Effect of obesity on knee joint biomechanics during gait in young adults

This article is MacLean, K. F. E., Callaghan, J. P., & Maly, M. R. (2016). Effect of obesity on knee joint biomechanics during gait in young adults. Cogent Medicine, 3(1). https://doi.org/10.1080/2331205X.2016.1173778While there are many comorbidities associated with obesity, one of the more poorly understood is knee osteoarthritis through obesity. The purpose of this study was to compare the kinematics and kinetics of gait and cumulative knee adductor load, which represents the sum of repetitive exposures to medial knee loading during daily activity, between young obese adults with young, healthy-weight adults. Eight obese and eight healthy-weight young adults participated. Data from a three-dimensional motion capture system and a synchronized floor-mounted force plate were collected during gait trials. Participants wore accelerometers to determine step counts for seven consecutive days. Dependent t-tests were used to identify differences in gait kinematics, kinetics and cumulative knee adductor load between groups. Compared to the healthy-weight participants, obese young adults demonstrated a slower walking speed, greater stance duration, less knee flexion at heel contact, greater knee adduction in early stance and less knee abduction at terminal stance (p < 0.05). The obese young adults had a greater external knee extension moment (p < 0.05) and external rotation moment (p < 0.05) in early stance. The obese group had a greater cumulative knee adductor load. These results provide insight into a potential pathway by which obesity predisposes a healthy young adult for knee osteoarthritis.This research is supported by Canada Research Chairs, Canadian Institutes of Health Research, and Natural Sciences and Engineering Research Council of Canad

Association of Machine Learning–Based Predictions of Medial Knee Contact Force With Cartilage Loss Over 2.5 Years in Knee Osteoarthritis

Objective: The relationship between in vivo knee load predictions and longitudinal cartilage changes has not been investigated. We undertook this study to develop an equation to predict the medial tibiofemoral contact force (MCF) peak during walking in persons with instrumented knee implants, and to apply this equation to determine the relationship between the predicted MCF peak and cartilage loss in patients with knee osteoarthritis (OA). Methods: In adults with knee OA (39 women, 8 men; mean ± SD age 61.1 ± 6.8 years), baseline biomechanical gait analyses were performed, and annualized change in medial tibial cartilage volume (mm3 /year) over 2.5 years was determined using magnetic resonance imaging. In a separate sample of patients with force-measuring tibial prostheses (3 women, 6 men; mean ± SD age 70.3 ± 5.2 years), gait data plus in vivo knee loads were used to develop an equation to predict the MCF peak using machine learning. This equation was then applied to the knee OA group, and the relationship between the predicted MCF peak and annualized cartilage volume change was determined. Results: The MCF peak was best predicted using gait speed, the knee adduction moment peak, and the vertical knee reaction force peak (root mean square error 132.88N; R2 = 0.81, P < 0.001). In participants with knee OA, the predicted MCF peak was related to cartilage volume change (R2 = 0.35, β = -0.119, P < 0.001). Conclusion: Machine learning was used to develop a novel equation for predicting the MCF peak from external biomechanical parameters. The predicted MCF peak was positively related to medial tibial cartilage volume loss in patients with knee OA

Knee power is an important parameter in understanding medial knee joint load in knee osteoarthritis.

Calder, K. M., Acker, S. M., Arora, N., Beattie, K. A., Callaghan, J. P., Adachi, J. D., & Maly, M. R. (2014). Knee Power Is an Important Parameter in Understanding Medial Knee Joint Load in Knee Osteoarthritis: Knee Power and OA. Arthritis Care & Research, 66(5), 687–694. https://doi.org/10.1002/acr.22223Objective To determine the extent to which knee extensor strength and power explain variance in knee adduction moment (KAM) peak and impulse in clinical knee osteoarthritis (OA). Methods Fifty-three adults (mean ± SD age 61.6 ± 6.3 years, 11 men) with clinical knee OA participated. The KAM waveform was calculated from motion and force data and ensemble averaged from 5 walking trials. The KAM peak was normalized to body mass (Nm/kg). The mean KAM impulse reflected the mean total medial knee load during stride (Nm × seconds). For strength, the maximum knee extensor moment attained from maximal voluntary isometric contractions (MVIC) was normalized to body mass (Nm/kg). For power, the maximum knee extensor power during isotonic contractions, with the resistance set at 25% of MVIC, was normalized to body mass (W/kg). Covariates included age, sex, knee pain on the Knee Injury and Osteoarthritis Outcome Score, gait speed, and body mass index (BMI). Relationships of the KAM peak and impulse with strength and power were examined using sequential stepwise forward linear regressions. Results Covariates did not explain variance in the KAM peak. While extensor strength did not, peak knee extensor power explained 8% of the variance in the KAM peak (P = 0.02). Sex and BMI explained 24% of the variance in the KAM impulse (P < 0.05). Sex, BMI, and knee extensor power explained 31% of the variance in the KAM impulse (P = 0.02), with power contributing 7% (P < 0.05). Conclusion Knee extensor power was more important than isometric knee strength in understanding medial knee loads during gait.Canadian Institutes of Health Research. Grant Number: 102643Canadian Institutes of Health Research Joint Motion Program Postdoctoral FellowshipNetwork Scholar Award through The Arthritis Society/Canadian Arthritis NetworkTier I Canada Research Chair in Spine Biomechanics and Injury PreventionAlliance for Better Bone Health Chair in RheumatologyNew Investigator Award from the Canadian Institutes of Health Researc

