Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities
Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed)...
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| Published in | Arthritis & rheumatology (Hoboken, N.J.) Vol. 66; no. 5; pp. 1218 - 1227 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wiley Subscription Services, Inc
01.05.2014
Blackwell Publishing Ltd |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objective
The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities.
Methods
The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit‐to‐stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed‐effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression.
Results
Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R2 value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed, the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW.
Conclusion
The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. |
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| AbstractList | The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed ) in a sample of subjects across a spectrum of activities.
The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors "subject" and "activity" on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression.
Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R(2) value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed , the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW.
The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue-related mechanisms that modulate the internal forces at the knee. Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities. Methods The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit‐to‐stand activities, and squatting. The effects of the factors “subject” and “activity” on the relationships between Fmed and EAM were quantified using mixed‐effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. Results Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R2 value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed, the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. Conclusion The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue–related mechanisms that modulate the internal forces at the knee. The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed ) in a sample of subjects across a spectrum of activities.OBJECTIVEThe external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed ) in a sample of subjects across a spectrum of activities.The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors "subject" and "activity" on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression.METHODSThe EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors "subject" and "activity" on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression.Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R(2) value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed , the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW.RESULTSAcross subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R(2) value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed , the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW.The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue-related mechanisms that modulate the internal forces at the knee.CONCLUSIONThe relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue-related mechanisms that modulate the internal forces at the knee. Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking. This study was undertaken to quantify the relationship between the EAM and directly measured medial tibiofemoral contact forces (Fmed) in a sample of subjects across a spectrum of activities. Methods The EAM for 9 patients who underwent total knee replacement was calculated using inverse dynamics analysis, while telemetric implants provided Fmed for multiple repetitions of 10 activities, including walking, stair negotiation, sit-to-stand activities, and squatting. The effects of the factors "subject" and "activity" on the relationships between Fmed and EAM were quantified using mixed-effects regression analyses in terms of the root mean square error (RMSE) and the slope of the regression. Results Across subjects and activities a good correlation between peak EAM and Fmed values was observed, with an overall R2 value of 0.88. However, the slope of the linear regressions varied between subjects by up to a factor of 2. At peak EAM and Fmed, the RMSE of the regression across all subjects was 35% body weight (%BW), while the maximum error was 127 %BW. Conclusion The relationship between EAM and Fmed is generally good but varies considerably across subjects and activities. These findings emphasize the limitation of relying solely on the EAM to infer medial joint loading when excessive directed cocontraction of muscles exists and call for further investigations into the soft tissue-related mechanisms that modulate the internal forces at the knee. |
| Author | Bergmann, Georg Trepczynski, Adam Taylor, William R. Kutzner, Ines Heller, Markus O. |
| Author_xml | – sequence: 1 givenname: Adam surname: Trepczynski fullname: Trepczynski, Adam organization: Charité‐Universitätsmedizin Berlin – sequence: 2 givenname: Ines surname: Kutzner fullname: Kutzner, Ines organization: Charité‐Universitätsmedizin Berlin – sequence: 3 givenname: Georg surname: Bergmann fullname: Bergmann, Georg organization: Charité‐Universitätsmedizin Berlin – sequence: 4 givenname: William R. surname: Taylor fullname: Taylor, William R. organization: Swiss Federal Institute of Technology Zurich – sequence: 5 givenname: Markus O. surname: Heller fullname: Heller, Markus O. organization: University of Southampton |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24470261$$D View this record in MEDLINE/PubMed |
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Osteoarthritis Cartilage. 2002 May;10(5):353-9 |
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| Snippet | Objective
The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during... The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during walking.... Objective The external knee adduction moment (EAM) is often considered a surrogate measure of the distribution of loads across the tibiofemoral joint during... |
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| SubjectTerms | Aged Arthroplasty, Replacement, Knee Biomechanical Phenomena - physiology Cohort Studies Female Femur - physiology Humans Knee Joint - physiology Knee Joint - surgery Male Mean square errors Models, Biological Motor Activity - physiology Osteoarthritis Osteoarthritis, Knee - surgery Range of Motion, Articular - physiology Regression Analysis Tibia - physiology Weight-Bearing - physiology |
| Title | Modulation of the Relationship Between External Knee Adduction Moments and Medial Joint Contact Forces Across Subjects and Activities |
| URI | https://onlinelibrary.wiley.com/doi/abs/10.1002%2Fart.38374 https://www.ncbi.nlm.nih.gov/pubmed/24470261 https://www.proquest.com/docview/1753290451 https://www.proquest.com/docview/1520109117 https://pubmed.ncbi.nlm.nih.gov/PMC4158863 |
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