1
|
The Effect of Age and Fall History on Lower Extremity Neuromuscular Function During Descent of a Single Transition Step. J Aging Phys Act 2022; 31:249-256. [PMID: 36068074 DOI: 10.1123/japa.2021-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 06/01/2022] [Accepted: 07/12/2022] [Indexed: 01/12/2023]
Abstract
Despite the higher injury rate of falls on steps versus level ground, few studies have examined the influence of age and fall history on step descent. The purpose of this study was to determine the lead and trail limb neuromuscular function (peak joint moments and powers, electromyographic activity) differences between young females (n = 15) and older females with (n = 15) and without (n = 15) a fall history while descending a single step. Trail limb moments and powers did not differ between groups. Lead limb sagittal plane powers at the hip and knee were greater in the young adults. Electromyographic co-activation levels (knee and ankle) were not significantly different between groups. However, peroneal activation was greater in the older groups, which may have assisted in stabilizing the ankle joint in lieu of increased co-activation at the ankle. These results demonstrate consideration of step descent is important in working with older women at risk of falls.
Collapse
|
2
|
Pentidis N, Mersmann F, Bohm S, Giannakou E, Aggelousis N, Arampatzis A. Effects of long-term athletic training on muscle morphology and tendon stiffness in preadolescence: association with jump performance. Eur J Appl Physiol 2020; 120:2715-2727. [PMID: 32930859 PMCID: PMC7674345 DOI: 10.1007/s00421-020-04490-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022]
Abstract
Purpose Evidence on training-induced muscle hypertrophy during preadolescence is limited and inconsistent. Possible associations of muscle strength and tendon stiffness with jumping performance are also not investigated. We investigated the thickness and pennation angle of the gastrocnemius medialis muscle (GM), as indicators for potential muscle hypertrophy in preadolescent athletes. Further, we examined the association of triceps surae muscle–tendon properties with jumping performance. Methods Eleven untrained children (9 years) and 21 similar-aged artistic gymnastic athletes participated in the study. Muscle thickness and pennation angle of the GM were measured at rest and muscle strength of the plantar flexors and Achilles tendon stiffness during maximum isometric contractions. Jumping height in squat (SJ) and countermovement jumps (CMJ) was examined using a force plate. We evaluated the influence of normalised muscle strength and tendon stiffness on jumping performance with a linear regression model. Results Muscle thickness and pennation angle did not differ significantly between athletes and non-athletes. In athletes, muscle strength was greater by 25% and jumping heights by 36% (SJ) and 43% (CMJ), but Achilles tendon stiffness did not differ between the two groups. The significant predictor for both jump heights was tendon stiffness in athletes and normalised muscle strength for the CMJ height in non-athletes. Conclusion Long-term artistic gymnastics training during preadolescence seems to be associated with increased muscle strength and jumping performance but not with training-induced muscle hypertrophy or altered tendon stiffness in the plantar flexors. Athletes benefit more from tendon stiffness and non-athletes more from muscle strength for increased jumping performance.
Collapse
Affiliation(s)
- Nikolaos Pentidis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Erasmia Giannakou
- Department of Physical Education and Sports Science, Democritus University of Thrace, Komotini, Greece
| | - Nickos Aggelousis
- Department of Physical Education and Sports Science, Democritus University of Thrace, Komotini, Greece
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany. .,Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany.
| |
Collapse
|
3
|
Edwards N, Dulai J, Rahman A. A Scoping Review of Epidemiological, Ergonomic, and Longitudinal Cohort Studies Examining the Links between Stair and Bathroom Falls and the Built Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091598. [PMID: 31067692 PMCID: PMC6540131 DOI: 10.3390/ijerph16091598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 11/16/2022]
Abstract
Stair and bathroom falls contribute to injuries among older adults. This review examined which features of stairs and bathrooms have been assessed in epidemiological, ergonomic, and national aging studies on falls or their risk factors. Epidemiological and ergonomic studies were eligible if published from 2006-2017, written in English, included older persons, and reported built environment measures. The data extracted included the following: study population and design, outcome measures, and stair and bathroom features. National aging studies were eligible if English questionnaires were available, and if data were collected within the last 10 years. Sample characteristics; data collection methods; and data about falls, the environment, and assistive device use were extracted. There were 114 eligible articles assessed-38 epidemiologic and 76 ergonomic. Among epidemiological studies, 2 assessed stair falls only, 4 assessed bathroom falls only, and 32 assessed falls in both locations. Among ergonomic studies, 67 simulated stairs and 9 simulated bathrooms. Specific environmental features were described in 14 (36.8%) epidemiological studies and 73 (96%) ergonomic studies. Thirteen national aging studies were identified-four had stair data and six had bathroom data. Most epidemiologic and national aging studies did not include specific measures of stairs or bathrooms; the built environment descriptions in ergonomic studies were more detailed. More consistent and detailed environmental measures in epidemiologic and national aging studies would better inform fall prevention approaches targeting the built environment.
