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- Thorstensson, Carina A., et al.
(författare)
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Eight weeks of exercise reduced knee adduction moment during one-leg rise in patients with early knee osteoarthritis
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundReduced functional performance is a risk factor for development of knee osteoarthritis, and peak knee adduction moment is associated with radiographic progression. Knee adduction moment can be reduced by high tibial osteotomy. The effect of dynamic stabilization through increased muscle performance is not known.AimsTo study the effect from exercise on external peak knee adduction moment during one-leg rise, and the relationship between peak knee adduction moment during one-leg rise and maximum number of one-leg rise.Methods13 patients, aged 48–63, with mild to moderate knee osteoarthritis underwent 8 weeks of supervised exercise, aiming at increasing neuromuscular control and lower extremity strength. The maximum number of one-leg rise from a stool (48 cm), 3-dimensional gait analysis and self-estimated knee symptoms were assessed before and after exercise intervention. Peak external knee adduction moment during one-leg rise and gait was calculated using a Vicon system. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as assessment of knee symptoms. Patients defined their most symptomatic knee as index knee.ResultsPeak knee adduction moment during one-leg rise was reduced for the index knee from 0.57 Nm/kg at baseline to 0.51 after 8 weeks of exercise (p=0.04). The change for the opposite knee was not significant (from 0.58 to 0.56 Nm/kg, p=0.23). No significant changes were seen for index or opposite knees in peak adduction moment during gait (p>0.40). A higher maximum number of one-leg rise was correlated to a lower peak adduction moment for the index knee at baseline (rs =-0.35, p=0.24) and follow up (rs = -0.65, p=0.03). For the opposite knee the correlation was similar at baseline (rs= -0.47, p=0.10), and no correlation was seen at follow up (rs = 0.13, p=0.70). Correlations for change over time were poor (-0.43 to -0.03) and not significant (p>0.20). Patients with symptomatic knee osteoarthritis had higher peak adduction moment in their opposite knee, than patients without symptoms at baseline (0.72 (0.09) vs. 0.50 (0.11), p=0.01) and follow-up (0.66 (0.14) vs. 0.51 (0.07), p=0.04). The differences for the index knee pointed in the same direction, however not significant (p>0.28).ConclusionPeak knee adduction moment in the most symptomatic knee of middle-aged patients with early signs of knee osteoarthritis can be reduced by exercise. Improved muscular performance might reduce the risk of radiographic progression of knee osteoarthritis. It seem of importance to reduce pain prior to starting exercising. A lower maximum number of one-leg rise is associated with higher peak knee adduction moment and has the potential to serve as a surrogate in studies where 3-dimensional analysis is not feasible.
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| 2. |
- Thorstensson, Carina, et al.
(författare)
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The effect of eight weeks of exercise on knee adduction moment in early knee osteoarthritis - a pilot study.
- 2007
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 15:10, s. 1163-1170
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Reduced muscle function, causing greater knee joint load, is a potentially modifiable risk factor of knee osteoarthritis (OA). Exercise is an important treatment of knee CA, but the effect on joint load has not been determined. The aim of this study was to investigate the effect of exercise on knee adduction moment during one-leg rise and gait. Design: Patients below age 65 with early signs of radiographic knee OA, from a population-based cohort on OA development, were invited to participate in the study. They defined their most symptomatic knee as the index knee. Knee adduction moment during one-leg rise from a stool (48 cm), and during gait was assessed using a three-dimensional motion analysis system, before and after eight weeks of supervised exercise. Results: Thirteen patients, seven women, mean age 54.5, 12/13 with Kellgren and Lawrence grade I or II, took part in the study. Peak knee adduction moment during one-leg rise was reduced by 0.08 (95% CI 0.01;0.16) Nm/kg, or 14%, for the index knee, and 0.05 (95% CI -0.04;0.14), or 8% for the opposite knee after eight weeks. The reductions in peak adduction moment during gait were smaller and not significant. Conclusions: This study indicates that peak knee adduction moment could be reduced by supervised, individualized exercise in middle-aged patients presenting early signs of knee osteoarthritis, suggesting further investigation of this area. Peak adduction moment during one-leg rise seems to be more sensitive to deviations and change than peak adduction moment during gait in this population. (C) 2007 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
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| 3. |
- von Porat, Anette, et al.
(författare)
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Knee kinematics and kinetics during gait, step and hop in males with a 16 years old ACL injury compared with matched controls
- 2006
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 1433-7347 .- 0942-2056. ; 14:6, s. 546-554
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to compare subjects who sustained an ACL injury during soccer 16 years ago with a control group with regard to knee kinematics and kinetics of gait, step activity and cross over hop. Secondly, in the injured subjects, the purpose was to study the impact on kinematics and kinetics of characteristics such as operative status, meniscal resection, being symptomatic, having knee extensor weakness and of having radiographic knee OA. Data from a 3-dimensional gait analysis system (VICON) were used to calculate kinetics and kinematics during gait, step activity and cross over hop of 12 male subjects who had an anterior cruciate ligament injury 16 years earlier. Twelve uninjured subjects matched for age, sex, BMI and activity level served as controls. No significant differences in knee kinematics and kinetics between the ACL group and the control group were found. The variability of some parameters of step and all parameters of hop activity was generally larger in the ACL injured subjects compared with the controls. The ACL injured subjects had a significantly worse clinical status compared with the controls. Reduced knee extension strength was associated with joint moment reductions especially during step activity and cross over hop. Despite a significantly worse clinical status, as determined by self-report and isokinetic strength testing, no significant differences were seen in knee joint kinetics and kinematics in an ACL injured group 16 years after injury compared with a matched control group. The variation was larger among the ACL injured subjects indicating the need for larger study groups in gait and movement analysis in long-term follow-up of ACL injury.
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