Test-retest reliability of knee kinematics measurement during gait with 3D motion analysis system (original) (raw)
Related papers
BMC Musculoskeletal Disorders, 2015
Background: The goal of this study was to biomechanically assess tibial rotation in the knee joint simultaneous changes in rotation of large joints of the lower limbs and pelvis during gait in patients during early postoperative stages following anterior cruciate ligament (ACLR) reconstruction. We hypothesized that tibial rotation is associated with changes in rotation of the large joints of the lower limbs and the pelvis during gait in patients after ACLR reconstruction. Methods: The patients were divided into two groups. The ACLR group (n = 32 males) underwent primary ACLR in one leg and postoperative physiotherapy. The control group (n = 30 males) had no knee injuries. After clinical assessment in both groups, the values of kinematic parameters of foot, tibial, femoral, and pelvic rotation were measured during gait on a flat surface using the three-dimensional BTS Smart System. In the ACLR group, measurements were taken during the 4th, 9th, and 14th weeks of postoperative physiotherapy. The results of the ACLR group were compared with those of the control group. Results: During gait, between the 9th and 14th weeks following ACLR, there are normal values of foot, tibia, and pelvic rotation in the operated legs compared with results obtained from un-operated legs and the control group. Discussion: Analysis of rotations occurring only in knee joints does not reflect all of the multiarticular disorders of gait kinematics. The study also suggests that analyzing tibial rotation in the knee joint with simultaneous changes in rotation in large joints of the lower limbs provides better opportunities than singular analysis of rotation in the knee joint for the assessment of disorders in gait kinematics. Conclusions: In gait, at the maximal extension of the knee during preparation for the stance phase, external hip rotation patterns have not been fully restored 14 weeks after ACLR.
Gait knee kinematics after ACL reconstruction: 3D assessment
International Orthopaedics, 2014
Purpose While many studies about anterior-cruciateligament-deficient (ACLD) patients have demonstrated functional adaptations to protect the knee joint, an increasing number of patients undergo ACL reconstruction (ACLR) surgery in order to return to their desired level of activity. The purpose of this study was to compare 3D kinematic patterns between individuals having undergone ACLR with their healthy contralateral knee and a control group. Methods Three-dimensional kinematic data were obtained from 15 patients pre-and post-ACLR, 15 contralateral knees and 15 healthy controls. Data were recorded during treadmill walking at self-selected speed. Flexion/ extension, external/internal tibial rotation, adduction/ abduction and anterior/posterior tibial translation were compared between groups. Results ACLR knees showed a significantly higher kneejoint extension during the entire stance phase compared with ACLD knees. However, ACLR knees still showed a deficit of extension compared with healthy control knees. In the axial plane, there was no significant difference in pre-and postoperative kinematic data. Significant difference was achieved between ACLR knees and healthy control knees, specifically between 28 and 34 % and 44 and 54 % of the gait cycle. There was no significant difference in anterior-posterior translation or coronal plane between groups. Conlusion Following ACL reconstruction, patients have better clinical and kinematic parameters. Despite improvements, knee kinematics during gait in the ACLR group differed from the control group. These kinematic changes could lead to abnormal loading in the knee joint and initiate the process for future chondral degeneration.
Reliability of a method for analyzing three-dimensional knee kinematics during gait
Gait & Posture, 2008
Background: Different attachment systems have been proposed in an effort to reduce skin movement artifacts when recording knee bone movement during gait. One such system, called exoskeleton, has shown promising accuracy but little is known concerning its reliability. The objective of this study was to determine the intra-and inter-observer reliability of this attachment system for recording 3D knee kinematics during gait. Methods: Two separate studies were conducted. The intra-observer study involved one observer who reinstalled the exoskeleton on 15 healthy subjects and recorded gait kinematics four times for each subject. The inter-observer study also involved 15 healthy subjects and for each of these subjects, three observers reinstalled and recorded gait kinetics three times in randomized order. Findings: In the intra-observer setting, ICC values were 0.92, 0.94 and 0.88 for knee flexion/extension, abduction/adduction and internal/ external tibial rotation, respectively. In the inter-observer setting, the corresponding values were 0.94, 0.92 and 0.89. Interpretation: The high ICC values found indicate very high reliability of the exoskeleton for recording 3D knee kinematics despite reinstallation. Moreover, the values between both settings are very similar which indicates that reliability is independent of the observer who performs the installation. Therefore, evaluations may be carried out by several different clinicians without impacting reliability. #
2012
One of the primary goals of physiotherapy after anterior cruciate ligament (ACL) reconstruction is to restore of the patient's normal gait patterns. However, to date, only a limited number of studies have examined gait during physiotherapeutic procedures following ACL reconstruction. Thus, the objective of the present study was to evaluate gait kinematics and symmetry in male patients after ACL reconstruction during the first two stages of their physiotherapy programme. Ninety-seven males, including 53 patients after primary ACL reconstruction in one limb and 44 healthy controls, participated in the study. The patients were examined using a movement analysis system during their physiotherapeutic programme (from the 2nd to the 12th week following reconstruction). Some selected parameters of gait kinematics, a dynamic range of movement in the knee joint and gait asymmetry coefficients were evaluated. During the 12th week of physiotherapy, a mean gait velocity increased by more tha...
