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Functional knee joint assymetry in subjects with unilateral knee osteoarthritis: An analysis of 11 different motor tasks
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ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116
or fair”. The worse radiological subgroup revealed a significant bigger BMI at time of surgery compared to the better subgroup (27.4 ± 3.6 kg/m2 vs. 23.4 ± 3.4 kg/m2 , p = 0.01). At follow-up after growth arrest the difference was nearly equalized. By then the BMI of both subgroups could be classified as obese (26.1 ± 4.2 kg/m2 vs. 27.7 ± 4.0 kg/m2 ). Discussion & conclusions: In order to investigate the influence of radiological outcome on SCFE patients’ gait subgroup analysis was performed. Basically radiological findings matched functional results gained by 3D-gait analysis. Functional outcome varied slightly depending on the radiological findings after growth arrest. Differences were most pronounced for foot progression. Only with the help of GA it was possible to describe deviations more precisely. Further studies with longer follow up have to show which functional deviations are relevant for the development of osteoarthritis and might be influenced by conservative or operative treatment. References [1] Westhoff B, Ruhe K, Weimann-Stahlschmidt K, Zilkens C, et al. The gait function of slipped capital femoral epiphysis in patients after growth arrest and its correlation with the clinical outcome. International Orthopaedics November 2011:24. [2] Heyman CH, Herndon CH. Legg-Perthes disease: a method for the measurement of the roentgenographic result. The Journal of Bone Joint Surgery American Volume 1950;32(A):767–78.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.022 O10 Functional knee joint assymetry in subjects with unilateral knee osteoarthritis: An analysis of 11 different motor tasks L. Scheys 1 , H. Vandenneucker 2 , B. Callewaert 3 , P. Mertens 4 , K. Brabants 4 , J. Bellemans 2 , K. Desloovere 3
followed by a crossover (WCO)/sidestep turn (WSS), ascent onto a step (SA), descent off a step (SD), SD followed by a crossover (SDCO)/sidestep turn (SDSS), mild (MiS) or maximum squat (MaS), chair rise (CR) and lunge (L). In addition, data from 10 healthy control subjects (matched on age, sex and BMI) were included from the labs’ reference database. Results: The analysis revealed statistically significant bilateral kinematic asymmetries between the subjects’ involved and noninvolved side for a large range of motor tasks, with the non-involved side much more closely matching healthy controls’ knee joint function. E.g., compared to the non-affected side peak knee flexion angles during stance were significantly reduced at the involved side during W (mean% difference: 16%), WCO (18.4%), WSS (11.2%), SD (14.6), SDCO (26.6%) and SDSS (22.9%). Similarly, peak flexion angles during lunge were reduced by an average of 4.1% at the involved vs. non-involved side. In contrast there was no significant difference at the non-involved side vs. healthy controls. Despite a clear assymetry in knee joint loading during left–right synchronized high-loading motor tasks, i.e. MiS, MaS and CR, there was no significant reduction in peak flexion angle. Furthermore we found a significant systematic offset towards external knee rotation which was consistent throughout the entire cycle of all analyzed motor tasks at the involved vs. non-involved side, but not at the non-involved side vs. healthy controls. Discussion & conclusions: This study demonstrates that individuals with knee OA exhibit interlimb asymmetry by significantly changing knee kinematics and kinetics in their affected limb across a large range of daily life activities. Squat and chair rising highlighted the strategy for reduced knee loading on the affected side, while keeping the knee kinematics symmetrical. The lack of apparent differences between the unaffected side and controls suggests the absence of severe compensation signs in knee kinematics. The collected data has the potential to provide a better understanding of compensation strategies in OA subjects and their relevance for the further progression of OA at both the affected and unaffected limb.
