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The significance of frontal plane static alignment in anticipating dynamic knee moment among transtibial prosthesis users: A cross-sectional study
In the process of transtibial prosthetic fitting, alignment is the process of positioning the prosthetic foot relative to the residual limb. Changes in frontal plane alignment can impact knee moments during walking, which can either cause or, when aligned properly, prevent injuries. However, clinica...
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| Published in: | Gait & posture 2024-07, Vol.112, p.128-133 |
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| creator | Jonkergouw, Niels Sprockel, Astrid T. Bruijn, Sjoerd M. Kooiman, Vera Prins, Maarten R. Leijendekkers, Ruud A. |
| description | In the process of transtibial prosthetic fitting, alignment is the process of positioning the prosthetic foot relative to the residual limb. Changes in frontal plane alignment can impact knee moments during walking, which can either cause or, when aligned properly, prevent injuries. However, clinical evaluation of dynamic knee moments is challenging, limiting prosthetists' insights into dynamic joint loading. Typically, knee joint loading is assessed in static stance using the knee moment arm as a proxy for subsequent dynamic alignment. It remains uncertain if static alignment accurately represents actual dynamics during walking.
Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson's correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p |
| doi_str_mv | 10.1016/j.gaitpost.2024.05.012 |
| format | article |
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Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson's correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p<0.001; Second: r=0.62, r2=38%, p=0.001) and knee adduction moment (First: r=0.42, r2=17%, p=0.030; Second: r=0.59, r2=35%, p=0.001). A 1 mm between-subject difference in static knee moment arm corresponded, on average, with a 0.9% difference in knee adduction moment at the first peak and a 1.5% difference at the second peak of the ground reaction force.
While static alignment is important to optimize adduction moments during stance it may only partly mitigate excessive moments during gait. The fair correlation and limited percentage of explained variance underscores the importance of dynamic alignment in optimizing the body's dynamic load during walking.
•Static KMA has a fair to good correlation to dynamic KMA in transtibial amputees.•KMA has a very good to excellent correlation to the external knee adduction moment.•There is a limited explained variance of static KMA to the dynamic parameters.•A 1 mm static KMA shift causes a 1% dynamic adduction moment change.</description><identifier>ISSN: 0966-6362</identifier><identifier>ISSN: 1879-2219</identifier><identifier>EISSN: 1879-2219</identifier><identifier>DOI: 10.1016/j.gaitpost.2024.05.012</identifier><identifier>PMID: 38772124</identifier><language>eng</language><publisher>England: Elsevier B.V</publisher><subject>Adult ; Aged ; Alignment ; Amputees ; Artificial Limbs ; Biomechanical Phenomena ; Bone-anchored prosthesis ; Cross-Sectional Studies ; Female ; Gait - physiology ; Gait analysis ; Humans ; Knee Joint - physiology ; Knee moments ; Male ; Middle Aged ; Prosthesis Fitting ; Tibia - physiology ; Transtibial ; Walking - physiology</subject><ispartof>Gait & posture, 2024-07, Vol.112, p.128-133</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c363t-412b4413207f623c32e9e61f68083827c647bcde26e27959fb8359a4be5d5c4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38772124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jonkergouw, Niels</creatorcontrib><creatorcontrib>Sprockel, Astrid T.</creatorcontrib><creatorcontrib>Bruijn, Sjoerd M.</creatorcontrib><creatorcontrib>Kooiman, Vera</creatorcontrib><creatorcontrib>Prins, Maarten R.</creatorcontrib><creatorcontrib>Leijendekkers, Ruud A.</creatorcontrib><title>The significance of frontal plane static alignment in anticipating dynamic knee moment among transtibial prosthesis users: A cross-sectional study</title><title>Gait & posture</title><addtitle>Gait Posture</addtitle><description>In the process of transtibial prosthetic fitting, alignment is the process of positioning the prosthetic foot relative to the residual limb. Changes in frontal plane alignment can impact knee moments during walking, which can either cause or, when aligned properly, prevent injuries. However, clinical evaluation of dynamic knee moments is challenging, limiting prosthetists' insights into dynamic joint loading. Typically, knee joint loading is assessed in static stance using the knee moment arm as a proxy for subsequent dynamic alignment. It remains uncertain if static alignment accurately represents actual dynamics during walking.
Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson's correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p<0.001; Second: r=0.62, r2=38%, p=0.001) and knee adduction moment (First: r=0.42, r2=17%, p=0.030; Second: r=0.59, r2=35%, p=0.001). A 1 mm between-subject difference in static knee moment arm corresponded, on average, with a 0.9% difference in knee adduction moment at the first peak and a 1.5% difference at the second peak of the ground reaction force.
While static alignment is important to optimize adduction moments during stance it may only partly mitigate excessive moments during gait. The fair correlation and limited percentage of explained variance underscores the importance of dynamic alignment in optimizing the body's dynamic load during walking.
