Clinical Biomechanics最新文献

{"title":"Anterior variable-angle locked plating of complex patella fractures – Does the type of polar screw matter?","authors":"Karl Stoffel ,&nbsp;Ivan Zderic ,&nbsp;Torsten Pastor ,&nbsp;William Woodburn ,&nbsp;Richard Castle ,&nbsp;Jessica Penman ,&nbsp;Eladio Saura-Sanchez ,&nbsp;Boyko Gueorguiev ,&nbsp;Christoph Sommer","doi":"10.1016/j.clinbiomech.2025.106492","DOIUrl":"10.1016/j.clinbiomech.2025.106492","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of complex patella fractures represents a challenging clinical problem. Whereas controversy exists regarding the most appropriate fixation method, anterior plating is an emerging treatment option. A novel design of anterior variable-angle locking plates features radiating legs with integrated screw holes aiming at capturing fragments of the distal comminuted zone via either a locking or a cortical polar screw.</div><div>The aim of this study was to compare the biomechanical performance of the novel anterior variable-angle locking plates used for fixation of complex patella fractures with either a locking or a cortical polar screw.</div></div><div><h3>Methods</h3><div>Complex five-part AO/OTA 34-C3 patella fractures mimicking comminution around the distal pole were simulated in twelve human cadaveric knees. Specimens were randomized to two groups for treatment with an anterior variable-angle locking plate fixing the patella with either one locking or one cortical caudo-cranial bicortical polar screw. Biomechanical testing was performed over 5000 cycles by pulling on the quadriceps tendon, simulating active knee extension and passive flexion within the range from 90° flexion to full extension. Interfragmentary movements were captured by motion tracking.</div></div><div><h3>Findings</h3><div>No significant differences between the two fixation techniques were detected in terms of longitudinal and shear articular displacements, and relative rotations around the mediolateral axis measured between the proximal and distal fragments at the central patella aspect between 1000 and 5000 cycles, <em>P</em> ≥ 0.116.</div></div><div><h3>Interpretation</h3><div>From a biomechanical perspective, anterior locked plating of complex patella fractures provides comparable fixation stability when using either a locking or a cortical polar screw.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106492"},"PeriodicalIF":1.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643677","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":"In vitro biomechanical evaluation of a strutted intradiscal spacer for lumbar discectomy","authors":"Werner Schmoelz ,&nbsp;Anna Spicher ,&nbsp;Richard Lindtner ,&nbsp;Romed Hörmann ,&nbsp;Robin Srour","doi":"10.1016/j.clinbiomech.2025.106491","DOIUrl":"10.1016/j.clinbiomech.2025.106491","url":null,"abstract":"<div><h3>Background</h3><div>Discectomy plus implantation of a strutted intradiscal spacer has been shown to reduce reoperations and reherniations versus discectomy alone following lumbar disc herniation. This study explored the underlying biomechanics of the intradiscal spacer.</div></div><div><h3>Methods</h3><div>Six fresh-frozen cadaveric lumbar spine specimens (L2 to L5) from three donors were used. Following box annulotomy to simulate disc herniation, a discectomy was performed. One segment from each donor was randomly assigned to either an untreated control group or the test group where an intradiscal spacer was implanted. A six degree of freedom universal spine tester assessed range of motion (RoM) in flexion/extension, lateral bending and axial rotation in the native state in load controlled [±7.5 Nm] and intervals up to 60,000 cycles. Disc height was measured on fluoroscopy for multiple timepoints. The segments were also analyzed to detect possible reherniation during the cycling loading.</div></div><div><h3>Findings</h3><div>Following 60,000 cycles, the mean percentage RoM increase versus the intact state was less for discectomy plus the intradiscal spacer versus discectomy alone for lateral bending (170.7 ± 10.0 vs. 222.5 ± 33.3 %), flexion/extension (178.5 ± 6.1 vs. 204.6 ± 44.3 %) and axial rotation (284.4 ± 127.2 vs. 362.3 % ± 240.4 %). Mean overall disc height loss versus the annulotomy state was also less with the intradiscal spacer versus discectomy alone (−19.3 ± 3.7 vs. -29.1 ± 6.1 %). There was no evidence of device subsidence or migration.</div></div><div><h3>Interpretation</h3><div>This study helps to explain the clinical observation that insertion of a strutted intradiscal spacer following discectomy reduces reherniation rate by mechanically limiting the increase in RoM and disc height loss following lumbar discectomy.