Collapse
Affiliation(s)
- Nancy Edwards
- School of Nursing, University of Ottawa, Ottawa, ON K1S 5L5, Canada.
| | - Joshun Dulai
- School of Nursing, University of Ottawa, Ottawa, ON K1S 5L5, Canada.
| | - Alvi Rahman
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC H3A 0G4, Canada.
| |
Collapse
|
4
|
Wang S, Chan KHC, Lam RHM, Yuen DNS, Fan CKM, Chu TTC, Baur H, Cheung RTH. Effects of foot progression angle adjustment on external knee adduction moment and knee adduction angular impulse during stair ascent and descent. Hum Mov Sci 2019; 64:213-220. [PMID: 30784892 DOI: 10.1016/j.humov.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 11/19/2022]
Abstract
Foot progression angle adjustment was shown to reduce external knee adduction moment (EKAM) and knee adduction angular impulse (KAAI) during level ground walking. However, evidence on effects of foot progression angle adjustment on the above surrogate measures of medial knee loading during stair climbing is limited. Hence, this study examined the effects of toe-in and toe-out gait on EKAM and KAAI during stair ascent and descent. Kinematic and kinetic data were collected from thirty-two healthy adults during stair ascent and descent with toe-in, toe-out and natural gait. A repeated measures ANOVA indicated that toe-in gait significantly reduced the first EKAM peak (P < 0.001) and KAAI (P = 0.002), while toe-out gait significantly increased the first (P < 0.001) and second (P = 0.04) EKAM peaks and KAAI (P < 0.001) when compared with natural gait during stair ascent. During stair descent, toe-in gait significantly reduced the first (P < 0.001) and second (P = 0.032) EKAM peaks and KAAI (P < 0.001), whilst toe-out gait significantly increased the first EKAM peak (P = 0.022) and KAAI (P = 0.028) when compared with natural gait. In conclusion, toe-in gait was found to be a viable strategy in reducing medial knee loading during stair climbing.
Collapse
Affiliation(s)
- Sizhong Wang
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Kitty H C Chan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Rachel H M Lam
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Daisy N S Yuen
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Carmen K M Fan
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Thomas T C Chu
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong
| | - Heiner Baur
- Movement Laboratory, Health Department, Bern University of Applied Sciences, Switzerland
| | - Roy T H Cheung
- Gait & Motion Analysis Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
| |
Collapse
|
5
|
Moniz-Pereira V, Kepple TM, Cabral S, João F, Veloso AP. Joint moments' contributions to vertically accelerate the center of mass during stair ambulation in the elderly: An induced acceleration approach. J Biomech 2018; 79:105-111. [PMID: 30104054 DOI: 10.1016/j.jbiomech.2018.07.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 06/18/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Abstract
Falls are a serious problem faced by the elderly. Older adults report mostly to fall while performing locomotor activities, especially the ones requiring stair negotiation. During these tasks, older adults, when compared with young adults, seem to redistribute their lower limb joint moments. This may indicate that older adults use a different strategy to accelerate the body upward during these tasks. The purposes of this study were to quantify the contributions of each lower limb joint moment to vertically accelerate the center of mass during stair ascent and descent, in a sample of community-dwelling older adults, and to verify if those contributions were correlated with age and functional fitness level. A joint moment induced acceleration analysis was performed in 29 older adults while ascending and descending stairs at their preferred speed. Agreeing with previous studies, during both tasks, the ankle plantarflexor and the knee extensor joint moments were the main contributors to support the body. Although having a smaller contribution to vertically accelerate the body, during stair descent, the hip joint moment contribution was related with the balance score. Further, older adults, when compared with the results reported previously for young adults, seem to use more their knee extensor moment than the ankle plantarflexor moment to support the body when the COM downward velocity is increasing. By contributing for a better understanding of stair negotiation in community dwelling older adults, this study may help to support the design of interventions aiming at fall prevention and/or mobility enhancement within this population.
