Clinical Biomechanics最新文献

{"title":"Postural control in individuals with mental disorders: A systematic review and META-analysis","authors":"Carla Emilia Rossato ,&nbsp;Aline Josiane Waclawovsky ,&nbsp;Gabriela dos Santos de Souza ,&nbsp;Debora Tornquist ,&nbsp;Carlos Bolli Mota ,&nbsp;Aron Ferreira da Silveira ,&nbsp;Felipe Barreto Schuch","doi":"10.1016/j.clinbiomech.2025.106741","DOIUrl":"10.1016/j.clinbiomech.2025.106741","url":null,"abstract":"<div><div>Background: Some evidence suggests that people with mental disorders presents postural balances, but there is a scarcity of meta-analyses summarizing the evidence comparing posture of people with mental disorders with paired controls. Objectives: The aim of this study was to summarize the evidence comparing postural balance between individuals with mental disorders and healthy controls. Methods: We searched databases (PubMed, PsycINFO, Embase, SportDiscus and Web of Science) from inception until June 3, 2025, for studies comparing postural balance, assessed by center of pressure (COP), in people with and without mental disorders. The primary outcome was the COP in different axes (X and Y), assessed under multiple conditions (eyes open/close, feet apart/together). Random effects meta-analyses calculated the mean differences (MD) between groups Whenever relevant; heterogeneity was explored by meta-regression and subgroup analyses. The risk of bias of the included studies was assessed using the Newcastle-Ottawa scale (NOS). The protocol was registered with PROSPERO (CRD42024554769). Findings: 33 studies were included, totaling 2.601 participants (1.424 with mental disorders [mean age = 39.30 ± 10.54 years, 43.05 % women] and 1.177 controls [mean age = 39.68 ± 10.35, 50.44 % women]. People with mental disorders showed greater COP area sway in the feet apart and eyes open (<em>N</em> = 12, MD = 0.20, 95 %CI 0.07, 0.32, I² = 62.67) and eyes closed conditions (<em>N</em> = 8, MD = 0.42, 95 %CI 0.15, 0.69, I² = 59.10) compared to controls. The majority of studies (96.96 %) had a low or moderate risk of bias. Interpretation: Individuals with mental disorders show alterations in postural balance compared to healthy controls.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106741"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A partial differential equation model of a novel treatment for chronic wound biofilm infections","authors":"Sandeep Shirgill ,&nbsp;Najida Begum ,&nbsp;Sarah A. Kuehne ,&nbsp;Gowsihan Poologasundarampillai ,&nbsp;Sara Jabbari ,&nbsp;John Ward","doi":"10.1016/j.clinbiomech.2025.106744","DOIUrl":"10.1016/j.clinbiomech.2025.106744","url":null,"abstract":"<div><h3>Background:</h3><div>Chronic wounds, such as pressure ulcers, venous leg ulcers, and diabetic foot ulcers, present a significant healthcare challenge due to their prolonged healing times and association with biofilm infections. This study introduces a mathematical model to investigate wound healing dynamics during the proliferative stage, focusing on chronic wound conditions characterised by poor vascularisation, clotting deficiencies, cellular senescence, and bacterial biofilms.</div></div><div><h3>Methods:</h3><div>The model examines the interactions between fibroblasts, keratinocytes, granulation tissue, nutrients, and signalling molecules under normal and impaired healing scenarios. The potential of bioactive glass fibres, doped with antimicrobial and wound healing ions, is also explored.</div></div><div><h3>Findings:</h3><div>Model results reflect the impairment of wound healing by biofilm infections, with larger bacterial populations leading to poorer outcomes. Simulations suggest that antimicrobial ions reduce bacterial populations and improve nutrient availability, supporting fibroblast and immune cell activity. Reapplication of bioactive glass fibres enhances ion concentrations, further promoting granulation tissue formation and wound closure under certain conditions.</div></div><div><h3>Interpretation:</h3><div>Results identify critical parameters that hinder healing in untreated wounds and demonstrate how bioactive glass fibre design can be optimised to enhance healing outcomes. This work provides a foundation for designing cost-effective treatments for chronic wounds, addressing a significant unmet clinical need.