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106491"},"PeriodicalIF":1.4,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683520","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":"Low multiscale entropy of ankle joint position during toe gait in children with cerebral palsy is related to contracture development","authors":"Tony Biakceunung Rungling ,&nbsp;Thomas Sinkjær ,&nbsp;Jens Bo Nielsen ,&nbsp;Jakob Lorentzen ,&nbsp;Maria Willerslev-Olsen ,&nbsp;Rasmus Feld Frisk","doi":"10.1016/j.clinbiomech.2025.106490","DOIUrl":"10.1016/j.clinbiomech.2025.106490","url":null,"abstract":"<div><h3>Background</h3><div>Toe walking in children with cerebral palsy is typically less stable and less energy-efficient than plantigrade walking in typically developing children. We hypothesized that children with cerebral palsy may, nevertheless, show more stable toe walking due to the development of contractures compared to age-matched typically developing children.</div></div><div><h3>Methods</h3><div>Multiscale entropy of the vertical position of the ankle joint was used to measure ankle joint stability during the stance phase of walking. Kinematic data were obtained from 37 children with spastic cerebral palsy and habitual toe walking, who walked on a treadmill at their preferred speed (1.3 ± 0.5 km/h for cerebral palsy children and 1.5 ± 0.4 km/h for typically developing children). Recordings from 21 age-matched typically developing children were used for comparison. Typically developing children walked both normally (plantigrade) and on toes.</div></div><div><h3>Findings</h3><div>Multiscale entropy was significantly higher during toe walking than plantigrade walking in typically developing children (<em>P &lt;</em> 0.001). For children under 6 years, multiscale entropy was higher in cerebral palsy children than in typically developing children. For children over 6 years, the opposite was observed. In children with cerebral palsy, multiscale entropy decreased with reduced passive range of motion in the ankle joint (<em>P</em> &lt; 0.001).</div></div><div><h3>Interpretation</h3><div>These findings suggest that contractures in children with cerebral palsy stabilize the ankle during toe walking. Younger children may show greater stability due to early contracture development, while advanced contractures in older children may reduce stability.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106490"},"PeriodicalIF":1.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of strength potential of the thumb muscles and their relationship to trapeziometacarpal osteoarthritis: An exploratory cadaveric study","authors":"Mirka Normand ,&nbsp;Mohammad Reza Effatparvar ,&nbsp;Felix-Antoine Lavoie ,&nbsp;Jean-Michel Brismée ,&nbsp;Stéphane Sobczak","doi":"10.1016/j.clinbiomech.2025.106489","DOIUrl":"10.1016/j.clinbiomech.2025.106489","url":null,"abstract":"<div><h3>Background</h3><div>The ten muscles of the thumb allow for a variety of movement combinations yielding similar functional outcomes yet using different load transmission with different biomechanical stresses resulting in heterogenous trapeziometacarpal wear patterns. Our exploratory study investigates the correlation between the severity and location of trapeziometacarpal joint osteoarthritis and estimated individual thumb muscles maximal force.</div></div><div><h3>Method</h3><div>Normalized muscle mass to body mass and physiological cross-sectional area ratio were calculated following systematic muscular dissection of 19 cadaveric hands, 60 % males, average age 79.2, SD = 7.1. Correlations were analyzed with 3 different measures of articular degenerations.</div></div><div><h3>Findings</h3><div>Moderate negative correlation was found between Eaton-Glickel osteoarthritis grade and normalized muscle mass of opponens pollicis (rₛ = −0.59, <em>p</em> &lt; .01) and abductor pollicis longus (rₛ = −0.60, p &lt; .01). Moderate negative correlation was also found between trapeziometacarpal index and normalized opponens pollicis and abductor pollicis longus muscle mass (rₛ = −0.63, <em>p</em> &lt; .01) and (rₛ = −0.51, <em>p</em> &lt; .05), respectively. No correlation was identified between physiological cross-sectional area ratios and the above degeneration metrics.</div></div><div><h3>Interpretation</h3><div>Our current findings identified moderate negative correlations between the normalized mass to body mass of abductor pollicis longus and opponens pollicis for both Eaton-Glickel osteoarthritis grade and trapeziometacarpal index, which would support the current hand therapy exercise recommendations for the arthritic trapeziometacarpal population. Caution must be taken in the interpretation of correlations with articular zones degradation as our analytical power was reduced by the complete eburnation of few articular surfaces.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106489"},"PeriodicalIF":1.