Is knee biomechanics different in uphill walking on different slopes for older adults with total knee replacement? |
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| Institution: | 1. Department of Trauma and Orthopaedics Norfolk and Norwich University NHS Foundation Trust, Colney Lane, Norwich NR4 7UY, United Kingdom of Great Britain and Northern Ireland;2. Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom of Great Britain and Northern Ireland;3. School of Biological Sciences, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom of Great Britain and Northern Ireland;4. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford OX3 7LD, United Kingdom of Great Britain and Northern Ireland;1. California State University, Long Beach, 1250 Bellflower Blvd., Long Beach, CA 90840, USA;2. The University of Tennessee, Knoxville, 1914 Andy Holt Ave., Knoxville, TN 37996, USA;3. Tennessee Orthopaedic Clinics, 9430 Park West Blvd., Knoxville, TN 37923, USA;1. School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada;2. Department of Surgery, Division of Orthopaedics, Dalhousie University, Halifax, NS, Canada;3. School of Physiotherapy, Dalhousie University, Halifax, NS, Canada |
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| Abstract: | The purpose of this study was to investigate knee biomechanics in uphill walking on slopes of 5°, 10° and 15° for total knee replacement (TKR) patients. Twenty-five post-TKR patients and ten healthy controls performed five walking trials on level ground and different slopes on an instrumented ramp system. A 2 × 2 × 4 (limb × group × incline slope) mixed model ANOVA was used to examine selected variables. The peak knee extension moment (KEM) was greater in 15° uphill walking compared to level, 5° and 10° uphill walking. TKR patients had lower peak KEM and smaller knee extension range of motion than healthy controls in all walking conditions. The Replaced Limb showed lower peak KEM in 10° and 15° uphill walking than the Non-replaced Limb and smaller knee extension range of motion (ROM) in 10° uphill walking. Knee extension and abduction ROM increased with increased incline angles. The greater peak loading-response vertical ground reaction force was found in level walking compared to three levels of uphill walking. The peak loading-response knee abduction moment was greater in level walking compared to 10° and 15° uphill walking. However, the medial knee contact force was greater in non-replaced limb compared to replaced limb in 10° and 15° uphill walking. The results suggest 5° uphill walking may have the potential to become a safe exercise for unilateral TKR patients. |
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| Keywords: | Total knee arthroplasty Inclined surface Knee extension moment Knee abduction moment Gait |
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