Collapse
Affiliation(s)
- Vera Moniz-Pereira
- Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | | | - Silvia Cabral
- Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal
| | - Filipa João
- Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal
| | - António P Veloso
- Universidade de Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal
| |
Collapse
|
6
|
Conway ZJ, Blackmore T, Silburn PA, Cole MH. Dynamic balance control during stair negotiation for older adults and people with Parkinson disease. Hum Mov Sci 2018; 59:30-36. [PMID: 29602049 DOI: 10.1016/j.humov.2018.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023]
Abstract
It is well understood that stability during ambulation is reliant upon appropriate control of the trunk segment, but research shows that the rhythmicity of this segment is significantly reduced for people with Parkinson's disease (PD). Given the increased risk associated with stair ambulation, this study investigated whether people with PD demonstrate poorer trunk control during stair ambulation compared with age-matched controls. Trunk accelerations were recorded for twelve PD patients and age-matched controls during stair ascent and descent. Accelerations were used to derive measures of harmonic ratios and root mean square (RMS) acceleration to provide insight into the rhythmicity and amplitude of segmental motion. Compared with what is typically seen during level-ground walking, gait rhythmicity during stair negotiation was markedly reduced for older adults and people with PD. Furthermore, both groups exhibited significantly poorer trunk movements during stair descent compared to stair ascent, suggesting that both populations may face a greater risk of falling during this task. As stair negotiation is a common activity of daily life, the increased risk associated with this task should be considered when working with populations that have an increased risk of falling.
Collapse
Affiliation(s)
- Zachary J Conway
- Australian Catholic University, School of Exercise Science, Brisbane, Queensland, Australia.
| | - Tim Blackmore
- Australian Catholic University, School of Exercise Science, Brisbane, Queensland, Australia; University of Portsmouth, Department of Sport & Exercise Science, Hampshire, United Kingdom
| | - Peter A Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael H Cole
- Australian Catholic University, School of Exercise Science, Brisbane, Queensland, Australia.
| |
Collapse
|
7
|
Evidence of compensatory joint kinetics during stair ascent and descent in Parkinson's disease. Gait Posture 2017; 52:33-39. [PMID: 27863279 DOI: 10.1016/j.gaitpost.2016.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/12/2016] [Accepted: 11/07/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Stair ambulation is a challenging activity of daily life that requires larger joint moments than walking. Stabilisation of the body and prevention of lower limb collapse during this task depends upon adequately-sized hip, knee and ankle extensor moments. However, people with Parkinson's disease (PD) often present with strength deficits that may impair their capacity to control the lower limbs and ultimately increase their falls risk. OBJECTIVE To investigate hip, knee and ankle joint moments during stair ascent and descent and determine the contribution of these joints to the body's support in people with PD. METHODS Twelve PD patients and twelve age-matched controls performed stair ascent and descent trials. Data from an instrumented staircase and a three-dimensional motion analysis system were used to derive sagittal hip, knee and ankle moments. Support moment impulses were calculated by summing all extensor moment impulses and the relative contribution of each joint was calculated. RESULTS Linear mixed model analyses indicated that PD patients walked slower and had a reduced cadence relative to controls. Although support moment impulses were typically not different between groups during stair ascent or descent, a reduced contribution by the ankle joint required an increased knee joint contribution for the PD patients. CONCLUSIONS Despite having poorer knee extensor strength, people with PD rely more heavily on these muscles during stair walking. This adaptation could possibly be driven by the somewhat restricted mobility of this joint, which may provide these individuals with an increased sense of stability during these tasks.
Collapse
|
8
|
Jacobs JV. A review of stairway falls and stair negotiation: Lessons learned and future needs to reduce injury. Gait Posture 2016; 49:159-167. [PMID: 27427833 DOI: 10.1016/j.gaitpost.2016.06.030] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/27/2016] [Accepted: 06/23/2016] [Indexed: 02/02/2023]
Abstract
Stairways are a common location for falls, and they result in a disproportionate risk of death or severe injury. Stairway falls are a significant problem across the lifespan and are often coincident with risky behaviors during stair use. The mechanics of successful stair negotiation for healthy young and older adults have been well described. These studies imply that current stair design does not offer an optimal universal design to meet the needs of older adults or people with health conditions. In addition, impaired stair negotiation associates with more than impaired strength, including functional impairments of cognitive load, sensory function and central motor coordination. Identification of behavioral strategies or stairway environments that assist or hinder recovery from a loss of balance on stairs remains incomplete. Therefore, future studies should investigate the mechanisms of balance recovery on stairs as well as the effectiveness of environmental interventions to mitigate stairway falls and injuries. Potential areas for evaluation may include modifying stair dimensions, surfaces, handrails, visual cues, and removing distractors of attention. Studies should also evaluate combinatorial interventions on person-related factors, such as behavioral interventions to decrease risky behaviors during stair use as well as interventions on cognitive, sensory, and motor functions relevant to stair use. Moreover, future studies should take advantage of new technologies to record stair use outside the laboratory in order to identify people or locations at risk for stairway falls. Such studies would inform the potential for broad-spectrum programs that decrease the risk of stairway falls and injuries.
