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Modulation of the relationship between external knee adduction moments and medial joint contact forces across subjects and activities

Modulation of the relationship between external knee adduction moments and medial joint contact forces across subjects and activities
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 for the distribution of loads across the tibio-femoral joint during walking. The purpose of this study was to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities.

Methods: The EAM for 9 total knee replacement patients was calculated using inverse dynamic analysis while their telemetric implants provided Fmed for multiple repetitions of 10 activities including walking, stair negotiation, sit-to-stand and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed-effect regression analyses in terms of the root mean squared error (RMSE) and the slope of the regression.

Results: Across subjects and activities a good correlation between peak EAM and Fmed was observed with an overall R² 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 Fmed, 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 Fmed is generally good, but varies considerably across subjects and activities. These findings emphasize the limitation in relying solely on the EAM to infer medial joint loading when excessive directed co-contraction of muscles exists, and call for further investigations into the soft tissue related mechanisms that modulate the internal forces at the knee.
2326-5205
Trepczynski, Adam
76476dda-3d55-42d7-844d-566933e97a28
Kutzner, Ines
78d5837f-7c5e-4477-b386-1bb6693e06c1
Bergmann, Georg
9103a1c1-3bc2-4356-a274-8969fcb1e74b
Taylor, William R
def46161-f2b9-4087-b228-26092f1f397b
Heller, Markus O.
3da19d2a-f34d-4ff1-8a34-9b5a7e695829
Trepczynski, Adam
76476dda-3d55-42d7-844d-566933e97a28
Kutzner, Ines
78d5837f-7c5e-4477-b386-1bb6693e06c1
Bergmann, Georg
9103a1c1-3bc2-4356-a274-8969fcb1e74b
Taylor, William R
def46161-f2b9-4087-b228-26092f1f397b
Heller, Markus O.
3da19d2a-f34d-4ff1-8a34-9b5a7e695829

Trepczynski, Adam, Kutzner, Ines, Bergmann, Georg, Taylor, William R and Heller, Markus O. (2014) Modulation of the relationship between external knee adduction moments and medial joint contact forces across subjects and activities. Arthritis & Rheumatology. (doi:10.1002/art.38374). (PMID:24470261)

Record type: Article

Abstract

Objective: The external knee adduction moment (EAM) is often considered a surrogate measure for the distribution of loads across the tibio-femoral joint during walking. The purpose of this study was to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities.

Methods: The EAM for 9 total knee replacement patients was calculated using inverse dynamic analysis while their telemetric implants provided Fmed for multiple repetitions of 10 activities including walking, stair negotiation, sit-to-stand and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed-effect regression analyses in terms of the root mean squared error (RMSE) and the slope of the regression.

Results: Across subjects and activities a good correlation between peak EAM and Fmed was observed with an overall R² 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 Fmed, 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 Fmed is generally good, but varies considerably across subjects and activities. These findings emphasize the limitation in relying solely on the EAM to infer medial joint loading when excessive directed co-contraction of muscles exists, and call for further investigations into the soft tissue related mechanisms that modulate the internal forces at the knee.

Full text not available from this repository.

More information

e-pub ahead of print date: 28 April 2014
Published date: 27 May 2014
Organisations: Bioengineering Group

Identifiers

Local EPrints ID: 361622
URI: http://eprints.soton.ac.uk/id/eprint/361622
ISSN: 2326-5205
PURE UUID: b807cf2c-3f1c-4bcb-bf3c-64d67c1c9ce9
ORCID for Markus O. Heller: ORCID iD orcid.org/0000-0002-7879-1135

Catalogue record

Date deposited: 29 Jan 2014 11:09
Last modified: 18 Feb 2021 17:19

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