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Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults.

ABSTRACT: The knee adduction moment (KAM) relates to medial knee osteoarthritis (OA). Several gait modifications to reduce the KAM for the prevention of knee OA have been studied. Most of the modifications, however, involve voluntary changes in leg alignment. Here we investigated the biomechanical effects for reducing the KAM of a walking style with a small trunk rotation and arm swing gait, which is a natural walking style used while wearing a kimono (Nanba walk) that shifts the ground reaction force toward the stance leg (reduced lever arm). Twenty-nine healthy adults (21.5 ± 0.6 years) participated in the present study. A three-dimensional analysis system with 10 cameras and 1 force plate was used to obtain the KAM and other biomechanical data. Surface electromyography (EMG) of the hip and trunk muscles (internal obliquus abdominal muscle: IO, external obliquus abdominal muscle: EO, multifidus muscle: MF, and gluteus medius muscle: Gmed) was also assessed, and integrated EMG (iEMG) of the four muscles was assessed in the first and second halves of the stance phase. The 1st and 2nd peak KAMs were significantly decreased during Nanba walking (0.40±0.09 and 0.37±0.13 Nm/kg) compared with normal walking (0.45±0.09 and 0.45±0.13 Nm/kg; P = 0.002, P<0.001, respectively). The lever arm lengths at the 1st and 2nd peak KAMs were also significantly decreased during Nanba walking compared with normal walking (p = 0.023 and p<0.001, respectively). The iEMGs of IO, EO and Gmed muscles during the first half, and the iEMGs of EO and GM during the second half of the stance phase were significantly increased during Nanba walking compared with normal walking. The Nanba gait modification could be a useful strategy for reducing the KAM with high activation of the trunk and hip joint muscles for the prevention and/or treatment of medial knee OA.

SUBMITTER: Ota S

PROVIDER: S-EPMC5480874 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults.

Ota Susumu S Ogawa Yukari Y Ota Hiroki H Fujiwara Tomoya T Sugiyama Tadashi T Ochi Akira A

PloS one 20170622 6

The knee adduction moment (KAM) relates to medial knee osteoarthritis (OA). Several gait modifications to reduce the KAM for the prevention of knee OA have been studied. Most of the modifications, however, involve voluntary changes in leg alignment. Here we investigated the biomechanical effects for reducing the KAM of a walking style with a small trunk rotation and arm swing gait, which is a natural walking style used while wearing a kimono (Nanba walk) that shifts the ground reaction force tow ...[more]

PMID: 28640896

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Project description:People with knee osteoarthritis may benefit from exercise prescriptions that minimize knee loads in the frontal plane. The primary objective of this study was to determine whether a novel 12-week strengthening program designed to minimize exposure to the knee adduction moment (KAM) could improve symptoms and knee strength in women with symptomatic knee osteoarthritis. A secondary objective was to determine whether the program could improve mobility and fitness, and decrease peak KAM during gait. The tertiary objective was to evaluate the biomechanical characteristics of this yoga program. In particular, we compared the peak KAM during gait with that during yoga postures at baseline. We also compared lower limb normalized mean electromyography (EMG) amplitudes during yoga postures between baseline and follow-up. Primary measures included self-reported pain and physical function (Knee injury and Osteoarthritis Outcome Score) and knee strength (extensor and flexor torques). Secondary measures included mobility (six-minute walk, 30-second chair stand, stair climbing), fitness (submaximal cycle ergometer test), and clinical gait analysis using motion capture synchronized with electromyography and force measurement. Also, KAM and normalized mean EMG amplitudes were collected during yoga postures. Forty-five women over age 50 with symptomatic knee osteoarthritis, consistent with the American College of Rheumatology criteria, enrolled in our 12-week (3 sessions per week) program. Data from 38 were analyzed (six drop-outs; one lost to co-intervention). Participants experienced reduced pain (mean improvement 10.1–20.1 normalized to 100; p<0.001), increased knee extensor strength (mean improvement 0.01 Nm/kg; p = 0.004), and increased flexor strength (mean improvement 0.01 Nm/kg; p = 0.001) at follow-up compared to baseline. Participants improved mobility on the six-minute walk (mean improvement 37.7 m; p<0.001) and 30-second chair stand (mean improvement 1.3; p = 0.006) at follow-up compared to baseline. Fitness and peak KAM during gait were unchanged between baseline and follow-up. Average KAM during the yoga postures were lower than that of normal gait. Normalized mean EMG amplitudes during yoga postures were up to 31.0% of maximum but did not change between baseline and follow-up. In this cohort study, the yoga-based strengthening postures that elicit low KAMs improved knee symptoms and strength in women with knee OA following a 12 week program (3 sessions per week). The program also improved mobility, but did not improve fitness or reduce peak KAM during gait. The KAM during the yoga postures were lower than that of normal gait. Overall, the proposed program may be useful in improving pain, strength, and mobility in women with knee osteoarthritis. Clinical efficacy needs to be assessed using a randomized controlled trial design.ClinicalTrials.gov NCT02146105.

Dataset Information

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults.

Publications

Beneficial effects of a gait used while wearing a kimono to decrease the knee adduction moment in healthy adults.

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