Collapse
Affiliation(s)
- Jesse V Jacobs
- Center for Physical Ergonomics, Liberty Mutual Research Institute for Safety, 71 Frankland Rd., Hopkinton, MA, 01748, USA.
| |
Collapse
|
9
|
Skinner JW, Lee HK, Roemmich RT, Amano S, Hass CJ. Execution of Activities of Daily Living in Persons with Parkinson Disease. Med Sci Sports Exerc 2016; 47:1906-12. [PMID: 25494393 DOI: 10.1249/mss.0000000000000598] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Muscular weakness and the motor difficulties associated with Parkinson disease (PD) often impair the performance of activities of daily living (ADL). However, little is known about the magnitude and distribution of relative muscular effort of persons with PD during ADL. The purpose of this investigation was to determine the relative magnitude of lower extremity moment production that persons with PD use to perform common ADL. METHODS Fifteen participants with mild-to-moderate PD and 14 age/sex-matched controls volunteered. Participants performed a series of ADL tasks, as follows: gait initiation (GI), gait, and stair ascending tasks. Participants were then asked to perform maximal-effort isokinetic tests of hip and knee extension and ankle plantarflexion at speeds of 90° per second and 120° per second. Relative effort was quantified as a percentage of the maximal isokinetic value produced by a joint during performance of the ADL. Relative effort and peak isokinetic joint moments were analyzed using a mixed-model ANOVA with repeated measures. All other comparisons were evaluated using independent t-tests. RESULTS Persons with PD produced smaller ankle plantarflexion moment at both 90° per second and 120° per second (P < 0.05). Relative effort during GI (271% vs 189%, P < 0.05) and gait (270% vs 161%, P < 0.05) was significantly greater at the ankle in persons with PD. Contribution of the ankle to the support moment was lower in PD during stair ascending (24% vs 34%) and GI (63% vs 57%) compared with that in controls. CONCLUSIONS The reduced ankle moments during ADL are indicative of deficits in muscular capabilities in those with PD. Moreover, PD caused a redistribution of joint torques, such that PD participants used their hip extensors more and ankle plantarflexors less.
Collapse
Affiliation(s)
- Jared W Skinner
- 1Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL; 2Motion Analysis Laboratory, Kennedy Krieger Institute, Baltimore, MD; 3Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD; 4Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens OH; and 5Center for Movement Disorders and Neurorestoration, Gainesville, FL
| | | | | | | | | |
Collapse
|
10
|
Biomechanical demands of the 2-step transitional gait cycles linking level gait and stair descent gait in older women. J Biomech 2015; 48:4191-7. [DOI: 10.1016/j.jbiomech.2015.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 09/08/2015] [Accepted: 09/24/2015] [Indexed: 11/17/2022]
|
11
|
Qu X. Effects of lower-limb muscular fatigue on stair gait. J Biomech 2015; 48:4059-4064. [DOI: 10.1016/j.jbiomech.2015.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/29/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
|
12
|
Mersmann F, Bohm S, Schroll A, Boeth H, Duda G, Arampatzis A. Muscle shape consistency and muscle volume prediction of thigh muscles. Scand J Med Sci Sports 2014; 25:e208-13. [DOI: 10.1111/sms.12285] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2014] [Indexed: 01/25/2023]
Affiliation(s)
- F. Mersmann
- Department of Training and Movement Sciences; Humboldt-Universität zu Berlin; Berlin Germany
| | - S. Bohm
- Department of Training and Movement Sciences; Humboldt-Universität zu Berlin; Berlin Germany
| | - A. Schroll
- Department of Training and Movement Sciences; Humboldt-Universität zu Berlin; Berlin Germany
| | - H. Boeth
- Julius Wolff Institute; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - G. Duda
- Julius Wolff Institute; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Arampatzis
- Department of Training and Movement Sciences; Humboldt-Universität zu Berlin; Berlin Germany
| |
Collapse
|
13
|
