Determining the individual relationship between the step width and peak knee adduction moment during stepping in medial knee osteoarthritis

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-07-22 DOI:10.1016/j.clinbiomech.2025.106619

Raziyeh Baghi , Wei Yin , Subham Badhyal , Ahmed Ramadan , Giovanni Oppizzi , Zongpan Li , Peter Bowman , Frank Henn , Li-Qun Zhang

{"title":"Determining the individual relationship between the step width and peak knee adduction moment during stepping in medial knee osteoarthritis","authors":"Raziyeh Baghi , Wei Yin , Subham Badhyal , Ahmed Ramadan , Giovanni Oppizzi , Zongpan Li , Peter Bowman , Frank Henn , Li-Qun Zhang","doi":"10.1016/j.clinbiomech.2025.106619","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Step-width modification can reduce peak knee adduction moment during gait in individuals with knee osteoarthritis, but determining optimal subject-specific step-width without testing multiple discrete positions remains a clinical challenge.</div></div><div><h3>Method</h3><div>We investigated step-width's relationship with peak knee adduction moment in 14 individuals with medial knee osteoarthritis and 14 healthy controls using a robotic stepping system with motorized footplates moving between narrow, neutral, and wide step-widths. We analyzed peak knee adduction moment-step width relationship slopes and compared peak three-dimensional knee moments between all stepping conditions using repeated-measure ANOVA analysis.</div></div><div><h3>Findings</h3><div>Both groups showed negative peak knee adduction moment-step width slopes, indicating reduced peak knee adduction moment with wider step-widths (knee osteoarthritis: <em>P</em> = 0.019, Controls: <em>P</em> = 0.016), with knee osteoarthritis group showing significantly higher slope and intercept values (<em>P</em> < 0.01, <em>P</em> < 0.001). Both groups demonstrated lower peak knee adduction moment and knee adduction moment impulse with wide step-width versus narrow and neutral step-widths (all <em>P</em> < 0.001). Lower peak knee adduction moment during wide step-width significantly correlated with increased tibia medial tilt (<em>P</em> < 0.001), increased footplate lateral reaction force (<em>P</em> = 0.023), reduced footplate inversion reaction torque (<em>P</em> < 0.001), reduced stepping speed (<em>P</em> = 0.022), and absence of knee osteoarthritis (<em>P</em> < 0.001).</div></div><div><h3>Interpretation</h3><div>Wider step-width effectively reduces peak knee adduction moment and knee adduction moment impulse during stepping. The robotic stepping system enables precise subject-specific step-width determination using peak knee adduction moment-step width relationships, potentially offering individualized rehabilitation strategies for knee osteoarthritis management.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"128 ","pages":"Article 106619"},"PeriodicalIF":1.4000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Biomechanics","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0268003325001925","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Step-width modification can reduce peak knee adduction moment during gait in individuals with knee osteoarthritis, but determining optimal subject-specific step-width without testing multiple discrete positions remains a clinical challenge.

Method

We investigated step-width's relationship with peak knee adduction moment in 14 individuals with medial knee osteoarthritis and 14 healthy controls using a robotic stepping system with motorized footplates moving between narrow, neutral, and wide step-widths. We analyzed peak knee adduction moment-step width relationship slopes and compared peak three-dimensional knee moments between all stepping conditions using repeated-measure ANOVA analysis.

Findings

Both groups showed negative peak knee adduction moment-step width slopes, indicating reduced peak knee adduction moment with wider step-widths (knee osteoarthritis: P = 0.019, Controls: P = 0.016), with knee osteoarthritis group showing significantly higher slope and intercept values (P < 0.01, P < 0.001). Both groups demonstrated lower peak knee adduction moment and knee adduction moment impulse with wide step-width versus narrow and neutral step-widths (all P < 0.001). Lower peak knee adduction moment during wide step-width significantly correlated with increased tibia medial tilt (P < 0.001), increased footplate lateral reaction force (P = 0.023), reduced footplate inversion reaction torque (P < 0.001), reduced stepping speed (P = 0.022), and absence of knee osteoarthritis (P < 0.001).

Interpretation

Wider step-width effectively reduces peak knee adduction moment and knee adduction moment impulse during stepping. The robotic stepping system enables precise subject-specific step-width determination using peak knee adduction moment-step width relationships, potentially offering individualized rehabilitation strategies for knee osteoarthritis management.

查看原文本刊更多论文

确定内侧膝骨关节炎患者步宽与膝关节内收峰力矩的个体关系

调整步宽可以减少膝关节骨性关节炎患者步态时的膝内收峰值，但在不测试多个离散位置的情况下确定最佳的受试者特定步宽仍然是临床挑战。方法研究了14例膝关节内侧骨性关节炎患者和14名健康对照者的步宽与膝关节内收力矩峰值的关系，采用带电动踏板的机器人步宽系统在窄步宽、中性步宽和宽步宽之间移动。我们分析了峰值膝关节内收力矩与步宽的关系斜率，并使用重复测量方差分析比较了所有步进条件下的峰值三维膝关节力矩。结果两组膝关节内收峰力矩-步宽斜率均为负，表明膝关节内收峰力矩随步宽的增大而减小（膝骨关节炎组：P = 0.019，对照组：P = 0.016），且膝骨关节炎组的斜率和截距值显著升高(P <；0.01, P <；0.001)。两组均表现出较低的膝关节内收力矩峰值和宽步宽的膝关节内收力矩脉冲，而窄步宽和中性步宽(所有P <；0.001)。宽步宽时膝下峰内收力矩与胫骨内侧倾斜增加显著相关(P <；0.001)，底板侧向反作用力增大（P = 0.023），底板倒转反作用力减小(P <；0.001)，降低步速（P = 0.022），无膝骨关节炎(P <；0.001)。更宽的步宽有效地减少了步进时膝关节内收力矩峰值和膝关节内收力矩脉冲。机器人步进系统可以通过峰值膝关节内收力矩-步宽关系精确确定受试者特定的步宽，潜在地为膝关节骨关节炎治疗提供个性化的康复策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.