Changes in Medial Knee Contact Force Through Gait Modification

2012 ◽  
Author(s):  
Allison L. Hall ◽  
Thor F. Besier ◽  
Amy Silder ◽  
Scott L. Delp ◽  
Darryl D. D’Lima ◽  
...  
Keyword(s):  
Contact Force ◽  
Treatment Strategies ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Non Invasive ◽  
Trunk Sway ◽  
Invasive Method ◽  
Gait Modification ◽  
External Knee Adduction Moment

The development of medial knee osteoarthritis (OA) has been attributed to overloading of the medial compartment articular cartilage [1]. Therefore, treatment strategies are often focused on reducing medial compartment loads. Gait modification represents a non-invasive method for achieving this goal. Previous studies have shown that a variety of gait modifications (e.g., toeing out, increased medial-lateral trunk sway, walking with medialized knees (i.e., medial thrust gait)) are effective in reducing the external knee adduction moment [e.g., 2–4]. Although the external knee adduction moment is often used as a surrogate measure of medial compartment force, a recent study showed that reductions in the external knee adduction moment do not guarantee reductions in medial compartment force [5]. Therefore, direct measurements of changes in medial contact force are important for determining the effectiveness of gait modifications.

Experimental Evaluation of Computationally Predicted Changes in Knee Loads Resulting From Medial Thrust Gait

2012 ◽  
Author(s):  
Allison L. Hall ◽  
Jonathan P. Walter ◽  
Thor F. Besier ◽  
Amy Silder ◽  
Scott L. Delp ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Experimental Evaluation ◽  
Treatment Strategies ◽  
Medial Compartment ◽  
Gait Patterns ◽  
Medial Knee ◽  
Knee Oa ◽  
Non Invasive ◽  
Gait Modification

Abnormal loading of the medial compartment of the knee is believed to be a contributing factor to the development of medial compartment knee osteoarthritis (OA) [1]. Treatment strategies for patients with medial knee OA include both invasive (i.e., surgery) and non-invasive (e.g., gait modification) options. A variety of modified gait patterns have been proposed as non-invasive treatments for patients with medial knee OA.

Effective Gait Modification Strategies for Offloading the Medial Compartment of the Knee

2008 ◽  
Author(s):  
Benjamin J. Fregly ◽  
Darryl D. D’Lima ◽  
Clifford W. Colwell
Keyword(s):  
Contact Force ◽  
Treatment Options ◽  
Medial Compartment ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Trunk Sway ◽  
Total Knee ◽  
Highly Correlated ◽  
Gait Modification ◽  
Acid Test

Gait modification is a conservative, non-invasive treatment option for patients with medial compartment knee osteoarthritis. If proven effective for offloading the medial compartment, it may provide one of the few treatment options with disease modifying potential. Furthermore, it could fill an important therapeutic “hole” for patients in their 40’s and 50’s who no longer achieve sufficient pain relief through pharmacological means and yet are too young to receive a total knee replacement. A variety of gait modifications have been proposed for offloading the medial compartment, including toeing out [1], walking more slowly or with decreased stride length [2], walking with increased medial-lateral trunk sway [3], using lateral heel wedges [4], or walking with medialized knees [5]. These modifications have been proposed primarily based on their ability to reduce the external knee adduction torque. While this external measure is highly correlated with medial compartment contact force [6], the acid test is to demonstrate experimentally that a gait modification reduces medial contact force directly.

