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Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis.

Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Bergman NR - J Foot Ankle Res (2013)

Bottom Line: Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004).Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = -0.44, p = 0.01) and KAAI (r = -0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01).Increased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne Vic 8001, Australia. pazit.levinger@vu.edu.au.

ABSTRACT

Background: Dynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA). Foot motion may alter the load on the medial tibiofemoral joint and hence affect the KAM. Therefore, this study aimed to investigate the relationship between tibia, rearfoot and forefoot motion in the frontal and transverse planes and the KAM in people with medial compartment knee OA.

Method: Motion of the knee, tibia, rearfoot and forefoot and knee moments were evaluated in 32 patients with clinically and radiographically-confirmed OA, predominantly in the medial compartment. Pearson's correlation coefficient was used to investigate the association between peak values of tibia, rearfoot and forefoot motion in the frontal and transverse planes and 1st peak KAM, 2nd peak KAM, and the knee adduction angular impulse (KAAI).

Results: Lateral tilt of the tibia was significantly associated with increased 1st peak KAM (r = 0.60, p < 0.001), 2nd peak KAM (r = 0.67, p = 0.001) and KAAI (r = 0.82, p = 0.001). Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004). Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = -0.44, p = 0.01) and KAAI (r = -0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01). Significant negative correlations were found between peak forefoot eversion relative to the rearfoot and 2nd peak KAM (r = -0.53, p = 0.002) and KAAI (r = -0.51, p = 0.003) and between peak forefoot inversion and 2nd peak KAM (r = -0.54, p = 0.001) and KAAI (r = -0.48, p = 0.005).

Conclusion: Increased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation. These findings have implications for the design of load-modifying interventions in people with knee OA.

No MeSH data available.


Related in: MedlinePlus

Frontal plane external KAMs: 1st peak KAM, 2nd peak KAM and knee adduction angular impulse (KAAI), which represents the area under the curve.
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Figure 2: Frontal plane external KAMs: 1st peak KAM, 2nd peak KAM and knee adduction angular impulse (KAAI), which represents the area under the curve.

Mentions: The magnitude of peak angular motion of the tibia, rearfoot relative to the global coordinate system (laboratory), rearfoot relative to the tibia and forefoot relative to the rearfoot in the frontal and transverse planes during the gait cycle were extracted including the following angles: (i) tibia lateral tilt and internal/external rotations (ii) peak rearfoot eversion/inversion and internal/external rotation relative to the tibia; (iii) rearfoot eversion/inversion and internal/external rotation relative to the global reference system (laboratory); (iv) peak forefoot abduction/adduction; and eversion/inversion. Knee frontal plane angular motion (knee varus) during initial contact and during stance (peak knee varus) and external KAM (normalised to % of body weight*height) including 1st peak and 2nd peak were also extracted. Knee adduction angular impulse (KAAI - the integral of the frontal plane knee moment over the stance phase of the gait cycle) [30] was also calculated. Figure 1 depicts the influence of knee alignment on the KAM, and Figure 2 depicts the three kinetic variables extracted from this data (1st peak KAM, 2nd peak KAM and KAAI).


Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis.

Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Bergman NR - J Foot Ankle Res (2013)

Frontal plane external KAMs: 1st peak KAM, 2nd peak KAM and knee adduction angular impulse (KAAI), which represents the area under the curve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750767&req=5

Figure 2: Frontal plane external KAMs: 1st peak KAM, 2nd peak KAM and knee adduction angular impulse (KAAI), which represents the area under the curve.
Mentions: The magnitude of peak angular motion of the tibia, rearfoot relative to the global coordinate system (laboratory), rearfoot relative to the tibia and forefoot relative to the rearfoot in the frontal and transverse planes during the gait cycle were extracted including the following angles: (i) tibia lateral tilt and internal/external rotations (ii) peak rearfoot eversion/inversion and internal/external rotation relative to the tibia; (iii) rearfoot eversion/inversion and internal/external rotation relative to the global reference system (laboratory); (iv) peak forefoot abduction/adduction; and eversion/inversion. Knee frontal plane angular motion (knee varus) during initial contact and during stance (peak knee varus) and external KAM (normalised to % of body weight*height) including 1st peak and 2nd peak were also extracted. Knee adduction angular impulse (KAAI - the integral of the frontal plane knee moment over the stance phase of the gait cycle) [30] was also calculated. Figure 1 depicts the influence of knee alignment on the KAM, and Figure 2 depicts the three kinetic variables extracted from this data (1st peak KAM, 2nd peak KAM and KAAI).

Bottom Line: Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004).Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = -0.44, p = 0.01) and KAAI (r = -0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01).Increased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Sport, Exercise and Active Living, College of Sport and Exercise Science, Victoria University, Melbourne Vic 8001, Australia. pazit.levinger@vu.edu.au.

ABSTRACT

Background: Dynamic joint loading, particularly the external knee adduction moment (KAM), is an important surrogate measure for the medio-lateral distribution of force across the knee joint in people with knee osteoarthritis (OA). Foot motion may alter the load on the medial tibiofemoral joint and hence affect the KAM. Therefore, this study aimed to investigate the relationship between tibia, rearfoot and forefoot motion in the frontal and transverse planes and the KAM in people with medial compartment knee OA.

Method: Motion of the knee, tibia, rearfoot and forefoot and knee moments were evaluated in 32 patients with clinically and radiographically-confirmed OA, predominantly in the medial compartment. Pearson's correlation coefficient was used to investigate the association between peak values of tibia, rearfoot and forefoot motion in the frontal and transverse planes and 1st peak KAM, 2nd peak KAM, and the knee adduction angular impulse (KAAI).

Results: Lateral tilt of the tibia was significantly associated with increased 1st peak KAM (r = 0.60, p < 0.001), 2nd peak KAM (r = 0.67, p = 0.001) and KAAI (r = 0.82, p = 0.001). Increased peak rearfoot eversion was significantly correlated with decreased 2nd peak KAM (r = 0.59, p < 0.001) and KAAI (r = 0.50, p = 0.004). Decreased rearfoot internal rotation was significantly associated with increased 2nd peak KAM (r = -0.44, p = 0.01) and KAAI (r = -0.38, p = 0.02), while decreased rearfoot internal rotation relative to the tibia was significantly associated with increased 2nd peak KAM (r = 0.43, p = 0.01). Significant negative correlations were found between peak forefoot eversion relative to the rearfoot and 2nd peak KAM (r = -0.53, p = 0.002) and KAAI (r = -0.51, p = 0.003) and between peak forefoot inversion and 2nd peak KAM (r = -0.54, p = 0.001) and KAAI (r = -0.48, p = 0.005).

Conclusion: Increased rearfoot eversion, rearfoot internal rotation and forefoot inversion are associated with reduced knee adduction moments during the stance phase of gait, suggesting that medial knee joint loading is reduced in people with OA who walk with greater foot pronation. These findings have implications for the design of load-modifying interventions in people with knee OA.

No MeSH data available.


Related in: MedlinePlus