• Journal of The Korean Society of Integrative Medicine
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• v.5 no.4
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• pp.41-48
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• 2017

Purpose : The purpose of this study was to verify the relationships among the knee adduction moment, hip rotation range, strength of hip rotators, and Foot Posture Index of healthy young adults. Method : Thirty-two healthy adults(24 male, 8 females) participated in this study. Subjects performed 5 walking trials to evaluate the knee adduction moments using a three-dimensional motion analysis system. Hip rotation ranges and hip rotator strengths were measured using a standard goniometer and a handheld dynamometer, respectively. The mean of three trials of clinical tests was used for data analysis. Results : The first peak knee adduction moment was significantly correlated with the hip rotation ranges and hip rotator strengths (P<.05). The second peak knee adduction moment was showed significant correlations with hip external rotation and rotation ratio. There were no correlations between Foot Posture Index and all knee adduction moments (P>.05). Conclusion : This study suggests that imbalances of the range of motion and strength of the internal and external rotation of the hip joint can affect knee adduction moments. The impact may exacerbate musculoskeletal disorders such as osteoarthritis of the knee. Therefore, further studies should be conducted to evaluate the effects of clinical interventions to correct these imbalances on the reduction of the knee adduction moments in patients with knee osteoarthritis.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1025-1030
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• 2016

The purpose of this study was to investigate the effects of combined wedge on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion of foot for genu varus among adult men during gait. This study was carried out with 10 adult men for genu varus in a motion analysis laboratory in J university. The subjects of the experiment were measured above 5cm width between the knees on contact of both medial malleolus of ankle while standing. The width of their knees in neutral position was measured without the inversion or eversion of the subtalar joint by the investigator. The subjects of the experiment were ten who were conducted randomly for standard insole, insole with $10^{\circ}$ lateral on rear foot wedge, insole at $10^{\circ}$lateral on rear foot and $5^{\circ}$ medial on fore foot wedge. Before and after intervention, changes on the range of motion in ankle and knee joint, ankle eversion moment and knee adduction moment, and center of pressure excursion were measured. In order to compare analyses among groups; repeated one-way ANOVA and $Scheff{\acute{e}}$ post hoc test were used. As a result, combined wedge group was significantly decreased compared to control wedge group in terms of knee varus angle in mid-stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of ankle eversion moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge group in terms of knee adduction moment in whole stance(p<.05). Combined wedge group was significantly decreased compared to lateral wedge in terms of center of pressure excursion in whole stance(p<.05). The results of this study suggest that combined wedge for genu varus decreased ankle eversion moment and knee adduction moment upon center of pressure excursion. We hypothesize that combined wedge may also be effective in the protection excessive ankle pronation.

• Journal of the Korean Society for Precision Engineering
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• v.29 no.2
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• pp.239-244
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• 2012

The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.90-101
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• 2003

Gait analysis can provide a better understanding of how the alignment of the lower limb and foot can contribute to force observed at the knee. Anatomic and mechanical factors that affect loading in the knee pint can contribute to pathologic change seen at the knee in degenerative pint disease and should be considered in treatment plan. The purpose of this study is to present the gait analysis data and to determine whether there is any relationships between alignment of the lower limb, foot progression angle and knee pint moments in elderly healthy women with 3-dimensional motion analyzer. The results were as follows; 1. Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04 m, Step length was 0.56 m. 2. According to the parameters of kinematics, the maximal knee flexion angle through swing phase showed left $46.82^{\circ}$, right $40.19^{\circ}$ and the maximal knee extension angle showed left $-1.32^{\circ}$, right $2.01^{\circ}$. knee varus showed left $26.90^{\circ}$, right $30.93^{\circ}$. 3. Moment, one of kinetic parameters of knee pint the maximal flexion moment showed left 0.363. Nm/kg, right 0.464 Nm/kg and maximal extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximal. adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg and the maximal internal rotatory moment showed left 0.13 Nm/kg, right 0.140 Nm/kg. 4. On sagittal plane, the maximal power of knee joint showed left 0.571 J/kg, right 0.629 J/kg. On coronal plane, the maximal power of knee joint showed left 0.11 J/kg, right 0.12 J/kg. On transverse plane, the maximal power of knee joint showed left 0.058 J/kg, right 0.072 J/kg. 5. The subject who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase. 6. The subject who had large foot progression angle had statistically lower in knee adduction moment in late stance phase. A relationship was observed between the alignment of the lower extremity and the adduction moment of the knee joint during stance phase. Hence, we need some research to figure, out the change of adduction moment according to the sort of knee joint osteoarthritis and the normal geriatrics as well. And we also require more effective, specific therapeutic program by making use of those background of researches.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.06a
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• pp.245-246
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• 2008

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.10a
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• pp.24-24
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• 2003

