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Personalization improves the biomechanical efficacy of foot progression angle modifications in individuals with medial knee osteoarthritis.
Uhlrich, Scott D; Kolesar, Julie A; Kidzinski, Lukasz; Boswell, Melissa A; Silder, Amy; Gold, Garry E; Delp, Scott L; Beaupre, Gary S.
Afiliación
  • Uhlrich SD; Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, United States; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States; Musculoskeletal Research Laboratory, VA Palo Alto Healthcare System, Palo Alto, CA 94304, United States. Electronic addr
  • Kolesar JA; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States; Musculoskeletal Research Laboratory, VA Palo Alto Healthcare System, Palo Alto, CA 94304, United States.
  • Kidzinski L; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States.
  • Boswell MA; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States.
  • Silder A; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States; Musculoskeletal Research Laboratory, VA Palo Alto Healthcare System, Palo Alto, CA 94304, United States.
  • Gold GE; Department of Radiology, Stanford University, Stanford, CA 94305, United States.
  • Delp SL; Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, United States; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States; Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94305, United States.
  • Beaupre GS; Department of Bioengineering, Stanford University, Stanford, CA 94305, United States; Musculoskeletal Research Laboratory, VA Palo Alto Healthcare System, Palo Alto, CA 94304, United States.
J Biomech ; 144: 111312, 2022 11.
Article en En | MEDLINE | ID: mdl-36191434
Modifying the foot progression angle during walking can reduce the knee adduction moment, a surrogate measure of medial knee loading. However, not all individuals reduce their knee adduction moment with the same modification. This study evaluates whether a personalized approach to prescribing foot progression angle modifications increases the proportion of individuals with medial knee osteoarthritis who reduce their knee adduction moment, compared to a non-personalized approach. Individuals with medial knee osteoarthritis (N=107) walked with biofeedback instructing them to toe-in and toe-out by 5° and 10° relative to their self-selected angle. We selected individuals' personalized foot progression angle as the modification that maximally reduced their larger knee adduction moment peak. Additionally, we used lasso regression to identify which secondary kinematic changes made a 10° toe-in gait modification more effective at reducing the first knee adduction moment peak. Seventy percent of individuals reduced their larger knee adduction moment peak by at least 5% with a personalized foot progression angle modification, which was more than (p≤0.002) the 23-57% of individuals who reduced it with a uniformly assigned 5° or 10° toe-in or toe-out modification. When toeing-in, greater reductions in the first knee adduction moment peak were related to an increased frontal-plane tibia angle (knee more medial than ankle), a more valgus knee abduction angle, reduced contralateral pelvic drop, and a more medialized center of pressure in the foot reference frame. In summary, personalization increases the proportion of individuals with medial knee osteoarthritis who may benefit from a foot progression angle modification.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla Límite: Humans Idioma: En Revista: J Biomech Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla Límite: Humans Idioma: En Revista: J Biomech Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos