1. Effect of toe-out gait modification on patellofemoral joint loading.
- Author
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Sabashi, Kento, Chiba, Takeshi, Yamanaka, Masanori, and Tohyama, Harukazu
- Subjects
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CONSERVATIVE treatment , *TIBIOFEMORAL joint , *REGRESSION analysis , *KNEE joint , *T-test (Statistics) - Abstract
Toe-out gait has been proposed as a conservative treatment to reduce medial tibiofemoral joint loading. However, patellofemoral joint loading during toe-out gait is not yet understood. Does the toe-out gait modification affect patellofemoral joint loading? Sixteen healthy adults were enrolled in this study. The natural gait and toe-out gait were measured using a three-dimensional motion analysis and a force plate. The knee flexion angle and external knee flexion moment during the stance phase were calculated. Thus, dynamic knee joint stiffness, a proxy of patellofemoral joint loading, was defined as a linear regression of the knee flexion moment and knee flexion angle during the early stance. Additionally, the peak patellofemoral compressive force during the early stance was calculated using a musculoskeletal simulation. A paired t -test was used to compare these biomechanical parameters during the natural gait and toe-out gait. The toe-out gait significantly increased the peak patellofemoral compressive force (mean difference = 0.37 BW, P = 0.017) and dynamic knee joint stiffness (mean difference = 0.07%BW*Ht/°, P = 0.001). The 1st peak of the knee flexion moment also significantly increased in the toe-out gait (mean difference = 1.01%BW*Ht, P = 0.003); however, the knee flexion angle did not change significantly (initial contact: mean difference = 1.7°, P = 0.078; peak: mean difference = 1.3°, P = 0.224). Toe-out gait increased the patellofemoral compressive force and dynamic knee joint stiffness because of increasing knee flexion moment, but not the knee flexion angle. When the toe-out gait is adapted, clinicians should pay attention to an increase in the patellofemoral joint loading. • Toe-out gait increased patellofemoral compressive force compared with natural gait. • Toe-out gait increased dynamic knee joint stiffness compared with natural gait. • Toe-out gait increased the knee flexion moment, but not the knee flexion angle. • Clinicians should pay attention to increases in patellofemoral joint loading. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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