The knee adduction moment measured with an instrumented force shoe in patients with knee osteoarthritis

JOURNAL OF BIOMECHANICS

卷:45

Article

van den Noort, Josien C.¹  van der Esch, Martin²  Steultjens, Martijn P. M.³  Dekker, Joost³  Schepers, H. Martin⁴  Veltink, Peter H.⁴  Harlaar, Jaap¹ 

[1] Vrije Univ Amsterdam, Med Ctr, Res Inst MOVE, Dept Rehabil Med, NL-1007 MB Amsterdam, Netherlands

[2] Reade Ctr Rehabil & Rheumatol, Div Res & Educ, NL-1056 AB Amsterdam, Netherlands

[3] Vrije Univ Amsterdam, Med Ctr, EMGO Inst Hlth & Care Res EMGO, Dept Rehabil Med, NL-1007 MB Amsterdam, Netherlands

[4] Univ Twente, Inst Biomed Technol & Tech Med MIRA, NL-7500 AE Enschede, Netherlands

关键词: Osteoarthritis;    Gait;    Joint moment;    Biomechanics;    Knee;    Rehabilitation;    Measurement system;    Shoe;   

DOI  :  10.1016/j.jbiomech.2011.10.027

来源: Elsevier

【 摘 要 】

The external knee adduction moment (KAdM) during gait is an important parameter in patients with knee osteoarthritis (OA). KAdM measurement is currently restricted to instruments only available in gait laboratories. However, ambulatory movement analysis technology, including instrumented force shoes (IFS) and inertial and magnetic measurement systems (IMMS), can measure kinetics and kinematics of human gait free of laboratory restrictions. The objective of this study was a quantitative validation of the accuracy of the KAdM in patients with knee OA, when estimated with an ambulatory-based method (AmbBM) versus a laboratory-based method (LabBM). AmbBM is employing the IFS and a linked-segment model, while LabBM is based on a force plate and optoelectronic marker system. Effects of ground reaction force (GRF), centre of pressure (CoP), and knee joint position measurement are evaluated separately. Twenty patients with knee OA were measured. The GRFs showed differences up to 0.22 N/kg, the CoPs showed differences up to 4 mm, and the medio-lateral and vertical knee position showed differences to 9 mm, between AmbBM and LabBM. The GRF caused an under-estimation in KAdM in early stance. However, this effect was counteracted by differences in CoP and joint position, resulting in a net 5% over-estimation. In midstance and late stance the accuracy of the KAdM was mainly limited by use of the linked-segment model for joint position estimation, resulting in an under-estimation (midstance 6% and late stance 22%). Further improvements are needed in the estimation of joint position from segment orientation. (C) 2011 Elsevier Ltd. All rights reserved.

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