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of experimentally induced gluteal muscle weakness on joint kinematics, reaction forces, and dynamic balance performance during stair climbing","authors":"Dimitris Dimitriou ,&nbsp;Michel Meisterhans ,&nbsp;Wolf-Wettstein Jessica ,&nbsp;Marina Geissmann ,&nbsp;Marie-Rosa Fasser ,&nbsp;Jonas Widmer ,&nbsp;Paul Borbas ,&nbsp;Armando Hoch ,&nbsp;Patrick O. Zingg","doi":"10.1016/j.clinbiomech.2025.106477","DOIUrl":"10.1016/j.clinbiomech.2025.106477","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of the present study was to investigate the effects of an experimentally induced weakness of the gluteal muscles on joint kinematics, reactions forces, and dynamic balance performance using the center of mass during stair climbing.</div></div><div><h3>Methods</h3><div>Ten healthy adult volunteers received sequential blocks of superior gluteal nerve to tensor fascia lata, superior, and inferior gluteal nerve on their dominant right leg. A full-body movement analysis during stair climbing was performed. A two-way repeated measured analysis of variances were applied to compare the average rotational kinematics, joint reaction forces and center of mass.</div></div><div><h3>Findings</h3><div>Following superior gluteal nerve block, 50 % of healthy participants couldn't complete the task. In participants who completed the task, their joint kinematics were significantly different compared to the control condition, demonstrating more hip flexion (average maximum difference at 50 %: 15 ± 14°, <em>p</em> &lt; 0.05) and more internal rotation (average maximum difference at 20 %: 8 ± 5°, p &lt; 0.05) than in the control condition. Significantly lower joint reaction forces were observed following superior und inferior gluteus nerve blocks at the hip compared to the control condition (up 110 % of body weight average maximum difference, <em>p</em> &lt; 0.05). Participants demonstrated also an increased displacement of their center of mass in the mediolateral direction during both stair-ascent and descent under the superior and inferior gluteal nerve block.</div></div><div><h3>Interpretation</h3><div>A weakness in the hip abductors severely affected stair climbing performance. Those who managed to complete the task demonstrated abnormal kinematics, reduced joint reaction forces, and poorer dynamic balance.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106477"},"PeriodicalIF":1.4,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implant stability and clinical performance of a bicruciate-retaining total knee arthroplasty: A radiostereometric analysis up to 7.5 years follow-up","authors":"Kelly Mills,&nbsp;Koen Defoort,&nbsp;Gijs van Hellemondt,&nbsp;Petra Heesterbeek","doi":"10.1016/j.clinbiomech.2025.106473","DOIUrl":"10.1016/j.clinbiomech.2025.106473","url":null,"abstract":"<div><h3>Background</h3><div>A previous randomized controlled trial showed higher tibial migration and more device-related complications in bicruciate-retaining compared to cruciate-retaining total knee arthroplasty, raising concerns about long-term implant stability and prompting this follow-up study to assess migration patterns and clinical outcomes up to 7.5 years postoperatively.</div></div><div><h3>Methods</h3><div>In this follow-up study, the bicruciate-retaining group from an initial single-centre randomized controlled trial was monitored at 5 and 7.5 years postoperatively. Implant migration was measured through model-based radiostereometric analysis and reported as total translation and rotation for femoral and tibial components. Clinical outcomes, including multiple patient-reported outcomes and functional assessments, were also evaluated.</div></div><div><h3>Findings</h3><div>A total of 13 bicruciate-retaining patients participated in this follow-up study, with 12 completing the 7.5-year follow-up. At 5 and 7.5 years postoperatively, the median(interquartile range) total translation and total rotation for the tibial components were 0.24 mm (0.18–0.48) and 0.59° (0.46–1.10) and 0.30 mm (0.18–0.81) and 0.73° (0.50–1.39), respectively. For the femoral components, total translation and total rotation were 0.46 mm (0.34–0.64) and 0.43° (0.25–0.69) at 5 years, and 0.43 mm (0.24–0.74) and 0.36° (0.30–0.83) at 7.5 years. Clinical and functional outcome scores, on average, were high but one patient reported mediolateral instability.</div></div><div><h3>Interpretation</h3><div>Migration patterns for both bicruciate-retaining components generally stabilized from 2 to 7.5 years postoperatively, although some outliers show migration of &gt;0.2 mm. Given the high frequency of device-related adverse events and potential healthy survivor bias, these findings do not support the routine clinical use of this implant.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106473"},"PeriodicalIF":1.