Solid-State Dynamic Nuclear Polarization at 263 GHz: Spectrometer Design and Experimental Results

Dynamic Nuclear Polarization (DNP) experiments transfer polarization from electron spins to nuclear spins with microwave irradiation of the electron spins for enhanced sensitivity in nuclear magnetic resonance (NMR) spectroscopy. Design and testing of a spectrometer for magic angle spinning (MAS) DNP experiments at 263 GHz microwave frequency, 400 MHz 1H frequency is described. Microwaves are generated by a novel continuous-wave gyrotron, transmitted to the NMR probe via a transmission line, and irradiated on a 3.2 mm rotor for MAS DNP experiments. DNP signal enhancements of up to 80 have been measured at 95 K on urea and proline in water–glycerol with the biradical polarizing agent TOTAPOL. We characterize the experimental parameters affecting the DNP efficiency: the magnetic field dependence, temperature dependence and polarization build-up times, microwave power dependence, sample heating effects, and spinning frequency dependence of the DNP signal enhancement. Stable system operation, including DNP performance, is also demonstrated over a 36 h period.National Institutes of Health (U.S.) (NIH grant EB-002804)National Institutes of Health (U.S.) (NIH grant EB-002026

Effect of obesity on knee joint biomechanics during gait in young adults

Abstract: While there are many comorbidities associated with obesity, one of the more poorly understood is knee osteoarthritis through obesity. The purpose of this study was to compare the kinematics and kinetics of gait and cumulative knee adductor load, which represents the sum of repetitive exposures to medial knee loading during daily activity, between young obese adults with young, healthy-weight adults. Eight obese and eight healthy-weight young adults participated. Data from a three-dimensional motion capture system and a synchronized floor-mounted force plate were collected during gait trials. Participants wore accelerometers to determine step counts for seven consecutive days. Dependent t-tests were used to identify differences in gait kinematics, kinetics and cumulative knee adductor load between groups. Compared to the healthy-weight participants, obese young adults demonstrated a slower walking speed, greater stance duration, less knee flexion at heel contact, greater knee adduction in early stance and less knee abduction at terminal stance (p &lt; 0.05). The obese young adults had a greater external knee extension moment (p &lt; 0.05) and external rotation moment (p &lt; 0.05) in early stance. The obese group had a greater cumulative knee adductor load. These results provide insight into a potential pathway by which obesity predisposes a healthy young adult for knee osteoarthritis

Point of care ultrasonography in patients with haemophilia and acute haemarthrosis: a physiotherapist and sonographer inter-professional agreement pilot study

Haemophilia treatment centres (HTCs) around the world are increasingly adopting point-of-care ultrasonography (POCUS) for the assessment of acute haemarthrosis and to monitor joint health. POCUS is in large part administered by physiotherapists in most comprehensive care teams. Appropriate implementation of haemophilia-specific POCUS requires an educational foundation and training to ensure competency and optimal outcomes. Inter-professional agreement and evaluation of image quality are important measures of competency and acceptable use of POCUS

Predictors of treatment adherence in patients with chronic disease using the Multidimensional Adherence Model: unique considerations for patients with haemophilia

Adherence to treatment recommendations in patients with chronic disease is complex and is influenced by numerous factors. Haemophilia is a chronic disease with reported levels of adherence ranging from 17–82%