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Clinical Characteristics of Hip Joint Rotations and Knee Adduction Moment through 3D Gait Analysis

3차원 보행분석을 통한 무릎 모음 모멘트와 고관절 내외회전의 임상적 특성

  • 김용욱 (전주대학교 물리치료학과) ;
  • 강승묵 (전주대학교 게임콘텐츠학과)
  • Received : 2017.08.29
  • Accepted : 2017.11.15
  • Published : 2017.12.30

Abstract

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

Keywords

References

  1. Baker K, Goggins J, Xie H, et al(2007). A randomized crossover trial of a wedged insole for treatment of knee osteoarthritis. Arthritis Rheum, 56(4), 1198-1203. https://doi.org/10.1002/art.22516
  2. Baliunas AJ, Hurwitz DE, Ryals AB, et al(2002). Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthritis Cartilage, 10(7), 573-579. https://doi.org/10.1053/joca.2002.0797
  3. Barrios JA, Crossley KM, Davis IS(2010). Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment. J Biomech, 43(11), 2208-2213. https://doi.org/10.1016/j.jbiomech.2010.03.040
  4. Cho Y, Ko Y, Lee W(2015). Relationships among foot position, lower limb alignment, and knee adduction moment in patients with degenerative knee osteoarthritis. J Phys Ther Sci, 27(1), 265-268. https://doi.org/10.1589/jpts.27.265
  5. Chong HC, Tennant LM, Kingston DC, et al(2017). Knee joint moments during high flexion movements: Timing of peak moments and the effect of safety footwear. Knee, 24(2), 271-279. https://doi.org/10.1016/j.knee.2016.12.006
  6. Cibulka MT, Strube MJ, Meier D, et al(2010). Symmetrical and asymmetrical hip rotation and its relationship to hip rotator muscle strength. Clin Biomech, 25(1), 56-62. https://doi.org/10.1016/j.clinbiomech.2009.09.006
  7. Collins TD, Ghoussayni SN, Ewins DJ, et al(2009). A six degrees-of-freedom marker set for gait analysis: repeatability and comparison with a modified Helen Hayes set. Gait Posture, 30(2), 173-180. https://doi.org/10.1016/j.gaitpost.2009.04.004
  8. Cornwall MW, McPoil TG, Lebec M, et al(2008). Reliability of the modified Foot Posture Index. J Am Podiatr Med Assoc, 98(1), 7-13. https://doi.org/10.7547/0980007
  9. Henriksen M, Bennell KL, Hinman RS, et al(2011). The knee rotation moment. a new pathomechanical paradigm in OA? Osteoarthritis Cartilage, 19(S1), S89-S90.
  10. Henriksen M, Graven-Nielsen T, Aaboe J, et al(2010). Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain. Arthritis Care Res, 62(4), 501-509. https://doi.org/10.1002/acr.20033
  11. Kutzner I, Küther S, Heinlein B, et al(2011). The effect of valgus braces on medial compartment load of the knee joint - in vivo load measurements in three subjects. J Biomech, 44(7), 1354-1360. https://doi.org/10.1016/j.jbiomech.2011.01.014
  12. Lin CJ, Lai KA, Chou YL, et al(2001). The effect of changing the foot progression angle on the knee adduction moment in normal teenagers. Gait Posture, 14(2), 85-91. https://doi.org/10.1016/S0966-6362(01)00126-6
  13. Maly MR, Culham EG, Costigan PA(2002). Static and dynamic biomechanics of foot orthoses in people with medial compartment knee osteoarthritis. Clin Biomech, 17(8), 603-610. https://doi.org/10.1016/S0268-0033(02)00073-6
  14. Miyazaki T, Wada M, Kawahara H, et al(2002). Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Ann Rheum Dis, 61(7), 617-622. https://doi.org/10.1136/ard.61.7.617
  15. Moyer RF, Birmingham TB, Bryant DM, et al(2015). Valgus bracing for knee osteoarthritis: a meta-analysis of randomized trials. Arthritis Care Res, 67(4), 493-501. https://doi.org/10.1002/acr.22472
  16. Moyer RF, Birmingham TB, Dombroski CE, et al(2013). Combined effects of a valgus knee brace and lateral wedge foot orthotic on the external knee adduction moment in patients with varus gonarthrosis. Arch Phys Med Rehabil, 94(1), 103-112. https://doi.org/10.1016/j.apmr.2012.09.004
  17. Redmond AC, Crosbie J, Ouvrier RA(2006). Development and validation of a novel rating system for scoring standing foot posture: the Foot Posture Index. Clin Biomech, 21(1), 89-98. https://doi.org/10.1016/j.clinbiomech.2005.08.002
  18. Rokkedal-Lausch T, Lykke M, Hansen MS, et al(2013). Normative values for the foot posture index between right and left foot: a descriptive study. Gait Posture, 38(4), 843-846. https://doi.org/10.1016/j.gaitpost.2013.04.006
  19. Shakoor N, Lidtke RH, Sengupta M, et al(2008). Effects of specialized footwear on joint loads in osteoarthritis of the knee. Arthritis Rheum, 59(9), 1214-1220. https://doi.org/10.1002/art.24017
  20. Sharma L, Hurwitz DE, Thonar EJ, et al(1998). Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheum, 41(7), 1233-1240. https://doi.org/10.1002/1529-0131(199807)41:7<1233::AID-ART14>3.0.CO;2-L
  21. Shelburne KB, Torry MR, Steadman JR, et al(2008). Effects of foot orthoses and valgus bracing on the knee adduction moment and medial joint load during gait. Clin Biomech, 23(6), 814-821. https://doi.org/10.1016/j.clinbiomech.2008.02.005
  22. Shin CS, Chaudhari AM, Andriacchi TP(2011). Valgus plus internal rotation moments increase anterior cruciate ligament strain more than either alone. Med Sci Sports Exerc, 43(8), 1484-1491. https://doi.org/10.1249/MSS.0b013e31820f8395
  23. Teng HL, MacLeod TD, Link TM, et al(2015). Higher knee flexion moment during the second half of the stance phase of gait is associated with the progression of osteoarthritis of the patellofemoral joint on magnetic resonance imaging. J Orthop Sports Phys Ther, 45(9), 656-664. https://doi.org/10.2519/jospt.2015.5859

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