Article

OBJECTIVE: To determine (1) if Medial Thrust or Trunk Lean reduces the knee
adduction moment (EKAM) the most during gait in patients with medial knee
osteoarthritis, (2) if the best overall strategy is the most effective for each
patient and (3) if these strategies affect ankle and hip kinetics. DESIGN: Thirty
patients with symptomatic medial knee osteoarthritis underwent
3-dimensional gait
analysis. Participants received verbal instructions on two gait strategies (Trunk
Lean and Medial Thrust) in randomized order after comfortable walking was
recorded. The peaks and impulse of the EKAM and strategy-specific kinematic and
kinetic variables were calculated for all conditions. RESULTS: Early stance EKAM
peak was significantly reduced during Medial Thrust (-29%). During Trunk Lean,
early and late stance EKAM peak and EKAM impulse reduced significantly (38%, 21%
and -25%, respectively). In 79% of the subjects, the Trunk Lean condition was
significantly more effective in reducing EKAM peak than Medial Thrust. Peak ankle
dorsi and plantar flexion, knee flexion and hip extension and adduction moments
were not significantly increased. CONCLUSIONS: Medial Thrust and Trunk Lean
reduced the EKAM during gait in patients with knee osteoarthritis. Individual
selection of the most effective gait modification strategy seems vital to
optimally reduce dynamic knee loading during gait. No detrimental effects on
external ankle and hip moments or knee flexion moments were found for these conditions.
CI - Copyright A(c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS