The implications of movement adaptations in knee patients for joint control and loading

Jones, Katherine 2024. The implications of movement adaptations in knee patients for joint control and loading. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Individuals who have anterior cruciate ligament reconstruction (ACLr) surgery are frequently unable to return to pre-injury functionality and are more predisposed to developing knee osteoarthritis (OA) than uninjured individuals. The internal mechanism driving structural and functional decline is not fully understood. Musculoskeletal models are an excellent approach to complement previous research. Firstly, dynamic knee stability was defined as the combination of knee and leg stiffness, co-contraction and joint contact loading. One observational study examined movement strategies in uninjured and individuals with ACLr combining movement analysis and musculoskeletal modelling (SIMM/OpenSim) using the University of Wisconsin-Madison lower leg model. Two smaller validation studies explored treadmill step width changes and compared experimental (EMG) with modelled muscle activation results. Four steady-state walking speeds were compared between ACLr and healthy individuals. For the interaction between speed and group, there were lower internal flexion moments (165%, p= 0.003) at peak knee flexion, and higher Co-Contraction Index (CCI) Four values (9%, p= 0.039) for slow and normal walking in individuals with ACLr. CCI Four is influenced by the soleus muscle suggesting an ACL agonist role aiding tibial stability. Secondly, step width was 129% wider on a treadmill than over ground (p= 0.002), with 64% higher external knee adduction moments (p= 0.010) and higher peak (21%, p= 0.028) and total mean (25%, p= 0.028) medial knee loading. Finally, the modelled and collected muscle data were in good agreement for both groups. Comparing dynamic knee stability during gait in uninjured and injured populations provided important quantitative insight into internal knee biomechanics. Knee injury and subsequent reconstruction led to altered joint movement control and loading patterns. It is recommended for healthcare settings to focus on maintaining a large knee flexion range of motion in individuals with ACLr to support a shock-absorbing gait style

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	12 March 2024
Last Modified:	21 Mar 2024 13:51
URI:	https://orca.cardiff.ac.uk/id/eprint/167110

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