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106744"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait analysis and prediction in Parkinson's disease using rhythmic auditory stimulation: A data-driven approach with machine learning models","authors":"Jingyuan Lin","doi":"10.1016/j.clinbiomech.2025.106725","DOIUrl":"10.1016/j.clinbiomech.2025.106725","url":null,"abstract":"<div><h3>Background</h3><div>Gait disturbance is a core feature of Parkinson's disease (PD), contributing to mobility loss and fall risk. Rhythmic auditory stimulation (RAS) can improve gait, yet response varies across patients. This study evaluated RAS effects on gait and developed a model to predict responders.</div></div><div><h3>Methods</h3><div>Three hundred PD patients were enrolled and assigned to RAS or control groups. Gait data were collected with a 3D motion capture system and force plates, and baseline assessments included UPDRS-III and MoCA score. Clinical and gait features (stride length, speed, swing time, double support) were analyzed. Paired analyses compared pre- and post-RAS changes. Machine learning models (Random Forest, XGBoost, SVM) were trained on demographic and baseline gait data to predict RAS responsiveness, defined as improvement in gait speed and double support time.</div></div><div><h3>Findings</h3><div>Among the 171 patients in the RAS group, 116 (67.8 %) were identified as responders based on improvements in gait speed and double support time.The RAS group showed significant improvements in gait speed (+0.14 m/s), stride length (+0.10 m), and reductions in double support (−0.026 s) and variability (−0.012), all <em>p</em> &lt; 0.001. Among models, Random Forest classifier demonstrated the best balanced performance (AUC = 0.713, accuracy = 0.71, F1 = 0.64, recall = 0.87), outperforming SVM and XGBoost models. Feature importance highlighted UPDRS-III, stride length, MoCA score, and gait asymmetry as key predictors.</div></div><div><h3>Interpretation</h3><div>RAS significantly enhances gait performance in PD, though with individual variability. A data-driven machine learning framework enables reasonable prediction of responders, supporting personalized gait rehabilitation strategies in clinical practice.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106725"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior talofibular ligament laxity restricts deep deltoid ligament strain in a cadaveric model of acquired planus 'The deep deltoid paradoxical intact sign'","authors":"Zhikai Li ,&nbsp;Gavin E. Jarvis ,&nbsp;Tobia Nava ,&nbsp;Zhiheng Li ,&nbsp;Luke Maxwell ,&nbsp;Cecilia Brassett ,&nbsp;Stephanie Potten ,&nbsp;Alan R. Norrish ,&nbsp;Chandra S. Pasapula","doi":"10.1016/j.clinbiomech.2025.106734","DOIUrl":"10.1016/j.clinbiomech.2025.106734","url":null,"abstract":"<div><h3>Background</h3><div>The Deep Deltoid Ligament (DDL) laxity development and subsequent rupture can occur in pes planus. Anteromedial drawer tests reveal reduced anteromedial anteroposterior (AP) ankle laxity with concurrent anterior talofibular ligament (ATFL) laxity. The paradoxical protection conferred by ATFL laxity to the DDL in progressive collapsing foot deformity (PCFD) warrants further investigation.</div></div><div><h3>Aims</h3><div>Investigate the effect of ATFL laxity on DDL laxity development in an experimental flat-foot model.</div></div><div><h3>Methods</h3><div>18 cadaveric feet were assigned to three experimental protocols: (1) control, (2) induced flat-foot, and (3) induced flat-foot with ATFL sectioned. The flat-foot model was induced by sectioning the plantar fascia, spring ligament (SL), and the plantar first tarsometatarsal ligament. Sectioning the SL due to the interconnectedness would result in defunctioning of the superficial deltoid. Positional markers were placed on the medial malleolus, fibula, and talus. Jig-mounted feet underwent 2000 loading cycles. Every 200 cycles, images were taken before and after antero-posterior force application and the markers used to determine anteromedial and anterolateral AP separation, modelled as a linear function of cycle number.