•Static KMA has a fair to good correlation to dynamic KMA in transtibial amputees.•KMA has a very good to excellent correlation to the external knee adduction moment.•There is a limited explained variance of static KMA to the dynamic parameters.•A 1 mm static KMA shift causes a 1% dynamic adduction moment change.</description><subject>Adult</subject><subject>Aged</subject><subject>Alignment</subject><subject>Amputees</subject><subject>Artificial Limbs</subject><subject>Biomechanical Phenomena</subject><subject>Bone-anchored prosthesis</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Gait - physiology</subject><subject>Gait analysis</subject><subject>Humans</subject><subject>Knee Joint - physiology</subject><subject>Knee moments</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prosthesis Fitting</subject><subject>Tibia - physiology</subject><subject>Transtibial</subject><subject>Walking - physiology</subject><issn>0966-6362</issn><issn>1879-2219</issn><issn>1879-2219</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkU1v1DAQhi1ERZe2f6HykUuCv5NwoqrKh1SJS3u2HGey9ZI4i-0g7d_gFzPbbblysjTzzMz7-iXkmrOaM24-7uqtC2W_5FILJlTNdM24eEM2vG26SgjevSUb1hlTGWnEOXmf844xpmQr3pFz2TaN4EJtyJ-HJ6A5bGMYg3fRA11GOqYlFjfR_eQidosrwVM3ITVDLDRE6iKWwh4bcUuHQ3QzEj8jAJ2XZ8bNC3ZKcjGX0IfjsoRinyCHTNcMKX-iN9RjLVcZfAlLRCaXdThckrPRTRmuXt4L8vjl7uH2W3X_4-v325v7yksjS6W46JXiUrBmNEJ6KaADw0fTshZdNt6opvcDCAOi6XQ39q3UnVM96EF7BfKCfDjtRWW_VsjFziF7mI6mlzVbyXRrpFZSI2pO6LPgBKPdpzC7dLCc2WMedmdf87DHPCzTFvPAweuXG2s_w_Bv7DUABD6fAECnvwMkm30AzGEICb_FDkv4342_XYKi6g</recordid><startdate>202407</startdate><enddate>202407</enddate><creator>Jonkergouw, Niels</creator><creator>Sprockel, Astrid T.</creator><creator>Bruijn, Sjoerd M.</creator><creator>Kooiman, Vera</creator><creator>Prins, Maarten R.</creator><creator>Leijendekkers, Ruud A.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202407</creationdate><title>The significance of frontal plane static alignment in anticipating dynamic knee moment among transtibial prosthesis users: A cross-sectional study</title><author>Jonkergouw, Niels ; Sprockel, Astrid T. ; Bruijn, Sjoerd M. ; Kooiman, Vera ; Prins, Maarten R. ; Leijendekkers, Ruud A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c363t-412b4413207f623c32e9e61f68083827c647bcde26e27959fb8359a4be5d5c4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alignment</topic><topic>Amputees</topic><topic>Artificial Limbs</topic><topic>Biomechanical Phenomena</topic><topic>Bone-anchored prosthesis</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Gait - physiology</topic><topic>Gait analysis</topic><topic>Humans</topic><topic>Knee Joint - physiology</topic><topic>Knee moments</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prosthesis Fitting</topic><topic>Tibia - physiology</topic><topic>Transtibial</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jonkergouw, Niels</creatorcontrib><creatorcontrib>Sprockel, Astrid T.</creatorcontrib><creatorcontrib>Bruijn, Sjoerd M.</creatorcontrib><creatorcontrib>Kooiman, Vera</creatorcontrib><creatorcontrib>Prins, Maarten R.</creatorcontrib><creatorcontrib>Leijendekkers, Ruud A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gait & posture</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jonkergouw, Niels</au><au>Sprockel, Astrid T.</au><au>Bruijn, Sjoerd M.</au><au>Kooiman, Vera</au><au>Prins, Maarten R.</au><au>Leijendekkers, Ruud A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The significance of frontal plane static alignment in anticipating dynamic knee moment among transtibial prosthesis users: A cross-sectional study</atitle><jtitle>Gait & posture</jtitle><addtitle>Gait Posture</addtitle><date>2024-07</date><risdate>2024</risdate><volume>112</volume><spage>128</spage><epage>133</epage><pages>128-133</pages><issn>0966-6362</issn><issn>1879-2219</issn><eissn>1879-2219</eissn><abstract>In the process of transtibial prosthetic fitting, alignment is the process of positioning the prosthetic foot relative to the residual limb. Changes in frontal plane alignment can impact knee moments during walking, which can either cause or, when aligned properly, prevent injuries. However, clinical evaluation of dynamic knee moments is challenging, limiting prosthetists' insights into dynamic joint loading. Typically, knee joint loading is assessed in static stance using the knee moment arm as a proxy for subsequent dynamic alignment. It remains uncertain if static alignment accurately represents actual dynamics during walking.
Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson's correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p<0.001; Second: r=0.62, r2=38%, p=0.001) and knee adduction moment (First: r=0.42, r2=17%, p=0.030; Second: r=0.59, r2=35%, p=0.001). A 1 mm between-subject difference in static knee moment arm corresponded, on average, with a 0.9% difference in knee adduction moment at the first peak and a 1.5% difference at the second peak of the ground reaction force.
While static alignment is important to optimize adduction moments during stance it may only partly mitigate excessive moments during gait. The fair correlation and limited percentage of explained variance underscores the importance of dynamic alignment in optimizing the body's dynamic load during walking.
•Static KMA has a fair to good correlation to dynamic KMA in transtibial amputees.•KMA has a very good to excellent correlation to the external knee adduction moment.•There is a limited explained variance of static KMA to the dynamic parameters.•A 1 mm static KMA shift causes a 1% dynamic adduction moment change.</abstract><cop>England</cop><pub>Elsevier B.V</pub><pmid>38772124</pmid><doi>10.1016/j.gaitpost.2024.05.012</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Gait & posture, 2024-07, Vol.112, p.128-133 |
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| source | ScienceDirect Freedom Collection |
| subjects | Adult Aged Alignment Amputees Artificial Limbs Biomechanical Phenomena Bone-anchored prosthesis Cross-Sectional Studies Female Gait - physiology Gait analysis Humans Knee Joint - physiology Knee moments Male Middle Aged Prosthesis Fitting Tibia - physiology Transtibial Walking - physiology |
| title | The significance of frontal plane static alignment in anticipating dynamic knee moment among transtibial prosthesis users: A cross-sectional study |
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