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Amplitude and phasing of trunk motion is critical for the efficacy of gait training aimed at reducing ambulatory loads at the knee

Amplitude and phasing of trunk motion is critical for the efficacy of gait training aimed at reducing ambulatory loads at the knee

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MÜNDERMANN, Annegret, Lars MÜNDERMANN, Thomas P. ANDRIACCHI, 2012. Amplitude and phasing of trunk motion is critical for the efficacy of gait training aimed at reducing ambulatory loads at the knee. In: Journal of Biomechanical Engineering. 134(1), 011010. ISSN 0148-0731. eISSN 1528-8951

@article{Mundermann2012-01Ampli-19203, title={Amplitude and phasing of trunk motion is critical for the efficacy of gait training aimed at reducing ambulatory loads at the knee}, year={2012}, doi={10.1115/1.4005540}, number={1}, volume={134}, issn={0148-0731}, journal={Journal of Biomechanical Engineering}, author={Mündermann, Annegret and Mündermann, Lars and Andriacchi, Thomas P.}, note={Article Number: 011010} }

Andriacchi, Thomas P. Mündermann, Lars Publ. in: Journal of Biomechanical Engineering ; 134 (2012), 1. - 011010 deposit-license 2012-05-04T07:00:54Z Mündermann, Annegret eng Mündermann, Lars Mündermann, Annegret Amplitude and phasing of trunk motion is critical for the efficacy of gait training aimed at reducing ambulatory loads at the knee Andriacchi, Thomas P. 2012-01 2012-05-04T07:00:54Z The purpose of this study was to determine the contribution of changes in amplitude and phasing of medio-lateral trunk sway to a change in the knee adduction moment when walking with increased medio-lateral trunk sway. Kinematic and kinetic data of walking trials with normal and with increased trunk sway were collected for 19 healthy volunteers using a standard motion analysis system. The relationship between the change in first peak knee adduction moment (Delta KAM) and change in trunk sway amplitude (Delta SA; difference between maximum contralateral trunk lean and maximum ipsilateral trunk lean) and phasing (SP; time of heel-strike relative to time of maximum contralateral and time of maximum ipsilateral trunk lean) was determined using nonlinear regression analysis. On average, subjects increased their SA by 9.7+/-3.6 deg (P<0.001) with an average SP of 98.8+/-88.8 ms resulting in an average reduction in the first peak knee adduction moment of -55.2+/-30.3% (P<0.001). 64.3% of variability in change in peak knee adduction moment with the increased trunk sway condition was explained by both differences in SA and SP, and the relationship among these parameters was described by the regression equation Delta KAM -27.220-4.128 . Delta DSA-64.785 . cos(SP). Hence, not only the amplitude but also the phasing of trunk motion is critical. Not only lower limb movement but also lumbar and thoracic lateral flexion should be considered in the decision making process for an optimal intervention aimed at reducing the load on the medial compartment of the knee during walking. However, these promising findings originated from studies on healthy subjects and their relevance for gait training interventions in patients with presumably painful knee osteoarthritis remains to be determined.

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