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Trunk Biomechanics in Individuals with Knee Disorders: A Systematic Review with Evidence Gap Map and Meta-analysis.
- Source :
- Sports Medicine - Open; 12/12/2022, Vol. 8 Issue 1, p1-20, 20p
- Publication Year :
- 2022
-
Abstract
- Background: The trunk is the foundation for transfer and dissipation of forces throughout the lower extremity kinetic chain. Individuals with knee disorders may employ trunk biomechanical adaptations to accommodate forces at the knee or compensate for muscle weakness. This systematic review aimed to synthesize the literature comparing trunk biomechanics between individuals with knee disorders and injury-free controls. Methods: Five databases were searched from inception to January 2022. Observational studies comparing trunk kinematics or kinetics during weight-bearing tasks (e.g., stair negotiation, walking, running, landings) between individuals with knee disorders and controls were included. Meta-analyses for each knee disorder were performed. Outcome-level certainty was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), and evidence gap maps were created. Results: A total of 81 studies investigating trunk biomechanics across six different knee disorders were included (i.e., knee osteoarthritis [OA], total knee arthroplasty [TKA], patellofemoral pain [PFP], patellar tendinopathy [PT], anterior cruciate ligament deficiency [ACLD], and anterior cruciate ligament reconstruction [ACLR]). Individuals with knee OA presented greater trunk flexion during squatting (SMD 0.88, 95% CI 0.58–1.18) and stepping tasks (SMD 0.56, 95% CI 0.13–.99); ipsilateral and contralateral trunk lean during walking (SMD 1.36; 95% CI 0.60–2.11) and sit-to-stand (SMD 1.49; 95% CI 0.90–2.08), respectively. Greater trunk flexion during landing tasks in individuals with PFP (SMD 0.56; 95% CI 0.01–1.12) or ACLR (SMD 0.48; 95% CI 0.21–.75) and greater ipsilateral trunk lean during single-leg squat in individuals with PFP (SMD 1.01; 95% CI 0.33–1.70) were also identified. No alterations in trunk kinematics of individuals with TKA were identified. Evidence gap maps outlined the lack of investigations for individuals with PT or ACLD, as well as for trunk kinetics across knee disorders. Conclusion: Individuals with knee OA, PFP, or ACLR present with altered trunk kinematics in the sagittal and frontal planes. The findings of this review support the assessment of trunk biomechanics in these individuals in order to identify possible targets for rehabilitation and avoidance strategies. Trial registration: PROSPERO registration number: CRD42019129257. [ABSTRACT FROM AUTHOR]
- Subjects :
- TORSO physiology
KNEE joint
CINAHL database
KNEE osteoarthritis
META-analysis
CONFIDENCE intervals
RUNNING
JUMPER'S knee
TOTAL knee replacement
RANGE of motion of joints
KNEE pain
SYSTEMATIC reviews
TORSO
SPORTS injuries
EVIDENCE gaps
SPORTS
DYNAMICS
STAIR climbing
DESCRIPTIVE statistics
WALKING
BODY movement
BIOMECHANICS
INFORMATION storage & retrieval systems
MEDLINE
DATA analysis software
PLICA syndrome
ANTERIOR cruciate ligament surgery
KNEE injuries
KINEMATICS
Subjects
Details
- Language :
- English
- ISSN :
- 21991170
- Volume :
- 8
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Sports Medicine - Open
- Publication Type :
- Academic Journal
- Accession number :
- 160705221
- Full Text :
- https://doi.org/10.1186/s40798-022-00536-6