Patients with medial knee osteoarthritis reduce medial knee contact forces by altering trunk kinematics, progression speed, and stepping strategy during stair ascent and descent : a pilot study

Meireles, S; Reeves, ND; Jones, R; Smith, CR; Thelen, DG; Jonkers, I

Abstract

Medial knee loading during stair negotiation in individuals with medial knee osteoarthritis, has only been reported in terms of joint moments, which may underestimate the knee loading. This study assessed knee contact forces (KCF) and contact pressures during different stair negotiation strategies. Motion analysis was performed in five individuals with medial knee osteoarthritis (52.8±11.0 years) and eight healthy subjects (51.0±13.4 years) while ascending and descending a staircase. KCF and contact pressures were calculated using a multi-body knee model while performing step-over-step at controlled and self-selected speed, and step-by-step strategies. At controlled speed, individuals with osteoarthritis showed decreased peak KCF during stair ascent but not during stair descent. Osteoarthritis patients showed higher trunk rotations in frontal and sagittal planes than controls. At lower self-selected speed, patients also presented reduced medial KCF during stair descent. While performing step-by-step, medial contact pressures decreased in osteoarthritis patients during stair descent. Osteoarthritis patients reduced their speed and increased trunk flexion and lean angles to reduce KCF during stair ascent. These trunk changes were less safe during stair descent where a reduced speed was more effective. Individuals should be recommended to use step-over-step during stair ascent and step-by-step during stair descent to reduce medial KCF.

Citation

Meireles, S., Reeves, N., Jones, R., Smith, C., Thelen, D., & Jonkers, I. (2019). Patients with medial knee osteoarthritis reduce medial knee contact forces by altering trunk kinematics, progression speed, and stepping strategy during stair ascent and descent : a pilot study. Journal of Applied Biomechanics, 35(4), 280-289. https://doi.org/10.1123/jab.2017-0159

• Journal Article Type: Article
• Acceptance Date: May 27, 2019
• Online Publication Date: May 29, 2019
• Publication Date: May 29, 2019
• Deposit Date: Jun 12, 2019
• Publicly Available Date: Jun 12, 2019
• Journal: Journal of Applied Biomechanics
• Print ISSN: 1065-8483
• Publisher: Human Kinetics
• Volume: 35
• Issue: 4
• Pages: 280-289
• DOI: https://doi.org/10.1123/jab.2017-0159
• Publisher URL: https://doi.org/10.1123/jab.2017-0159
• Related Public URLs: https://journals.humankinetics.com/journal/jab
• Additional Information: Access Information : Accepted author manuscript version reprinted, by permission, from Journal of Applied Biomechanics, 2019, 35 (4): 280-289, https://doi.org/10.1123/jab.2017-0159. © Human Kinetics, Inc.