Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-13T03:51:57.060Z Has data issue: false hasContentIssue false
  • English
  • Français

Leg and Joint Stiffness in Patients with Bilateral Medial Knee Osteoarthritis During Level Walking

Published online by Cambridge University Press:  05 May 2011

I-P. Wei ,
W.-C. Hsu ,
H.-L. Chien ,
C.-F. Chang ,
Y.-H. Liu ,
T.-J. Ho ,
T.-M. Wang ,
J.-G. Lin  and
T.-W. Lu
I-P. Wei*
Affiliation:
Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan 40402, R.O.C
W.-C. Hsu*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
H.-L. Chien*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
C.-F. Chang*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
Y.-H. Liu*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
T.-J. Ho*
Affiliation:
School of Chinese Medicine, China Medical University, Taichung, Taiwan 40402, R.O.C.
T.-M. Wang*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C. Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan 10051, R.O.C.
J.-G. Lin*
Affiliation:
Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan 40402, R.O.C
T.-W. Lu*
Affiliation:
Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan 10617, R.O.C.
*
*Medical Doctor
*** Ph.D. candidate
**** Master of Science
*** Ph.D. candidate
**** Master of Science
*Medical Doctor
*Medical Doctor
*Medical Doctor
***** Professor, corresponding author
Get access

Abstract

Knowledge of the control of the musculoskeletal system in patients with knee osteoarthritis (OA) during gait is helpful for the development of intervention programs in the management of these patients. The current study aimed to investigate the leg and joint stiffness, aswell as the associated joint kinematics and kinetics, in patients with bilateral medial knee OA during gait. Joint angles, moments and stiffness, as well as leg stiffness from fifteen patients with bilateral knee OA and fifteen normal controls during level walking, were obtained and their values at the beginning and end of single leg stance were compared using a t-test.

Patients with knee OA were found to modulate their leg and joint stiffness through acquired specific biomechanical strategies in order to maintain normal temporal-spatial patterns of gait. During weight acceptance, they increased their leg stiffness with increased knee stiffness but unalterd hip and ankle stiffness. During weight release, they modulated their hip and ankle kinetics with increased knee and ankle stiffness to improve the control stability of the limb with unaltered leg stiffness. It is suggested that muscle strengthening exercise intervention and/or rehabilitation for patients with knee OA should focus on activities that develop and/or maintain functions not only of the knee, but also of the overall lower extremity.