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Smith & Nephew, European Centre for Knee Research, Leuven, Belgium 2 K.U. Leuven, Department of Orthopedics and Traumatology, University Hosp., Pellenberg, Leuven, Belgium 3 K.U. Leuven, C-MAL Pellenberg, Department of Rehabilitation Sciences, Leuven, Belgium 4 Algemeen Ziekenhuis Middelheim, Department of Orthopedics, Antwerp, Belgium Introduction: Left–right symmetry in joint function is a frequently studied aspect of human motion. With a specific reference to knee osteoarthritis (OA) however, very few studies include the contralateral unaffected limb in their analysis and therefore there is a paucity of data relating to the symmetry in this subject group [1]. Although contemporary knee arthroplasty designs aim to restore natural knee kinematics during daily living [2], even fewer studies analyze left–right asymmetry during multiple motor tasks. Therefore the objective of this study was: (1) to analyze the kinematic and kinetic symmetry in persons with unilateral knee OA during a wide range of daily-life motor-tasks and (2) to analyze through an additional comparison with matched healthy controls to what extent both limbs replicate normal knee biomechanics. Patients/materials and methods: Ten subjects diagnosed with unilateral symptomatic primary knee osteoarthritis participated in this study (sex: 5 M, 5 F; 5 right-/5 left-affected; age: 62.8 ± 7.3 years; height: 1.72 ± 0.08 m; BMI: 26.2 ± 1.7; KL-grade 3.6 ± 0.5). During one single motion analysis session each subject performed 11 different motor tasks with 3 repetitions each: walking (W), W
References [1] Zeni JA and Higginson JS, The Knee;18(3):156–159. [2] Catani F et al., Journal of Orthopaedic Research; 27:1569–1575.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.023 O11 3D evaluation of the single limb mini squat test in patients with knee osteoarthritis Josefine E. Naili 1 , Elena M. Gutierrez-Farewik 2 , Mikael Reimeringer 3 , Anna-Clara Esbjörnsson 1 , Eva W. Broström 1 1 Karolinska Institutet, Women’s and Children’s Health, Stockholm, Sweden 2 Royal Institute of Technology, KTH Mechanics, Stockholm, Sweden 3 Karolinska University Hospital, Motion Analysis Laboratory, Stockholm, Sweden
Introduction: The maximum number of single limb mini-squats (SLMS) during 30 s is a valid and reliable test for patients with knee osteoarthritis (OA) [1]. The test requires neuromuscular control and the ability to quickly change between concentric and eccentric work of the muscles in hip and knee extensors. We aimed to evaluate the both the biomechanical aspects of the SLMS test in addition to the quantity of repetitions.
ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116
or fair”. The worse radiological subgroup revealed a significant bigger BMI at time of surgery compared to the better subgroup (27.4 ± 3.6 kg/m2 vs. 23.4 ± 3.4 kg/m2 , p = 0.01). At follow-up after growth arrest the difference was nearly equalized. By then the BMI of both subgroups could be classified as obese (26.1 ± 4.2 kg/m2 vs. 27.7 ± 4.0 kg/m2 ). Discussion & conclusions: In order to investigate the influence of radiological outcome on SCFE patients’ gait subgroup analysis was performed. Basically radiological findings matched functional results gained by 3D-gait analysis. Functional outcome varied slightly depending on the radiological findings after growth arrest. Differences were most pronounced for foot progression. Only with the help of GA it was possible to describe deviations more precisely. Further studies with longer follow up have to show which functional deviations are relevant for the development of osteoarthritis and might be influenced by conservative or operative treatment. References [1] Westhoff B, Ruhe K, Weimann-Stahlschmidt K, Zilkens C, et al. The gait function of slipped capital femoral epiphysis in patients after growth arrest and its correlation with the clinical outcome. International Orthopaedics November 2011:24. [2] Heyman CH, Herndon CH. Legg-Perthes disease: a method for the measurement of the roentgenographic result. The Journal of Bone Joint Surgery American Volume 1950;32(A):767–78.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.022 O10 Functional knee joint assymetry in subjects with unilateral knee osteoarthritis: An analysis of 11 different motor tasks L. Scheys 1 , H. Vandenneucker 2 , B. Callewaert 3 , P. Mertens 4 , K. Brabants 4 , J. Bellemans 2 , K. Desloovere 3