Gait changes of the ACL-deficient knee 3D kinematic assessment
Knee Surgery, Sports Traumatology, Arthroscopy, 2014
The patients with ACLD rotated the tibia more internally (−1.4° ± 0.2°) during the mid-stance phase, than control group (0.2° ± 0.3°). There was no significant difference in anteroposterior translation and adduction-abduction angles. Conclusion Significant alterations of joint kinematics in the ACLD knee were revealed in this study by manifesting a higher flexion gait strategy and excessive internal tibial rotation during walking that could result in a more rapid cartilage thinning throughout the knee. The preoperative data obtained in this study will be useful to understand the post-ACL reconstruction kinematic behaviour of the knee. Clinical relevance The findings in this study indicate that ACLD knee may adapt functionally to prevent excessive anterior-posterior translation but they fail to avoid rotational instability.
Orthopaedic Journal of Sports Medicine, 2017
Objectives: Gait analysis is a proven method for assessing knee biomechanical adaptations in anterior cruciate ligament deficient (ACLD) patients and to quantify the impact of the reconstructive surgery (ACLR). In an adult population, ACLR has shown partial kinematic correction, as they remain in internal tibial rotation, putting them at risk of rotational instability and develop osteoartitis. ACLD adolescents likely adopt similar gait changes to reduce knee instability, but may show quicker or more return to the normal compared to adults. The purpose of this study is to compare the tridimensional (3D) knee kinematics before and after ACLR in adolescents. Methods: 25 ACLD patients aged between 13 and 19 years old on a waiting list for ACLR were recruited. Bilateral knee 3D kinematic data was gathered during treadmill walking at comfortable self-selected speed using the KneeKG TM System before and 6-9 months after ACLR. Each participant underwent the same surgical protocol (2strand hamstring tendon graft, hamstring harvest proximally and kept distally, transphyseal tibial tunnel and transepiphyseal femoral tunnel) by the same experienced surgeon. Three analyses were done: ACLD knee pre vs. post-surgery, contralateral healthy knee pre vs. post-surgery, and ACLR knee vs. healthy contralateral knee. Results: In the sagittal and transverse planes, kinematic patterns remained similar to the pre-op; maintaining the characteristic knee flexion gait pattern during single support phase which is well documented in adult ACLD (hamstring facilitation strategy). The ACLR knee exhibited a more valgus dynamic alignment compared to presurgery throughout the gait cycle. The healthy contralateral knee kinematics displayed no significant changes in the frontal and sagittal planes after surgery compared to the pre-op pattern. In the transverse plane, post-op gait analysis showed significantly more external rotation at heel-strike and through weight acceptance. While looking at the gait symmetry post-surgery, ACLR knee revealed significantly more valgus while remaining in greater flexion during single limb support. In the transverse plane, an external rotation tendency is observed in the ACLR knee throughout the gait cycle, except during weight acceptance. Conclusion: This study shows that kinematic adaptations found in ACLD adolescents are likely to endure short term after surgery. For example, the greater knee flexion gait pattern used before surgery is still used after ACLR. Interestingly, adolescents used an external tibial rotation adaptation to limit internal tibial instability before the surgery and this pattern was still present post-surgery. Even if theses protection strategies are efficient, the increased dynamical valgus movement seen could place the graft under pressure while increasing patellofemoral stresses, a common complaint after ACLR. Lastly, post-surgery, the contralateral knee seems to mimic the external tibial rotation gait pattern strategy seen in ACL-knee. This study demonstrates that gait protective strategies are still present short term after the surgery. Biomechanical assessment helps ID these adaptations to optimize post-op rehabilitation and prevent secondary injuries.
Knee Surgery, Sports Traumatology, Arthroscopy, 2006
The aim of this study was to develop an ambulatory system for the three-dimensional (3D) knee kinematics evaluation, which can be used outside a laboratory during long-term monitoring. In order to show the efficacy of this ambulatory system, knee function was analysed using this system, after an anterior cruciate ligament (ACL) lesion, and after reconstructive surgery. The proposed system was composed of two 3D gyroscopes, fixed on the shank and on the thigh, and a por-Keywords Gait analysis AE Anterior cruciate ligament reconstruction AE 3D kinematics AE Outcome AE Gyroscopes