Muscle Forces May Explain Paradoxical Knee Loads During Different Gait Patterns

2010 ◽  
Author(s):  
Jonathan P. Walter ◽  
Darryl D. D’Lima ◽  
Benjamin J. Fregly
Keyword(s):  
Disease Progression ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Gait Patterns ◽  
Common Assumption ◽  
Clinical Disorder ◽  
Surrogate Measure ◽  
Gait Modification ◽  
External Knee Adduction Moment

Medial compartment knee osteoarthritis is a common clinical disorder [1] in which the articular cartilage in the medial compartment progressively deteriorates. To slow disease progression without surgical intervention, researchers have proposed gait modifications to offload the medial compartment. Since knee medial contact force (MCF) cannot be measured non-invasively in vivo, researchers have identified the external knee adduction moment (KAM) as a surrogate measure that is easy to calculate [2]. A common assumption has been that reducing the peak KAM will result in a corresponding reduction in peak MCF. While the magnitude of the peak KAM has been correlated with disease severity and rate of disease progression [3,4], it is not clear that reduction of this external load via gait modification will always result in a decrease in internal MCF.

Influence of Walking Speed and Severity of Knee Osteoarthritis on Medial Compartment Loading

2007 ◽  
Author(s):  
Joseph Zeni ◽  
Jill Higginson
Keyword(s):  
Knee Osteoarthritis ◽  
Walking Speed ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Inverse Dynamic ◽  
External Moment ◽  
Walking Velocity ◽  
Dynamic Techniques ◽  
Walking Speeds ◽  
External Knee Adduction Moment

Progression of knee osteoarthritis (OA) has been shown to occur in the presence of an increased load at the medial compartment [1]. Current gait analysis techniques allow researchers to use inverse dynamic techniques to calculate external knee adduction moments. These moments correlate to varus knee stresses and increased load in the medial knee compartment. These abnormal stresses have been hypothesized to play a role in the destruction of articular cartilage [2]. Previous authors have suggested that walking velocity will affect the adduction moment and that decreasing walking speed may reduce the maximal knee external moment during gait [3]. Based on these previous findings, we investigated various walking speeds in subjects with mild, moderate and severe OA and the effect on the external knee adduction moment.

scholarly journals Liver Fibrosis: Causes and Methods of Assessment, A Review

2015 ◽  
Vol 53 (4) ◽  
pp. 304-314 ◽  
Author(s):  
Ali Erfani Karimzadeh Toosi
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Hepatic Dysfunction ◽  
Current Knowledge ◽  
Treatment Strategies ◽  
Future Research ◽  
Progressive Development ◽  
Non Invasive ◽  
The Past ◽  
Invasive Method

AbstractHepatic fibrogenesis is the final result of injury to the liver. Fibrosis could lead to hepatic dysfunction, important in the pathogenesis of other chronic problems. Therefore, understanding the mechanism, accurate diagnosis and staging of it in early stages accelerates the treatment and reduces the prevalence of chirrosis. Treatment strategies of liver problems and detction methods depend on the amount and progression of liver fibrosis and the rate of cirrhosis development. Traditionally the invasive method, liver biopsy, is reference standard to follow progression and stage of fibrosis. However, during the past decade, progressive development of novel non-invasive methodologies has challenged the invasive method. Non-invasive methods have been initially introduced for chronic hepatitis C with increasing use in other chronic liver diseases. The need for liver biopsy has nowadays decreased significantly as a result of these methodologies. Most of the new non-invasive methods depend on either ‘biological’ or ‘physical’ approaches.In this review, starting from the mechanism of fibrogenesis, the current knowledge about diagnosis, treatment strategies and different methods for its evaluation is discussed. This is followed by a conclusion on what is expected to be known in this field during the future research.

scholarly journals Efficacy of chronic ultrasound neurostimulation on behaviors and distributed brain metabolism in depressive-like mice

2019 ◽  
Author(s):  
Marc Legrand ◽  
Laurent Galineau ◽  
Anthony Novell ◽  
Barbara Planchez ◽  
Bruno Brizard ◽  
...  
Keyword(s):  
Major Depression ◽  
Therapeutic Potential ◽  
Treatment Strategies ◽  
Chronic Mild Stress ◽  
Current Treatment ◽  
Transcranial Ultrasound ◽  
Anxiety And Depression ◽  
Mild Stress ◽  
Non Invasive ◽  
Invasive Method