followed by a crossover (WCO)/sidestep turn (WSS), ascent onto a step (SA), descent off a step (SD), SD followed by a crossover (SDCO)/sidestep turn (SDSS), mild (MiS) or maximum squat (MaS), chair rise (CR) and lunge (L). In addition, data from 10 healthy control subjects (matched on age, sex and BMI) were included from the labs’ reference database. Results: The analysis revealed statistically significant bilateral kinematic asymmetries between the subjects’ involved and noninvolved side for a large range of motor tasks, with the non-involved side much more closely matching healthy controls’ knee joint function. E.g., compared to the non-affected side peak knee flexion angles during stance were significantly reduced at the involved side during W (mean% difference: 16%), WCO (18.4%), WSS (11.2%), SD (14.6), SDCO (26.6%) and SDSS (22.9%). Similarly, peak flexion angles during lunge were reduced by an average of 4.1% at the involved vs. non-involved side. In contrast there was no significant difference at the non-involved side vs. healthy controls. Despite a clear assymetry in knee joint loading during left–right synchronized high-loading motor tasks, i.e. MiS, MaS and CR, there was no significant reduction in peak flexion angle. Furthermore we found a significant systematic offset towards external knee rotation which was consistent throughout the entire cycle of all analyzed motor tasks at the involved vs. non-involved side, but not at the non-involved side vs. healthy controls. Discussion & conclusions: This study demonstrates that individuals with knee OA exhibit interlimb asymmetry by significantly changing knee kinematics and kinetics in their affected limb across a large range of daily life activities. Squat and chair rising highlighted the strategy for reduced knee loading on the affected side, while keeping the knee kinematics symmetrical. The lack of apparent differences between the unaffected side and controls suggests the absence of severe compensation signs in knee kinematics. The collected data has the potential to provide a better understanding of compensation strategies in OA subjects and their relevance for the further progression of OA at both the affected and unaffected limb.
1
Smith & Nephew, European Centre for Knee Research, Leuven, Belgium 2 K.U. Leuven, Department of Orthopedics and Traumatology, University Hosp., Pellenberg, Leuven, Belgium 3 K.U. Leuven, C-MAL Pellenberg, Department of Rehabilitation Sciences, Leuven, Belgium 4 Algemeen Ziekenhuis Middelheim, Department of Orthopedics, Antwerp, Belgium Introduction: Left–right symmetry in joint function is a frequently studied aspect of human motion. With a specific reference to knee osteoarthritis (OA) however, very few studies include the contralateral unaffected limb in their analysis and therefore there is a paucity of data relating to the symmetry in this subject group [1]. Although contemporary knee arthroplasty designs aim to restore natural knee kinematics during daily living [2], even fewer studies analyze left–right asymmetry during multiple motor tasks. Therefore the objective of this study was: (1) to analyze the kinematic and kinetic symmetry in persons with unilateral knee OA during a wide range of daily-life motor-tasks and (2) to analyze through an additional comparison with matched healthy controls to what extent both limbs replicate normal knee biomechanics. Patients/materials and methods: Ten subjects diagnosed with unilateral symptomatic primary knee osteoarthritis participated in this study (sex: 5 M, 5 F; 5 right-/5 left-affected; age: 62.8 ± 7.3 years; height: 1.72 ± 0.08 m; BMI: 26.2 ± 1.7; KL-grade 3.6 ± 0.5). During one single motion analysis session each subject performed 11 different motor tasks with 3 repetitions each: walking (W), W
References [1] Zeni JA and Higginson JS, The Knee;18(3):156–159. [2] Catani F et al., Journal of Orthopaedic Research; 27:1569–1575.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.023 O11 3D evaluation of the single limb mini squat test in patients with knee osteoarthritis Josefine E. Naili 1 , Elena M. Gutierrez-Farewik 2 , Mikael Reimeringer 3 , Anna-Clara Esbjörnsson 1 , Eva W. Broström 1 1 Karolinska Institutet, Women’s and Children’s Health, Stockholm, Sweden 2 Royal Institute of Technology, KTH Mechanics, Stockholm, Sweden 3 Karolinska University Hospital, Motion Analysis Laboratory, Stockholm, Sweden
Introduction: The maximum number of single limb mini-squats (SLMS) during 30 s is a valid and reliable test for patients with knee osteoarthritis (OA) [1]. The test requires neuromuscular control and the ability to quickly change between concentric and eccentric work of the muscles in hip and knee extensors. We aimed to evaluate the both the biomechanical aspects of the SLMS test in addition to the quantity of repetitions.