The effect of surface inclination and limb on knee loading measures in transtibial prosthesis users
- PDF / 593,662 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 86 Downloads / 229 Views
(2019) 16:37
RESEARCH
Open Access
The effect of surface inclination and limb on knee loading measures in transtibial prosthesis users Sean S. Doyle1,3, Edward D. Lemaire2,3*, Julie Nantel1 and Emily H. Sinitski3
Abstract Background: Osteoarthritis (OA) is a degenerative disease caused by the wearing of joint cartilage and bone. Literature has established that a prosthesis user’s intact limb is at greater risk of developing OA. This study analyzed the effect of commonly encountered surface inclinations on knee joint loading measures in able-bodied and transtibial prosthesis users. Methods: 12 transtibial prosthesis users and 12 able-bodied participants walked across level ground, up slope, down slope, and cross slope (further divided into top and bottom slope depending on the location of the limb being analyzed). First and second peak external knee adduction moment (KAM), external knee adduction moment rate, and external knee adduction moment impulse were extracted from the stance phase of gait. Mixed ANOVA statistics with Bonferonni post hoc analyses were performed. Results: Significant limb differences were only found for KAM rate and first peak KAM. When compared to all other surfaces up slope had the significantly lowest KAM rate and was not significantly lower for all other tested variables. Down slope had significantly greater KAM rate than all surfaces except bottom slope. KAM second peak and KAM impulse analysis resulted in no significant differences. Conclusions: Individuals at risk for developing, or currently dealing with, knee OA could avoid walking for extended periods on down slope. Walking up moderate slopes may be considered as a complementary activity to level walking for rehabilitation and delaying OA progression. The lack of significant limb differences suggests that second peak KAM and KAM impulse may not be appropriate loadrelated indicators of OA initiation among prosthesis users without OA. KAM rate was the most sensitive joint loading variable and therefore should be investigated further as an appropriate variable for identifying OA risk in individuals with transtibial amputations. Keywords: Knee, Biomechanics, Forces, Moments, Osteoarthritis, Slope, Cross-slope, Level
Introduction Osteoarthritis (OA) is a degenerative disease caused by the wearing of joint cartilage and bone. OA is the most frequent cause of disability in the United States, with the knee medial compartment being the most affected area [1]. Biomechanical risk factors for OA include obesity, trauma, muscular weakness, and overloading from * Correspondence: [email protected] 2 University of Ottawa, Faculty of Medicine, Roger Guindon Hall, 451 Smyth Road, Ottawa, Ontario K1H 8M5, Canada 3 Ottawa Hospital Research Institute, 505 Smyth Road, Ottawa, ON K1H8M2, Canada Full list of author information is available at the end of the article
varying sports and occupations [2]. Osteoarthritis is particularly relevant for people with lower limb amputations, where asymmetry and gait compensations can increase joint loads on the intac
Data Loading...