Oberländer KD, Brüggemann GP, Höher J, Karamanidis K. Knee mechanics during landing in anterior cruciate ligament patients: A longitudinal study from pre- to 12 months post-reconstruction. Clin Biomech (Bristol, Avon) 2014; 29:512-7. [PMID: 24815055 DOI: 10.1016/j.clinbiomech.2014.03.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/28/2014] [Accepted: 03/31/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with a history of anterior cruciate ligament rupture are at elevated risk of developing knee osteoarthritis. Altered knee kinematics and kinetics during functional activities have been viewed as risk factors for cartilage breakdown and, therefore, one of the primary goals of anterior cruciate ligament reconstruction is to restore knee joint function. METHODS Patients' (n=18) knee mechanics while performing a single leg hop for distance were calculated for both legs using a soft-tissue artifact optimized rigid lower-body model at the pre-reconstruction state and six and twelve months after anterior cruciate ligament reconstruction. FINDINGS Independent of the analyzed time point the involved leg showed a lower external flexion and adduction moment at the knee, and an increased anterior translation and external rotational offset of the shank with respect to the thigh compared to the uninvolved leg. There were no differences for any of the analyzed knee kinematic and kinetic parameters within the control subject group. INTERPRETATION The identified kinematic changes can cause a shift in the normal load-bearing regions of the knee and may support the view that the risk of developing knee osteoarthritis in an anterior cruciate ligament ruptured joint while performing activities involving frequent landing and stopping actions is less likely to be associated with the knee adduction moment and is rather due to kinematic changes. Anterior cruciate ligament reconstruction surgery failed to restore normal knee kinematics during landing, potentially explaining the persistent risk for the development of knee osteoarthritis in patients who have returned to sports following reconstruction surgery.
Collapse
Affiliation(s)
- Kai Daniel Oberländer
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Institute of Movement and Sport Gerontology, German Sport University Cologne, Germany.
| | - Gert-Peter Brüggemann
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Germany
| | - Jürgen Höher
- Clinic for Sports Traumatology at Cologne Merheim Medical Center, University of Witten-Herdecke, Germany
| | - Kiros Karamanidis
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Department of Mathematics and Technology, University of Applied Sciences Koblenz, RheinAhrCampus Remagen, Germany
| |
Collapse
|
14
|
Mills K, Hettinga BA, Pohl MB, Ferber R. Between-Limb Kinematic Asymmetry During Gait in Unilateral and Bilateral Mild to Moderate Knee Osteoarthritis. Arch Phys Med Rehabil 2013; 94:2241-7. [DOI: 10.1016/j.apmr.2013.05.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 05/13/2013] [Accepted: 05/14/2013] [Indexed: 10/26/2022]
|
15
|
Kulmala JP, Äyrämö S, Avela J. Knee extensor and flexor dominant gait patterns increase the knee frontal plane moment during walking. J Orthop Res 2013; 31:1013-9. [PMID: 23417834 DOI: 10.1002/jor.22323] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/21/2013] [Indexed: 02/04/2023]
Abstract
High gait-induced knee frontal plane moment is linked with the development of knee osteoarthritis. Gait patterns across the normal population exhibit large inter-individual variabilities especially at the knee sagittal plane moment profile during loading response and terminal stance phase. However, the effects of different gait patterns on this moment remain unknown. Therefore, we examined whether different gait patterns are associated with atypically high knee frontal plane moments. Profiles of knee joint moments divided a sample of 24 subjects into three subgroups (11, 7, 6) through cluster analysis. Kinetics, kinematics, and spatio-temporal parameters were compared among clusters. Subjects who showed a typical sagittal plane moment pattern (n = 11) had 43% lower first peak of knee frontal plane moment compared to the cluster, which showed the dominance of the knee extensor moment during stance phase (n = 7, p < 0.01). In addition, a typical gait pattern cluster had 44% lower second peak knee frontal plane moment than the cluster, which showed the dominance of the knee flexor moment during the terminal stance phase (n = 6, p < 0.05). These findings indicate that different knee strategies driving gait considerably impact knee loading, suggesting that knee extensor and flexor dominant gait patterns demonstrate atypically high knee frontal plane moments. People in these subgroups may, therefore, be at higher risk of developing knee osteoarthritis.
Collapse
Affiliation(s)
- Juha-Pekka Kulmala
- Department of Biology of Physical Activity, University of Jyväskylä, Rautpohjan Katu 8A, 40014 Jyväskylä, Finland.
| | | | | |
Collapse
|
16
|
Bosse I, Oberländer KD, Savelberg HH, Meijer K, Brüggemann GP, Karamanidis K. Dynamic stability control in younger and older adults during stair descent. Hum Mov Sci 2012; 31:1560-70. [DOI: 10.1016/j.humov.2012.05.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 03/31/2012] [Accepted: 05/16/2012] [Indexed: 10/28/2022]
|