Subject-specific toe-in or toe-out gait modifications reduce the larger knee adduction moment peak more than a non-personalized approach.
Subject-specific toe-in or toe-out gait modifications reduce the larger knee adduction moment peak more than a non-personalized approach.
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DOI：
10.1016/j.jbiomech.2017.11.003
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发表时间：
2018-01-03
影响因子：
2.4
通讯作者：
Delp SL
中科院分区：
文献类型：
--
作者：
Uhlrich SD;Silder A;Beaupre GS;Shull PB;Delp SL
膝关节内收力矩（KAM）是内侧间室膝关节负荷的替代指标，与膝关节骨关节炎的进展相关。脚趾内和脚趾外步态修改通常分别降低第一和第二KAM峰值。我们调查了是否分配一个特定的受试者的脚前进角（FPA）的修改减少了峰值KAM比分配相同的修改给每个人。为了探索运动学习对肌肉协调和动力学的影响，我们还评估了正常行走期间的峰值膝关节屈曲力矩和股四头肌-腘绳肌共同收缩，当受试者第一次学习他们的主题特定FPA时，以及训练20分钟后。使用振动触觉反馈，我们训练了20名健康成年人相对于其自然FPA以5°和10°的脚趾向内和脚趾向外，然后将受试者特定FPA确定为每个受试者最大限度地降低其较大KAM峰值的角度。当以特定受试者的FPA行走时，18名受试者显著降低了他们较大的KAM峰值; 8名受试者通过脚趾向内行走，10名受试者通过脚趾向外行走。平均而言，当以受试者特定FPA行走时，受试者的较大KAM峰值降低了18.6 ± 16.2%，这比所有受试者脚趾向内10°（10.0 ± 17.1%，p = 0.013）或脚趾向外10°（11.0 ± 18.3%，p = 0.002）时实现的降低更多。当受试者第一次学习他们的主题特定FPA时，股四头肌-腘绳肌共同收缩和峰值膝关节屈曲力矩增加，但只有共同收缩在训练后恢复到基线水平。这些结果表明，受试者特定的步态修改减少峰值KAM比均匀分配的修改，并有可能减缓内侧间室膝关节骨关节炎的进展。
The knee adduction moment (KAM) is a surrogate measure for medial compartment knee loading and is related to the progression of knee osteoarthritis. Toe-in and toe-out gait modifications typically reduce the first and second KAM peaks, respectively. We investigated whether assigning a subject-specific foot progression angle (FPA) modification reduces the peak KAM by more than assigning the same modification to everyone. To explore the effects of motor learning on muscle coordination and kinetics, we also evaluated the peak knee flexion moment and quadriceps-hamstring co-contraction during normal walking, when subjects first learned their subject-specific FPA, and following 20 min of training. Using vibrotactile feedback, we trained 20 healthy adults to toe-in and toe-out by 5° and 10° relative to their natural FPA, then identified the subject-specific FPA as the angle where each subject maximally reduced their larger KAM peak. When walking at their subject-specific FPA, 18 subjects significantly reduced their larger KAM peak; 8 by toeing-in and 10 by toeing-out. On average, subjects reduced their larger KAM peak by 18.6 ± 16.2% when walking at their subject-specific FPA, which was more than the reductions achieved when all subjects toed-in by 10° (10.0 ± 17.1%, p = .013) or toed-out by 10° (11.0 ± 18.3%, p = .002). Quadriceps-hamstring co-contraction and the peak knee flexion moment increased when subjects first learned their subject-specific FPA, but only co-contraction returned to baseline levels following training. These findings demonstrate that subject-specific gait modifications reduce the peak KAM more than uniformly assigned modifications and have the potential to slow the progression of medial compartment knee osteoarthritis.
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影响因子：
2.8
作者：
DeMers, Matthew S.;Pal, Saikat;Delp, Scott L.
通讯作者：
Delp, Scott L.
影响因子：
2.4
作者：
Jenkyn, Thomas R.;Hunt, Michael A.;Birmingham, Trevor B.
通讯作者：
Birmingham, Trevor B.
影响因子：
7
作者：
Chehab, E. F.;Favre, J.;Erhart-Hledik, J. C.;Andriacchi, T. P.
通讯作者：
Andriacchi, T. P.
影响因子：
4.3
作者：
Damiano, DL;Martellotta, TL;Abel, MF
通讯作者：
Abel, MF
影响因子：
--
作者：
M端ndermann, A;Dyrby, CO;Andriacchi, TP
通讯作者：
Andriacchi, TP