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Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities
OBJECTIVE: The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (F(me...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158863/ https://www.ncbi.nlm.nih.gov/pubmed/24470261 http://dx.doi.org/10.1002/art.38374 |
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author | Trepczynski, Adam Kutzner, Ines Bergmann, Georg Taylor, William R Heller, Markus O |
author_facet | Trepczynski, Adam Kutzner, Ines Bergmann, Georg Taylor, William R Heller, Markus O |
author_sort | Trepczynski, Adam |
collection | PubMed |
description | OBJECTIVE: The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (F(med)) in a sample of subjects across a spectrum of activities. METHODS: The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided F(med) for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between F(med) and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. RESULTS: Across subjects and activities a good correlation between peak EAM and F(med) values was observed, with an overall R(2) value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and F(med), the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. CONCLUSION: The relationship between EAM and F(med) is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. |
format | Online Article Text |
id | pubmed-4158863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-41588632014-09-22 Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities Trepczynski, Adam Kutzner, Ines Bergmann, Georg Taylor, William R Heller, Markus O Arthritis Rheumatol Osteoarthritis OBJECTIVE: The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (F(med)) in a sample of subjects across a spectrum of activities. METHODS: The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided F(med) for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between F(med) and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. RESULTS: Across subjects and activities a good correlation between peak EAM and F(med) values was observed, with an overall R(2) value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and F(med), the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. CONCLUSION: The relationship between EAM and F(med) is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. Blackwell Publishing Ltd 2014-05 2014-04-28 /pmc/articles/PMC4158863/ /pubmed/24470261 http://dx.doi.org/10.1002/art.38374 Text en Copyright © 2014 by the American College of Rheumatology |
spellingShingle | Osteoarthritis Trepczynski, Adam Kutzner, Ines Bergmann, Georg Taylor, William R Heller, Markus O Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title_full | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title_fullStr | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title_full_unstemmed | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title_short | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
title_sort | modulation of the relationship between external knee adduction moments and medial joint contact forces across subjects and activities |
topic | Osteoarthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4158863/ https://www.ncbi.nlm.nih.gov/pubmed/24470261 http://dx.doi.org/10.1002/art.38374 |
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