Lewinson RT, Worobets JT, Stefanyshyn DJ. Calculation of external knee adduction moments: a comparison of an inverse dynamics approach and a simplified lever-arm approach.
Knee 2015;
22:292-7. [PMID:
26006770 DOI:
10.1016/j.knee.2015.04.003]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/17/2015] [Accepted: 04/06/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND
The external knee adduction moment (EKAM) is often studied in knee osteoarthritis research. This study compared EKAMs between two methods of calculation: a method that only requires ground reaction force and knee position data (i.e. lever-arm), and an inverse dynamics link-segment method.
METHODS
Sixteen participants walked while wearing a control shoe with and without a six millimeter lateral wedge insole. Peak EKAMs between the lever-arm and inverse dynamics methods were compared for the control condition, and the %change in moment induced by the lateral wedge was compared between methods.
RESULTS
When comparing EKAMs between methods, no correlation was found (r=0.24, p=0.36); peak EKAMs with the lever-arm method (26.0Nm) were significantly lower than EKAMs with the inverse dynamics method (40.2Nm, pb0.001); and Bland-Altman plots showed poor agreement between methods. When assessing the %change in moment with a lateral wedge, a moderate correlation was found (r=0.55, p=0.03) between methods; Bland-Altman plots showed moderate agreement between methods; and the lever-arm method (-6.4%) was not significantly different from the inverse dynamics method (-11.4%, p=0.09); however, the two methods produced opposite results 31% of the time.
CONCLUSION
The lever-arm method cannot estimate peak EKAMs, and can only approximate the %change in moment induced by a lateral wedge; however, the error rate was 31%. Therefore, the lever-arm method is not recommended for use in its current form.
CLINICAL RELEVANCE
This study may help guide the development of a fast and simple method for determining EKAMs for individuals with knee osteoarthritis.
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