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563531","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 of knee abduction moment to lower extremity segment accelerations during sport-specific movements in youth anterior cruciate ligament reconstruction patients at return-to-play","authors":"Lauren Butler ,&nbsp;Hannah L. Olander ,&nbsp;Ashley Erdman ,&nbsp;Sophia Ulman","doi":"10.1016/j.clinbiomech.2025.106485","DOIUrl":"10.1016/j.clinbiomech.2025.106485","url":null,"abstract":"<div><h3>Background</h3><div>Second injury rates after anterior cruciate ligament reconstruction are high, necessitating tools to identify injury risk factors prior to return to sport. Knee abduction moments are a predictor of anterior cruciate ligament injury but require access to a motion laboratory to collect, thus reducing clinical feasibility. Inertial measurement units have been explored as an efficient, lower cost solution. However, the relationship between linear acceleration, derived from inertial measurement units, and knee abduction moments have not been explored in youth athletes after anterior cruciate ligament reconstruction. Therefore, the purpose of this study is to assess the relationship between lower extremity segment acceleration, derived from wireless inertial measurement units, and knee abduction moment during athletic tasks in youth athletes after anterior cruciate ligament reconstruction.</div></div><div><h3>Methods</h3><div>Thirty-four participants (12 male, 15.0 ± 2.5 years) who were 10.1 ± 1.9 months post-anterior cruciate ligament reconstruction participated in the study. Participants performed a single leg hop, a run plant, and a 45° run cut task. Peak knee abduction moment was collected using optical motion capture and force plates while peak triaxial acceleration was collected for the lower extremity using inertial measurement units.</div></div><div><h3>Findings</h3><div>Moderate correlations were observed for thigh and shank linear acceleration and knee abduction moment across all athletic tasks. Observed differences in linear acceleration between limbs were also identified.</div></div><div><h3>Interpretation</h3><div>These findings support the use of linear acceleration, derived from wireless inertial measurement units, to supplement detection strategies of high knee abduction moment during athletic tasks in youth athletes after anterior cruciate ligament reconstruction.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106485"},"PeriodicalIF":1.4,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563532","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":"Load carriage influences intact limb knee loading estimate associated with osteoarthritis in individuals with transtibial amputation","authors":"Satria Ardianuari ,&nbsp;David C. Morgenroth ,&nbsp;Richard R. Neptune ,&nbsp;Glenn K. Klute","doi":"10.1016/j.clinbiomech.2025.106486","DOIUrl":"10.1016/j.clinbiomech.2025.106486","url":null,"abstract":"<div><h3>Background</h3><div>Load carriage can exacerbate the elevated intact limb knee loading in individuals with transtibial amputation, potentially contributing to osteoarthritis. Prosthetic foot mechanical properties like push-off power have the potential to reduce this elevated knee loading. This study investigated how load carriage position and prosthetic foot type affect intact limb knee loading measures for these individuals.</div></div><div><h3>Methods</h3><div>Twelve participants with unilateral transtibial amputation were recruited. Intact limb external knee adduction and flexion moments were analyzed, with prosthetic push-off power and work quantified for effects on first peak knee adduction moment. A linear mixed-effects regression evaluated the effects of load position and prosthetic foot on these metrics.</div></div><div><h3>Findings</h3><div>Participants exhibited the smallest first peak knee adduction moment and impulse with the intact-side load condition, followed by the back load and front load conditions, with the prosthetic-side load condition having the highest magnitude (20–35 % increase). However, we found no significant differences in these metrics by prosthetic foot. Additionally, load position and prosthetic foot did not significantly affect peak knee flexion moment. Only a negative trend toward correlation (<em>P</em> = 0.089) was observed between first peak knee adduction moment and prosthetic push-off work in the back load condition.</div></div><div><h3>Interpretation</h3><div>Intact-side load carriage may be more clinically beneficial for mitigating the risk of increased intact limb knee loading. Further, load carriage strategy affects intact limb knee loading more than specific prosthetic foot type. These biomechanical findings can help guide rehabilitative load carriage strategies to minimize the elevated risk of knee osteoarthritis in individuals with transtibial amputation.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106486"},"PeriodicalIF":1.