AbstractMajor depression is one of the main factors contributing to the Global Burden of Disease. Current treatment strategies (e.g., antidepressants and neurostimulation techniques) of major depression show some limitations including inaccuracy and invasiveness. Ultrasound neurostimulation (USNS) has been recently introduced as a physical non-invasive method for brain tissue stimulation and has gained increasing interest. In this study, we sought to evaluate the efficacy of transcranial USNS in an unpredictable chronic mild stress (UCMS) mouse model. The results show that transcranial USNS of the infralimbic cortex reduced anxiety-related behaviors as well as some, but not all, depression-related parameters. [18F]-FDG microPET imaging and brain metabolomic analyses showed that USNS triggered the activation of targeted brain region in addition to brain areas at a distance from the targeted zone, alleviating anxiety and depression-related behaviors induced by the UCMS regimen. Transcranial ultrasound neurostimulation show therapeutic potential in some aspects of major depression.

Toe-Out Gait Decreases the Second Peak of the Medial Knee Contact Force

2015 ◽  
Vol 31 (4) ◽  
pp. 275-280 ◽  
Author(s):  
Shinya Ogaya ◽  
Hisashi Naito ◽  
Akira Iwata ◽  
Yumi Higuchi ◽  
Satoshi Fuchioka ◽  
...  
Keyword(s):  
Contact Force ◽  
Simulation Analysis ◽  
Cartilage Damage ◽  
Reaction Force ◽  
Muscle Tension ◽  
Contact Forces ◽  
Knee Adduction Moment ◽  
Joint Reaction Force ◽  
Medial Knee ◽  
Second Peak

Toe-out angle alternation is a potential tactic for decreasing the knee adduction moment during walking. Published reports have not examined the medial knee contact force during the toe-out gait, although it is a factor affecting knee articular cartilage damage. This study investigated the effects of increased toe-out angle on the medial knee contact force, using musculoskeletal simulation analysis. For normal and toe-out gaits in 18 healthy subjects, the muscle tension forces were simulated based on the joint moments and ground reaction forces with optimization process. The medial knee contact force during stance phase was determined using the sum of the muscle force and joint reaction force components. The first and second peaks of the medial knee contact force were compared between the gaits. The toe-out gait showed a significant decrease in the medial knee contact force at the second peak, compared with the normal gait. In contrast, the medial knee contact forces at the first peak were not significantly different between the gaits. These results suggest that the toe-out gait is beneficial for decreasing the second peak of the medial knee contact force.

Knee adduction moment and medial knee contact force during gait in older people

2014 ◽  
Vol 40 (3) ◽  
pp. 341-345 ◽  
Author(s):  
Shinya Ogaya ◽  
Hisashi Naito ◽  
Akira Iwata ◽  
Yumi Higuchi ◽  
Satoshi Fuchioka ◽  
...  
Keyword(s):  
Older People ◽  
Contact Force ◽  
Knee Adduction Moment ◽  
Medial Knee

Prediction of Internal Contact Forces at the Knee From External Measurements

2008 ◽  
Author(s):  
Jonathan P. Walter ◽  
Scott A. Banks ◽  
Darryl D. D’Lima ◽  
Benjamin J. Fregly
Keyword(s):  
Stance Phase ◽  
Cartilage Damage ◽  
Contact Forces ◽  
Medial Compartment ◽  
Knee Adduction Moment ◽  
Baby Boomer Generation ◽  
Risk Of Disease ◽  
Surrogate Measure ◽  
External Knee Adduction Moment

As the baby boomer generation ages, knee osteoarthritis (OA) will become increasingly prevalent in our society. Articular cartilage damage in the knee is highly dependent upon subject-specific kinematics and load distribution inside the joint. In particular, researchers have hypothesized that overloading of the medial compartment is a primary contributing factor to the development of the disease [1]. However, since medial compartment load cannot be measured non-invasively in vivo, researchers typically use the external knee adduction moment during stance phase as a surrogate measure. This quantity has been correlated with the medial tibial contact force measured from an instrumented knee implant [2] and with the risk of disease progression over time [3].

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