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  • Cronström, A., et al. (author)
  • Factors affecting knee abduction during weight-bearing activities in individuals with anterior cruciate ligament reconstruction
  • 2019
  • In: Physical Therapy in Sport. - : Elsevier BV. - 1466-853X. ; 38, s. 8-15
  • Journal article (peer-reviewed)abstract
    • Objective: To investigate if muscle strength and muscle activation patterns are associated with increased knee abduction during two functional tasks, commonly used in rehabilitation for individuals with anterior cruciate ligament reconstruction (ACLR). Design: Cross-sectional study. Setting: Laboratory. Participants: 24 women and 29 men approximately 7 months after ACLR. Main outcome measures: Isometric peak torque of the trunk and lower extremity muscles were determined during maximal voluntary contractions. Trunk and lower extremity average muscle activation amplitude and peak knee abduction were evaluated during the single-leg squat (SLS) and the single-leg hop for distance (SLHD) for the injured side. Separate backward regressions were performed for men and women. Results: In women, lower knee flexion and extension strength were associated with greater peak knee abduction during the SLS (B = 4.63–18.26, p ≤ 0.036); lower knee flexion strength and iliocostalis activation on the non-injured side were associated with greater peak knee abduction during the SLHD (B = 0.60–20.48, p ≤ 0.043). No associations between muscle function and peak knee abduction were found in men. Conclusions: Muscle function may contribute differently to knee abduction in men and women after ACLR. This should be considered when designing rehabilitation programs to reduce knee abduction in these patients.
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  • Wolski, Marcin, et al. (author)
  • Early tibial subchondral bone texture changes after arthroscopic partial meniscectomy in knees without radiographic OA : A prospective cohort study
  • 2020
  • In: Journal of Orthopaedic Research. - : Wiley. - 0736-0266 .- 1554-527X. ; 38:8, s. 1819-1825
  • Journal article (peer-reviewed)abstract
    • Arthroscopic partial meniscectomy (APM) may lead to changes in underlying trabecular bone (TB) structure potentially promoting the development of knee joint osteoarthritis. Our aim was to investigate if there are early changes occurring in tibial subchondral TB texture in the leg undergoing medial APM compared with the unoperated non-injured contra-lateral leg. The bone texture was measured as the medial-to-lateral ratio of fractal dimensions (FD) calculated for regions selected on weight-bearing anteroposterior tibiofemoral x-rays. Twenty-one subjects before and 12 months after APM were included from 374 patients scheduled for unilateral medial APM. The medial-to-lateral ratio was calculated for horizontal, vertical, and roughest FDs respectively. Higher FD means higher bone roughness. Each FD was calculated over a range of scales using a variance orientation transform method. Mean values of medial-to-lateral horizontal FD calculated for APM knees at follow-up were higher than those at baseline. For unoperated knees the values were lower. The difference in the horizontal FD change from baseline to follow-up between APM and contra-lateral legs was 0.028 (95% CI, 0.004-0.052). The bone roughness changes may reflect the increase in peak knee adduction moment (KAM) and KAM impulse during walking reported for the same cohort in a previous study. They may also reflect early signs of osteoarthritis development and thus, we speculate that individuals with increased bone texture roughness ratio after APM might be at higher risk of knee osteoarthritis development.
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  • Ageberg, Eva, et al. (author)
  • Validity and inter-rater reliability of medio-lateral knee motion observed during a single-limb mini squat
  • 2010
  • In: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 11
  • Journal article (peer-reviewed)abstract
    • Background: Muscle function may influence the risk of knee injury and outcomes following injury. Clinical tests, such as a single-limb mini squat, resemble conditions of daily life and are easy to administer. Fewer squats per 30 seconds indicate poorer function. However, the quality of movement, such as the medio-lateral knee motion may also be important. The aim was to validate an observational clinical test of assessing the medio-lateral knee motion, using a three-dimensional (3-D) motion analysis system. In addition, the inter-rater reliability was evaluated. Methods: Twenty-five (17 women) non-injured participants (mean age 25.6 years, range 18-37) were included. Visual analysis of the medio-lateral knee motion, scored as knee-over-foot or knee-medial-to-foot by two raters, and 3-D kinematic data were collected simultaneously during a single-limb mini squat. Frontal plane 2-D peak tibial, thigh, and knee varus-valgus angles, and 3-D peak hip internal-external rotation, and knee varus-valgus angles were calculated. Results: Ten subjects were scored as having a knee-medial-to-foot position and 15 subjects a knee-over-foot position assessed by visual inspection. In 2-D, the peak tibial angle (mean 89.0 (SE 0.7) vs mean 86.3 (SE 0.4) degrees, p = 0.001) and peak thigh angle (mean 77.4 (SE 1.0) vs mean 81.2 (SE 0.5) degrees, p = 0.001) with respect to the horizontal, indicated that the knee was more medially placed than the ankle and thigh, respectively. Thus, the knee was in more valgus (mean 11.6 (SE 1.5) vs 5.0 (SE 0.8) degrees, p < 0.001) in subjects with the knee-medial-to-foot than in those with a knee-over-foot position. In 3-D, the hip was more internally rotated in those with a knee-medial-to-foot than in those with a knee-over-foot position (mean 10.6 (SE 2.1) vs 4.8 (SE 1.8) degrees, p = 0.049), but there was no difference in knee valgus (mean 6.1 (SE 1.8) vs mean 5.0 (SE 1.2) degrees, p = 0.589). The kappa value and percent agreement, respectively, was >0.90 and 96 between raters. Conclusions: Medio-lateral motion of the knee can reliably be assessed during a single-leg mini-squat. The test is valid in 2-D, while the actual movement, in 3-D, is mainly exhibited as increased internal hip rotation. The single-limb mini squat is feasible and easy to administer in the clinical setting and in research to address lower extremity movement quality.
