima S3
1Health Science University of Hokkaido Hospital, Department of Rehabilitation, Sapporo, Japan, 2Health Science University of Hokkaido, Graduate School of Rehabilitation Sciences, Tobetsu, Japan, 3Health Science University of Hokkaido, School of Rehabilitation Sciences, Tobetsu, Japan
Background: Patients with knee osteoarthritis (OA) have altered sagittal plane knee joint kinematics during gait. Previous studies showed that patients with knee OA had reduced knee flexion excursion (KFE) during the early stance (ES). Other studies indicated that individuals with knee OA had higher knee flexion at initial contact (IC) than asymptomatic individuals. Little is known about the influence of the knee joint kinematics on joint loading during gait.
Purpose: This study aimed to elucidate the impact of sagittal plane knee joint kinematics on joint loading during gait.
Methods: Ten healthy adult men participated in this study (age: 21.1±0.87 years; body height: 167.98±4.95 cm; and body weight: 58.68±4.32 kg). The participants performed gait trials under 4 different conditions (a baseline condition and 3 controlled conditions). The 3 controlled conditions were defined as follows:
1) Less flexion (LF) was defined as gait that decreased KFE owing to reduced peak knee flexion at ES.
2) IC flexion (IF) was defined as gait that decreased KFE owing to increased knee flexion at IC, and peak knee flexion at ES was not altered.
3) Flexion gait (FG) was defined as gait that increased knee flexion at IC and did not reduce KFE.
The participants controlled knee motion by received auditory signal feedback. Auditory signal feedback on knee angle was provided by a flexible goniometer (Biometric Ltd) and feedback logger (DKH corporation).
Data were collected using an 8-camera motion analysis system (Motion Analysis Corporation, 100 Hz) and three force plates (AMTI 1,000 Hz). A Helen Hayes marker set was used to collect kinematic data. In each trial, the participants walked 1.0 m/sec±5%. The walking speed was determined by measuring the transit time between two reference points using a stopwatch. For each condition, data for 5 successful trials were collected.
Peak external knee flexion moment (KFM), first peak external knee adduction moment (KAM), KFM impulse, KAM impulse (impulse was the integral value from IC to peak value), first peak vertical ground reaction force, and maximum loading rate were analyzed from the collected data. Repeated-measures analysis of variance and Friedman tests were performed for statistical analysis, and post hoc tests were performed using Bonferroni correction. The alpha level was set to 0.05, and the mean value of 5 trials was used for the analysis.
Results: Peak KFM decreased during LF and increased during FG compared to that at baseline. The KFM impulse values during IF and FG were significantly higher than those at baseline.
Conclusion(s): This study suggests that knee flexion-extension motion influences sagittal plane joint load. In FG, peak KFM and KFM impulse values increased because of the increasing peak knee flexion angle at ES. IF exhibited a greater knee flexion angle at IC than at baseline. However, peak knee flexion angle at ES did not significantly differ from that at baseline. This finding suggests that the knee flexion angle at IC also affects the KFM impulse.
Implications: The findings aid in understanding the relationship between sagittal plane knee joint kinematics and joint loading.
Keywords: Gait analysis, knee joint kinematics, joint load
Funding acknowledgements: Unfunded.
Purpose: This study aimed to elucidate the impact of sagittal plane knee joint kinematics on joint loading during gait.
Methods: Ten healthy adult men participated in this study (age: 21.1±0.87 years; body height: 167.98±4.95 cm; and body weight: 58.68±4.32 kg). The participants performed gait trials under 4 different conditions (a baseline condition and 3 controlled conditions). The 3 controlled conditions were defined as follows:
1) Less flexion (LF) was defined as gait that decreased KFE owing to reduced peak knee flexion at ES.
2) IC flexion (IF) was defined as gait that decreased KFE owing to increased knee flexion at IC, and peak knee flexion at ES was not altered.
3) Flexion gait (FG) was defined as gait that increased knee flexion at IC and did not reduce KFE.
The participants controlled knee motion by received auditory signal feedback. Auditory signal feedback on knee angle was provided by a flexible goniometer (Biometric Ltd) and feedback logger (DKH corporation).
Data were collected using an 8-camera motion analysis system (Motion Analysis Corporation, 100 Hz) and three force plates (AMTI 1,000 Hz). A Helen Hayes marker set was used to collect kinematic data. In each trial, the participants walked 1.0 m/sec±5%. The walking speed was determined by measuring the transit time between two reference points using a stopwatch. For each condition, data for 5 successful trials were collected.
Peak external knee flexion moment (KFM), first peak external knee adduction moment (KAM), KFM impulse, KAM impulse (impulse was the integral value from IC to peak value), first peak vertical ground reaction force, and maximum loading rate were analyzed from the collected data. Repeated-measures analysis of variance and Friedman tests were performed for statistical analysis, and post hoc tests were performed using Bonferroni correction. The alpha level was set to 0.05, and the mean value of 5 trials was used for the analysis.
Results: Peak KFM decreased during LF and increased during FG compared to that at baseline. The KFM impulse values during IF and FG were significantly higher than those at baseline.
Conclusion(s): This study suggests that knee flexion-extension motion influences sagittal plane joint load. In FG, peak KFM and KFM impulse values increased because of the increasing peak knee flexion angle at ES. IF exhibited a greater knee flexion angle at IC than at baseline. However, peak knee flexion angle at ES did not significantly differ from that at baseline. This finding suggests that the knee flexion angle at IC also affects the KFM impulse.
Implications: The findings aid in understanding the relationship between sagittal plane knee joint kinematics and joint loading.
Keywords: Gait analysis, knee joint kinematics, joint load
Funding acknowledgements: Unfunded.
Topic: Human movement analysis; Musculoskeletal: lower limb
Ethics approval required: Yes
Institution: Health Science University of Hokkaido
Ethics committee: Graduate School of Rehabilitation Sciences
Ethics number: 18R077070
All authors, affiliations and abstracts have been published as submitted.
