Medial knee joint contact force in the intact limb during walking in recently ambulatory service members with unilateral limb loss: a cross-sectional study
| Autor: | Alison L. Pruziner, Ross H. Miller, Barri L. Schnall, Rebecca L. Krupenevich, Erik J. Wolf |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Anatomy and Physiology Cross-sectional study medicine.medical_treatment lcsh:Medicine Bioengineering Prosthesis Osteoarthritis General Biochemistry Genetics and Molecular Biology Inverse dynamics 03 medical and health sciences 0302 clinical medicine Military Medicine Gait 030203 arthritis & rheumatology business.industry General Neuroscience lcsh:R 030229 sport sciences General Medicine medicine.disease Kinesiology Preferred walking speed Gait analysis Ambulatory Physical therapy Load General Agricultural and Biological Sciences business Transfemoral Transtibial |
| Zdroj: | PeerJ PeerJ, Vol 5, p e2960 (2017) |
| ISSN: | 2167-8359 |
| Popis: | BackgroundIndividuals with unilateral lower limb amputation have a high risk of developing knee osteoarthritis (OA) in their intact limb as they age. This risk may be related to joint loading experienced earlier in life. We hypothesized that loading during walking would be greater in the intact limb of young US military service members with limb loss than in controls with no limb loss.MethodsCross-sectional instrumented gait analysis at self-selected walking speeds with a limb loss group (N = 10, age 27 ± 5 years, 170 ± 36 days since last surgery) including five service members with transtibial limb loss and five with transfemoral limb loss, all walking independently with their first prosthesis for approximately two months. Controls (N = 10, age 30 ± 4 years) were service members with no overt demographical risk factors for knee OA. 3D inverse dynamics modeling was performed to calculate joint moments and medial knee joint contact forces (JCF) were calculated using a reduction-based musculoskeletal modeling method and expressed relative to body weight (BW).ResultsPeak JCF and maximum JCF loading rate were significantly greater in limb loss (184% BW, 2,469% BW/s) vs. controls (157% BW, 1,985% BW/s), with large effect sizes. Results were robust to probabilistic perturbations to the knee model parameters.DiscussionAssuming these data are reflective of joint loading experienced in daily life, they support a “mechanical overloading” hypothesis for the risk of developing knee OA in the intact limb of limb loss subjects. Examination of the evolution of gait mechanics, joint loading, and joint health over time, as well as interventions to reduce load or strengthen the ability of the joint to withstand loads, is warranted. |
| Databáze: | OpenAIRE |
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