Keywords

OA kneeWalking gaitStiffnessLower extremityKinematics and Kinetics
Type
Articles
Information
Journal of Mechanics , Volume 25 , Issue 3 , September 2009 , pp. 279 - 287
Copyright
Copyright © The Society of Theoretical and Applied Mechanics, R.O.C. 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Felson, D. T. and Zhang, Y., “An Update on the Epidemiology of Knee and Hip Osteoarthritis with a View to Prevention,” Arthritis Rheum, 41, pp. 1343–1355 (1998).3.0.CO;2-9>CrossRefGoogle Scholar
2.van den Berg, W. B. and van den Berg, W. B., “Pathophysiology of Osteoarthritis,” Joint, Bone, Spine: Revue du Rhumatisme, 67, pp. 555–556 (2000).CrossRefGoogle Scholar
3.Mundermann, A., Dyrby, C. O. and Andriacchi, T. P., “Secondary Gait Changes in Patients with Medial Compartment Knee Osteoarthritis: Increased Load at the Ankle, Knee, and Hip During Walking,” Arthritis Rheum, 52, pp. 2835–2844 (2005).CrossRefGoogle Scholar
4.Gok, H., Ergin, S. and Yavuzer, G., “Kinetic and Kinematic Characteristics of Gait in Patients with Medial Knee Arthrosis,” Acta Orthop Scand, 73, pp. 647–652 (2002).CrossRefGoogle Scholar
5.Huang, , “Effects of Severity of Degeneration on Gait Patterns in Pateints with Medial Knee Osteoarthritis,” In press (2008).Google Scholar
6.Kaufman, K. R., Hughes, C., Morrey, B. F., Morrey, M. and An, K. N., “Gait Characteristics of Patients with Knee Osteoarthritis,” Journal of Biomechanics, 34, pp. 907–915 (2001).CrossRefGoogle Scholar
7.Farley, C. T. and Morgenroth, D. C., “Leg Stiffness Primarily Depends on Ankle Stiffness During Human Hopping,” Journal of Biomechanics, 32, pp. 267–273 (1999).CrossRefGoogle Scholar
8.Gunther, M. and Blickhan, R., “Joint Stiffness of the Ankle and the Knee in Running,” Journal of Biomechanics, 35, pp. 1459–1474 (2002).CrossRefGoogle Scholar
9.Ferris, D. P., Louie, M. and Farley, C. T. I. F. D. P., “Running in the Real World: Adjusting Leg Stiffness for Different Surfaces,” Proceedings of the Royal Society of London — Series B: Biological Sciences, 265, pp. 989–994 (1998).CrossRefGoogle Scholar
10.DeVita, P., Hortobagyi, T., DeVita, P. and Hortobagyi, T., “Age Increases the Skeletal Versus Muscular Component of Lower Extremity Stiffness During Stepping Down,” Journals of Gerontology Series A — Biological Sciences and Medical Sciences, 55, pp. B593–B600 (2000).CrossRefGoogle Scholar
11.Butler, R. J., Davis, I. M., Laughton, C. M. and Hughes, M., “Dual-Function Foot Orthosis: Effect on Shock and Control of Rearfoot Motion,” Foot and Ankle International, 24, pp. 410–414 (2003).CrossRefGoogle Scholar
12.Ferris, D. P., Louie, M. and Farley, C. T., “Running in the Real World: Adjusting Leg Stiffness for Different Surfaces,” Proceedings Biological Sciences/The Royal Society, 265, pp. 989–994 (1998).CrossRefGoogle Scholar
13.DeVita, P. and Hortobagyi, T., “Age Causes a Redistribution of Joint Torques and Powers During gait,” Journal of Applied Physiology, 88, pp. 1804–1811 (2000).CrossRefGoogle Scholar
14.Hortobagyi, T. and DeVita, P., “Muscle Pre- and Coactivity During Downward Stepping are Associated with Leg Stiffness in Aging,” Journal of Electromyography and Kinesiology, 10, pp. 117–126 (2000).CrossRefGoogle Scholar
15.Lark, S. D., Buckley, J. G., Bennett, S., Jones, D., Sargeant, A. J., Lark, S. D., Buckley, J. G., Bennett, S., Jones, D. and Sargeant, A. J., “Joint Torques and Dynamic Joint Stiffness in Elderly and Young Men During Stepping Down,” Clinical Biomechanics, 18, pp. 848–855 (2003).CrossRefGoogle Scholar
16.Holt, K. G., Wagenaar, R. C., LaFiandra, M. E., Kubo, M. and Obusek, J. P., “Increased Musculoskeletal Stiffness During Load Carriage at Increasing Walking Speeds Maintains Constant Vertical Excursion of the Body Center of Mass,” Journal of Biomechanics, 36, pp. 465–471 (2003).CrossRefGoogle Scholar
