Article

The external knee adduction moment has been identified as a key biomarker in
biomechanics research, with associations with this variable and degenerative
diseases such as knee osteoarthritis. Heterogeneity in participant
characteristics and the protocols used to measure this variable may however
complicate its interpretation. Previous reviews have focused on interventions or
did not control for potential moderator variables in their analysis. In this
meta-regression analysis, we aimed to determine the influence of factors
including the cohort type, footwear, and walking speed on the measurement of knee
adduction moment. We performed a systematic review of the literature, identifying
articles that used the Plug-in-Gait inverse dynamics model to calculate the knee
adduction moment during level walking, and used a mixed effect model to determine
the effect of the previously described factors on the measurement. Results for
861 individuals were described in 19 articles. Walking speed had the largest
influence on knee adduction moment (p<0.001), and participants with medial knee
osteoarthritis had an increased knee adduction moment (p=0.008) compared to
healthy subjects. Footwear was found to have a significant overall effect
(p=0.024). Participants tested barefoot or wearing their own shoes had lower
adduction moments than those tested in footwear provided by the researchers.
Overall, the moderators accounted for 60% of the heterogeneity in the results.
These results support the hypothesis that an increased knee adduction moment is
associated with medial compartment knee osteoarthritis, and that footwear choice
can influence the results.
Gait speed has the largest effect on knee adduction
moment measurement and should be carefully controlled for in studies
investigating this variable.
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Langue : ANGLAIS