</div></div><div><h3>Findings</h3><div>In ATFL-intact flat feet, antero-posterior force-induced anteromedial separation and thus DDL laxity increased by 3.45 ± 0.34 mm per 1000 cycles (mean ± SD), whereas in ATFL-sectioned and control feet, this was 0.64 ± 0.59 and 0.59 ± 0.32 mm per 1000 cycles respectively. Minimal cycle-induced change occurred in anterolateral separation in the three conditions. ATFL-sectioned feet had greater antero-posterior force-induced anterolateral separation (9.33 ± 1.42 mm) before cyclic loading than control (1.85 ± 0.85 mm) and ATFL-intact flat feet (1.85 ± 0.31 mm).</div></div><div><h3>Interpretation</h3><div>Sectioning ATFL in experimentally induced flat feet paradoxically reduces anteromedial separation/DDL laxity.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106734"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Strain in vertebral artery during passive cervical range of motion and spinal manipulation therapy: A systematic review and meta-analysis” [Clinical Biomechanics 130 (2025) 106685]","authors":"Caroline Fagundes ,&nbsp;Felipe Coutinho Kullmann Duarte ,&nbsp;Walter Herzog","doi":"10.1016/j.clinbiomech.2025.106721","DOIUrl":"10.1016/j.clinbiomech.2025.106721","url":null,"abstract":"","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106721"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing participant recruitment methods in knee osteoarthritis: Implications for community recruitment and its effects on clinical and biomechanical outcomes","authors":"Carson Halliwell ,&nbsp;Aleksandra Budarick ,&nbsp;Janie Astephen Wilson ,&nbsp;Derek Rutherford ,&nbsp;Meaghan Hannigan ,&nbsp;Rebecca Moyer","doi":"10.1016/j.clinbiomech.2025.106740","DOIUrl":"10.1016/j.clinbiomech.2025.106740","url":null,"abstract":"<div><h3>Background</h3><div>Community-based recruitment may relieve clinician-dependant strategies for participant recruitment in gait analyses for clinical populations. However, it is unknown whether individuals recruited through community-based self-report methods exhibit similar patient-reported outcomes and gait biomechanics to those clinically diagnosed by a healthcare provider. This study aims to explore the differences between self-reported and clinically diagnosed knee osteoarthritis in terms of pain, function, quality of life, and gait biomechanics.</div></div><div><h3>Methods</h3><div>Participants with self-reported knee osteoarthritis (<em>n</em> = 16) were recruited based on activity-related knee pain, while those with clinically diagnosed knee osteoarthritis (n = 16) diagnosed based on the American College of Rheumatology guidelines by an orthopaedic surgeon. Both groups completed the Knee Injury and Osteoarthritis Outcome Score and Intermittent and Constant Osteoarthritis Pain questionnaires. Gait analysis was performed using three-dimensional motion capture, with sagittal plane knee angles, and knee flexion and adduction moments. Independent <em>t</em>-tests and statistical parametric mapping were used for group comparisons.</div></div><div><h3>Findings</h3><div>No differences were found between groups for patient-reported outcomes. Compared to individuals with clinically diagnosed knee osteoarthritis, individuals with self-reported knee osteoarthritis walked with reduced knee flexion angles and reduced peak knee flexion and adduction moments.</div></div><div><h3>Interpretation</h3><div>While patient-reported outcomes were not different, the biomechanical characteristics indicate that individuals recruited using community-based self-reported methodology may walk with gait patterns more closely resembling severe knee osteoarthritis. Although neither recruitment strategy is superior, these data support that employing a community-based self-report recruitment criterion may yield individuals who walk with gait patterns more closely resembling severe knee osteoarthritis compared to those clinically diagnosed.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106740"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postural adjustments during activities of daily living with an upper limb prosthesis","authors":"Mira E. Mutnick ,&nbsp;Susannah M. Engdahl ,&nbsp;Alec McKheen ,&nbsp;Christina Lee ,&nbsp;Deanna H. Gates","doi":"10.1016/j.clinbiomech.2025.106745","DOIUrl":"10.1016/j.clinbiomech.2025.106745","url":null,"abstract":"<div><h3>Background</h3><div>People with upper limb difference (ULD) using prostheses often use compensatory trunk movements to perform activities of daily living (ADL). Compensatory movements may provide additional challenges for the postural control system to maintain balance. However, no prior studies have quantified postural adjustments during ADLs in this population. The purpose of this study was to determine if upper limb prosthesis users make larger postural adjustments during ADLs compared to people without ULD.