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578774","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":"Altered cumulative joint moments and increased joint moment symmetry during sit-to-stand transitions for transfemoral bone-anchored limb users: A case series","authors":"Peter B. Thomsen-Freitas ,&nbsp;Jason W. Stoneback ,&nbsp;James B. Tracy ,&nbsp;Mohamed E. Awad ,&nbsp;Danielle H. Melton ,&nbsp;Brecca M.M. Gaffney ,&nbsp;Cory L. Christiansen","doi":"10.1016/j.clinbiomech.2025.106476","DOIUrl":"10.1016/j.clinbiomech.2025.106476","url":null,"abstract":"<div><h3>Background</h3><div>Sit-to-stand transitions are demanding activities for people with unilateral transfemoral amputation. Movement asymmetries during sit-to-stand place greater stresses on the intact limb joints compared to the amputated limb joints, potentially contributing to musculoskeletal overuse injury and pain. Bone-anchored limbs address socket-related prosthesis issues, but their impact on cumulative joint moments during sit-to-stand is yet to be fully understood. The purpose of this study was to investigate changes in cumulative joint moments and moment symmetry during sit-to-stand transitions among transfemoral bone-anchored limb users.</div></div><div><h3>Methods</h3><div>A case-series of eight participants who underwent secondary bone-anchored limb implantation surgery were included. Ten consecutive days of physical activity monitoring (daily sit-to-stand) and motion capture during a 5-times sit-to-stand task were collected preoperatively (using socket prosthesis) and 12-months postoperatively. Cumulative low back, hip, and knee joint moments ([absolute joint moment impulse] x [average daily sit-to-stand]) were calculated. Between-limb symmetry was assessed using the Normalized Symmetry Index. Longitudinal changes in cumulative joint moments and moment symmetry were estimated with Hedge's <em>g</em> effect sizes.</div></div><div><h3>Findings</h3><div>Medium-to-large effects (<em>g</em> &gt; 0.5) were observed for increased frontal-plane amputated-limb hip moment and increased sagittal-plane cumulative low back and intact-limb knee moments. Small-to-medium effects (<em>g</em> &lt; 0.5) were observed for improved between-limb frontal-plane hip moment symmetry.</div></div><div><h3>Interpretation</h3><div>Despite improved between-limb symmetry, persistent overloading of the intact limb was present one-year after bone-anchored limb implantation. Changes in loading without meaningful changes in average number of daily sit-to-stands suggest potential needs for advanced prosthetic component prescription and more effective movement pattern training for bone-anchored limb users.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106476"},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143552055","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":"Biomechanical adaptation to compensate balance recovery in people with knee osteoarthritis","authors":"Calum Downie ,&nbsp;Pazit Levinger ,&nbsp;Rezaul Begg","doi":"10.1016/j.clinbiomech.2025.106475","DOIUrl":"10.1016/j.clinbiomech.2025.106475","url":null,"abstract":"<div><h3>Background</h3><div>Older adults with knee osteoarthritis are twice as likely to fall compared to healthy counterparts. Furthermore, in healthy older adults, greater trunk flexion is associated with increased falling. While spatio-temporal and strength measures have been connected to balance dysfunction in osteoarthritis, to date no studies have investigated compensation of both upper and lower body kinematics on balance recovery in this population.</div></div><div><h3>Methods</h3><div>Forty-eight older people with knee osteoarthritis (age 71.02 ± 6.76 years, 54 % females, BMI 29.10 ± 4.58) and 15 asymptomatic controls (age 72.47 ± 4.81, 27 % females, BMI 26.17 ± 3.06) completed balance recovery during a simulated forwards fall. Ankle, knee, hip, trunk and head kinematics were collected and analysed using three trial types (no additional, cognitive dual-task and physical dual-task). Two-way MANCOVA were conducted to identify group differences in ankle, knee, hip, and trunk angle, and head position (control and knee osteoarthritis), trial differences (no additional, cognitive and physical dual-task) and group by trial differences.</div></div><div><h3>Findings</h3><div>Postural differences in older adults with knee osteoarthritis included greater knee flexion (<em>p</em> = .02) and lower hip and trunk flexion (<em>p</em> &lt; .01).</div></div><div><h3>Interpretation</h3><div>Following a simulated fall, older adults with knee osteoarthritis showed greater knee flexion at first contact which might suggest inability to resist forwards motion of the body.The more extended hip in this group and the resulting compensation of the upper body posture may lead to no difference in number of steps taken when compared to controls.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106475"},"PeriodicalIF":1.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}