17.Arampatzis, A., Bruggemann, G. P. and Metzler, V., “The Effect of Speed on Leg Stiffness and Joint Kinetics in Human Running,” Journal of Biomechanics, 32, pp. 1349–1353 (1999).CrossRefGoogle Scholar
18.Seyfarth, A., Geyer, H., Gunther, M. and Blickhan, R., “A Movement Criterion for Running,” Journal of Biomechanics, 35, pp. 649–655 (2002).CrossRefGoogle Scholar
19.Kellgren, J. H. and Lawrence, J. S., “Radiological Assessment Og Osteoarthrosis,” Annals of the Rheumatic Diseases, 16, pp. 494–502 (1957).CrossRefGoogle Scholar
20.Dalton, J. A., McNaull, F., Dalton, J. A. and McNaull, F., “A Call for Standardizing the Clinical Rating of Pain Intensity Using a 0 to 10 Rating Scale,” Cancer Nursing, 21, pp. 46–49 (1998).CrossRefGoogle Scholar
21.Lu, T. W. and Lu, C. H., “Forces Transmitted in the Knee Joint During Stair Ascent and Descent,” Journal of Mechanics, 22, pp. 289–297 (2006).CrossRefGoogle Scholar
22.Lin, H. C., Lu, T. W. and Hsu, H. C., “Comparisons of Joint Kinetics in the Lower Extremity Between Stair Ascent and Descent,” Journal of Mechanics, 21, pp. 41–50 (2005).CrossRefGoogle Scholar
23.Shih, K. S., Lu, T. W., Fu, Y. C., Hou, S.-M., , J. S. and Cheng, C. Y., “Biomechanical Analysis of Nonconstrained and Semiconstrained Total Elbow Replacement: A Preliminary Report,” Journal of Mechanics, 24, pp. 103–110 (2008).CrossRefGoogle Scholar
24.Cole, G. K., Nigg, B. M., Ronsky, J. L. and Yeadon, M. R., “Application of the Joint Coordinate System to Three-Dimensional Joint Attitude and Movement Representation: A Standardization Proposal,” Journal of Biomechanical Engineering, 115, pp. 344–349 (1993).CrossRefGoogle Scholar
25.Veldpaus, F. E., Woltring, H. J. and Dortmans, L. J., “A Least-Squares Algorithm for the Equiform Transformation from Spatial Marker Co-Ordinates,” Journal of Biomechanics, 21, pp. 45–54 (1988).CrossRefGoogle Scholar
26.Lu, T. W., Chen, H. L. and Wang, T. M., “Obstacle Crossing in Older Adults with Medial Compartment Knee Osteoarthritis,” Gait Posture, 26, pp. 553–559 (2007).CrossRefGoogle Scholar
27.Dempster, W. T., Gabel, W. C. and Felts, W. J., “The Anthropometry of the Manual Work Space for the Seated Subject,” Am. J. Phys. Anthropol, 17, pp. 289–317 (1959).CrossRefGoogle Scholar
28.Bell, A. L., Pedersen, D. R. and Brand, R. A., “A Comparison of the Accuracy of Several Hip Center Location Prediction Methods,” Journal of Biomechanics, 23, pp. 617–621 (1990).CrossRefGoogle Scholar
29.Lu, T. W., Chien, H. L., Chen, H. L., Lu, T.-W., Chien, H.-L. and Chen, H.-L., “Joint Loading in the Lower Extremities During Elliptical Exercise,” Medicine and Science in Sports and Exercise, 39, pp. 1651–1658 (2007).CrossRefGoogle Scholar
30.Soylu, A. R., Ertan, H., Korkusuz, F., Soylu, A. R., Ertan, H. and Korkusuz, F., “Archery Performance Level and Repeatability of Event-Related EMG,” Human Movement Science, 25, pp. 161–114 (2006).CrossRefGoogle Scholar
31.Granata, K. P., Padua, D. A. and Wilson, S. E., “Gender Differences in Active Musculoskeletal Stiffness. Part II. Quantification of Leg Stiffness During Functional Hopping Tasks,” Journal of Electromyography and Kinesiology, 12, pp. 127–135 (2002).CrossRefGoogle Scholar
32.Lu, T. W., O'Connor, J. J., Taylor, S. J. and Walker, P. S., “Validation of a Lower Limb Model with in Vivo Femoral Forces Telemetered from Two Subjects,” Journal of Biomechanics, 31, pp. 63–69 (1998).CrossRefGoogle Scholar
33.Pandya, N. K., Piotrowski, G. A., Pottenger, L. and Draganich, L. F., “Pain Relief in Knee Osteoarthritis Reduces the Propensity to Trip on an Obstacle,” Gait and Posture, 25, pp. 106–111 (2007).CrossRefGoogle Scholar
34.Hunter, J. P., Marshall, R. N., Hunter, J. P. and Marshall, R- N., “Effects of Power and Flexibility Training on Vertical Jump Technique,” Medicine and Science in Sports and Exercise, 34, pp. 478–486 (2002).CrossRefGoogle Scholar