</div></div><div><h3>Methods</h3><div>Nine individuals with ULD and nine without ULD performed unimanual and bimanual ADLs. Participants with ULD wore their prescribed body-powered or myoelectric prostheses. For each ADL, postural adjustments derived from center of pressure (CoP) position were compared across limbs (control, prosthetic, and intact). The impact of additional factors including prosthetic type, etiology, and duration of prosthetic use was also explored.</div></div><div><h3>Findings</h3><div>When using only the prosthesis or using it asymmetrically to the intact limb, people with ULD had larger CoP motion than people without ULD (<em>p</em> &lt; 0.012). Exploratory comparisons found that during tasks that required grasping larger objects, body-powered prosthesis users and people with acquired amputation had larger CoP motion than myoelectric prosthesis users and people with congenital limb difference, respectively (g &gt; 0.642). When performing a bimanual symmetric task, people who had owned their prosthesis longer had less CoP motion (<em>p</em> = 0.032).</div></div><div><h3>Interpretation</h3><div>Overall, the study demonstrates that individuals with ULD make larger postural adjustments when performing ADLs that incorporate their prosthesis. The extent of these differences is affected by prosthesis type, limb difference etiology, and duration of prosthesis ownership.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106745"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between hip flexor tightness and low back pain in non-care-seeking individuals","authors":"Kira Eimiller ,&nbsp;Matthew Vraa ,&nbsp;Kemery Sigmund ,&nbsp;Matthew Zellmer","doi":"10.1016/j.clinbiomech.2025.106739","DOIUrl":"10.1016/j.clinbiomech.2025.106739","url":null,"abstract":"<div><h3>Background</h3><div>Low back pain (LBP) is a prevalent musculoskeletal condition with significant economic consequences (Wu et al., 2020). Despite evidence of functional limitations, non-care-seeking individuals with LBP remain an under-researched population (Vraa et al., 2022). Hip flexor tightness has been proposed as a potential contributor to LBP due to its role in altered biomechanics and compensatory lumbar movements (Kim &amp; Shin, 2020). Tight hip flexors are frequently assumed to contribute to LBP, yet the nature of the relationship is unclear. The objective of this study was to examine the relationship between hip flexor tightness and LBP severity in individuals with and without LBP who have not sought medical care.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 118 adults (aged 20–61) assessed hip flexor range of motion (ROM) using the Modified Thomas Test and low back pain severity using the Modified Oswestry Disability Index. Between-group comparisons and generalized linear models examined the relationship between ROM, LBP presence, and disability.</div></div><div><h3>Findings</h3><div>LBP participants had significantly reduced ROM (4 ± 9° vs. 8 ± 9°, <em>p</em> = 0.003). However, in the adjusted generalized linear model, only BMI remained a significant predictor of hip flexor ROM (<em>p</em> = 0.011), while LBP status was not independently associated with hip flexor ROM (<em>p</em> = 0.180).</div></div><div><h3>Interpretation</h3><div>Reduced hip flexor ROM was observed in non-care-seeking individuals with LBP but was not independently predictive after adjustment. BMI was the only significant factor associated with hip flexor ROM, underscoring the multifactorial nature of LBP.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106739"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detecting the pterygomaxillary disjunction using an instrumented hammer: A cadaveric study","authors":"Manon Bas dit Nugues ,&nbsp;Giuseppe Rosi ,&nbsp;Charles Henri Flouzat-Lachaniette ,&nbsp;Gaoussou Toure ,&nbsp;Guillaume Haiat","doi":"10.1016/j.clinbiomech.2025.106736","DOIUrl":"10.1016/j.clinbiomech.2025.106736","url":null,"abstract":"<div><h3>Background</h3><div>In many maxillofacial surgeries, the surgeon must perform a pterygomaxillary disjunction in order to separate the jaw from the skull. The disjunction is performed using an osteotome which is impacted with a hammer until its tip crosses through the pterygoid plates. To determine whether the disjunction has occurred and avoid complications, surgeons still rely on their proprioception.