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  • Creaby, Mark W., et al. (author)
  • Frontal plane kinematics predict three-dimensional hip adduction during running
  • 2017
  • In: Physical Therapy in Sport. - : Elsevier BV. - 1466-853X. ; 27, s. 1-6
  • Journal article (peer-reviewed)abstract
    • Objectives To investigate if frontal plane kinematics are predictive of three dimensional (3D) hip adduction and hip internal rotation during running. Study design Cross-sectional. Setting Biomechanics laboratory. Participants Thirty healthy male runners aged 18–45 years. Main outcome measures Two dimensional (2D) angles in the frontal plane (peak pelvic obliquity, peak hip adduction, peak femoral valgus, peak knee valgus and peak tibial valgus) and 3D hip adduction and hip internal rotation during stance phase of running were obtained. Results Linear regression modelling revealed that peak 2D pelvic obliquity (a drop towards the contralateral leg) and peak femoral valgus significantly predicted 88% of the variance in peak 3D hip adduction (p < 0.001). Frontal plane kinematics however, were not predictive of peak hip internal rotation in 3D (p > 0.05). Conclusions Frontal plane kinematics, specifically contralateral pelvic drop and femoral valgus, predicted the vast majority of the variance in 3D hip adduction during the stance phase of running. This indicates that 2D video may have potential as a clinically feasible proxy for measurement of peak 3D hip adduction – a risk factor for patellofemoral pain.
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  • Nae, Jenny, et al. (author)
  • Measurement properties of a test battery to assess postural orientation during functional tasks in patients undergoing anterior cruciate ligament injury rehabilitation
  • 2017
  • In: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 47:11, s. 863-873
  • Journal article (peer-reviewed)abstract
    • STUDY DESIGN: Cross-sectional study. BACKGROUND: Visual rating of postural orientation during functional tasks may be a valuable tool to track rehabilitation progress following anterior cruciate ligament (ACL) injury. A valid test battery assessing postural orientation as a separate construct is lacking. OBJECTIVES: To evaluate measurement properties of a test battery to assess postural orientation in patients with ACL injury. METHODS: The content validity of functional tasks was assessed by expert focus group discussions. Fifty-one patients (45% women) with ACL injury performed 9 functional tasks of varying difficulty. Interpretability, internal consistency, interrater reliability, and measurement error were assessed for segment-specific postural orientation errors (POEs), within-task POEs, and total POE score. Postural orientation errors were scored on video on an ordinal scale from 0 (no POEs) to 3 (major POEs). RESULTS: Stair ascent, deep squat, and crossover hop for distance were excluded in focus group discussions. Postural orientation errors in some tasks were excluded due to floor effects. The minisquat and drop jump were excluded due to poor internal consistency (α≤.184). Interrater reliability values for segment-specific POEs and within-task POEs yielded fair to almost perfect agreement (κ = 0.429-0.875) and almost perfect agreement for total POE score (intraclass correlation coefficient = 0.842), without systematic differences between raters. The smallest detectable changes were 0.7 and 5 points for groups and individuals, respectively. CONCLUSION: The final test battery (single-leg mini-squat, stair descent, forward lunge, singleleg hop for distance) of 4 POEs (foot pronation, medial knee-to-foot position, hip joint POEs, and trunk segment POEs) demonstrated good measurement properties in people with ACL injury.
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