</div></div><div><h3>Methods</h3><div>The aim of this study is to validate a vibroacoustic set-up constituted by an instrumented hammer equipped with a force sensor, aiming at detecting if the disjunction has occurred. To do so, fourteen osteotomies were performed in anatomical subject jaws. For each impact, the force signal was recorded and analyzed. A classification algorithm (Support Vector Machine method coupled with a cost matrix) was developed based on indicators extracted from the signal to determine whether the disjunction had occurred. Impacts were classified into two classes, one before and the other after the osteotome had crossed the pterygoid plates. To avoid undetected disjunctions a cost matrix was added to the algorithm. The coefficients from the matrix were chosen using by minimizing the Negative Likelihood Ratio.</div></div><div><h3>Findings</h3><div>The algorithm was able to distinguish impacts before and after the disjunction with an accuracy of 96 %. Moreover, the instrumented hammer was able to detect the disjunction with a maximum delay of two impacts.</div></div><div><h3>Interpretation</h3><div>These results pave the way for the development of a per-operative decision support system for the pterygomaxillary disjunction.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106736"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of vertical ground reaction forces while walking to contralateral structural worsening in adults with unilateral knee osteoarthritis: the Multicenter Osteoarthritis Study","authors":"Patrick Corrigan ,&nbsp;Cara L. Lewis ,&nbsp;Kerry E. Costello ,&nbsp;Deepak Kumar ,&nbsp;David T. Felson ,&nbsp;Tuhina Neogi ,&nbsp;Kathryn L. Bacon ,&nbsp;Michael P. LaValley ,&nbsp;Ali Guermazi ,&nbsp;Frank Roemer ,&nbsp;Michael C. Nevitt ,&nbsp;Cora E. Lewis ,&nbsp;James C. Torner ,&nbsp;Joshua J. Stefanik","doi":"10.1016/j.clinbiomech.2025.106718","DOIUrl":"10.1016/j.clinbiomech.2025.106718","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear why knee osteoarthritis (KOA) progresses from a unilateral to bilateral joint disease. This study aimed to evaluate relations between vertical ground reaction forces (VGRFs) while walking and structural worsening in the unaffected limb of adults with unilateral KOA.</div></div><div><h3>Methods</h3><div>Discrete metrics were extracted from the unaffected limb VGRF signal while walking at a self-selected speed. Structural worsening of the unaffected knee was evaluated over 2 years with radiographs (primary) and MRIs (secondary). Logistic regression models evaluated associations between VGRF metrics and structural worsening outcomes, while adjusting for relevant covariates. Similar relations were evaluated in adults without OA in either knee to determine if VGRF metrics uniquely relate to contralateral structural worsening in adults with unilateral KOA.</div></div><div><h3>Findings</h3><div>In adults with unilateral KOA (<em>n</em> = 262), VGRFs were not associated with radiographic joint space narrowing within the tibiofemoral compartments of the unaffected knee. Additionally, VGRFs were not associated with MRI-detected cartilage loss in the medial tibiofemoral compartment. However, for the lateral tibiofemoral compartment, higher vertical loading and unloading rates were protective against cartilage loss (Odd ratios (OR) = 0.31–0.47), while larger vertical impulses and valley magnitudes were associated with increased odds of cartilage loss (OR = 2.50 and 2.26, respectively). No relations were found in adults without OA in either knee (<em>n</em> = 985).</div></div><div><h3>Interpretation</h3><div>VGRF metrics lack the ability to predict medial tibiofemoral structural worsening in knees without OA. However, vertical impulse and valley magnitude can assist with identifying contralateral knees at risk for lateral tibiofemoral cartilage loss in those with unilateral KOA.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"132 ","pages":"Article 106718"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145685688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}