For the elderly, achieving a close-to-normal ambulation is important for activities of daily life. Recent researches of SE(Silver Engineering) restoring physical ability would help the elderly by developing the advanced gait assisting devices and orthoses. For the applications using the advanced technologies, the gait characteristics of the elderly must be understood. However, a few studies were performed to investigate the physiological or pathological gaits. The purpose of this study is to provide the gait analysis data and also to investigate relationships between alignment of the lower limb, foot progression angle and knee joint moments in the healthy elderly. By participating a total of 20 healthy elderly persons in this study, the following facts were found: 1) Cadence showed 114.8 steps/min, gait speed showed 1.05 m/s, time per a stride showed 1.06 sec, time per a step showed 0.53 sec, single-supporting phase was 0.41 sec, double-supporting phase was 0.24 sec, stride length was 1.04m, Step length was 0.56m; 2) The maximum knee flexion angle through swing phase showed left 46.82$^{\circ}$, right 40.19$^{\circ}$ and the maximum knee extension angle showed left -1.32$^{\circ}$, right 2.01$^{\circ}$. Knee varus showed left 26.90$^{\circ}$, right 30.93$^{\circ}$; 3) The maximum knee flexion moment showed left 0.363 Nm/kg, right 0.464 Nm/kg, The maximum knee extension moment showed left 0.389 Nm/kg, right 0.463 Nm/kg. The maximum knee adduction moment showed left 0.332 Nm/kg, right 0.379 Nm/kg. The maximum internal rotational moment showed left 0.13 Nm/kg, right 0.140 Nm/kg; 4) The subjects who had varus alignment of the lower extremity had statistically higher in knee adduction moment in mid stance phase; and 5) The subjects who had large foot progression angle had statistically lower in knee adduction moment in late stance phase.

• Physical Therapy Korea
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• v.15 no.2
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• pp.64-72
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• 2008

The purpose of this study was to determine the differences in joint moment in the intact limb of uni-transfemoral amputees and to identify the implications of knee osteoarthritis. As an experimental method, three-dimensional gait analysis was performed on 10 uni-transfemoral amputees and 10 healthy males. Kinematics and kinetics at the hip, knee, and ankle joint were calculated. As a statistical method, independent t-tests were conducted to perform a comparison between the transfemoral amputee group and the control group. The results showed that the external knee adduction moment increased in the transfemoral amputee group (.22 Nm/kg) compared with that of the control group (.13 Nm/kg) at terminal stance (p=.008). External knee flexion moment also increased in the transfemoral amputee group (.24 Nm/kg) but this difference was not statistically significant. External hip flexion moment increased in the transfemoral amputee group (1.35 Nm/kg) compared with that of the control group (.45 Nm/kg) at initial stance, and external hip extension moment decreased in the transfemoral amputee group (-.26 Nm/kg) compared with that of the control group (-.76 Nm/kg) at terminal stance. Although external ankle plantarflexion moment of the transfemoral amputee group increased, it was not found to be statistically significant. The results suggest that the intact limb joint moment of the uni-transfemoral amputees during walking can be different from that of healthy subjects. In conclusion, it was found that there is a link between the increase of external knee adduction moment and the prevalence of knee osteoarthritis in uni-transfemoral amputees. This result is expected to provide some objective data for rehabilitation programs related to knee osteoarthritis in transfemoral amputees.

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.181-188
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• 2007

The purpose of this study was to investigate the biomechanical effects of wearing different type of insole shoes on gait characteristics in patients with knee osteoarthritis. Seven patients with knee osteoarthritis (Grade 3 & 4 by Kellgren & Lawrence) were participated in the study. They wore two different type of shoes (with Gel-type Insole: GIS, with Normal insole: NIS) during gait. Three dimensional cinematography and Ground Reaction Force(GRF) data were used to get the maximal value of horizontal distance between the center of pressure in GRF and knee joint center, GRF in mediolateral direction, peak value of GRF in frontal plane, vertical compressive force and adduction moment in knee joint. The results were as follows: The maximal value of horizontal distance between the center of pressure in GRF and knee joint center was smaller in GIS than NIS. The peak value of GRF in mediolateral direction was found in 30% of gait cycle, five subjects wearing GIS showed lower value of peak GRF in mediolateral direction than wearing NIS. The peak value of GRF in frontal plane and vertical compressive force in knee joint did not show any difference between GIS and NIS. The adduction moment in GIS decreased in the late stance of gait and the mean value of the adduction moment in GIS smaller than that in NIS. GIS may help to move quickly knee joint center to the center of pressure in GRF, therefore it may prevent increasing the adduction moment in knee joint.

• Korean Journal of Applied Biomechanics
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• v.26 no.4
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• pp.369-375
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• 2016

Objective: The purpose of this study was to investigate the possibility of injuries and the types of movement related to damage by body parts, and to prepare for prevention of injuries and development of a training program. Method: For this study, the experiment was conducted according to levels of 60 percentages (ST) and 85 percentages (MA) and 10 subjects from the Korean elite national weightlifting team were included. Furthermore, we analyzed joint moment and muscle activation pattern with three-dimensional video analysis. Ground reaction force and EMG analyses were performed to measure the factors related to injuries and motion. Results: Knee reinjuries such as anterior cruciate ligament damage caused by deterioration of the control ability for the forward movement function of the tibia based on the movement of the biceps femoris when the rectus femoris is activated with the powerful last-pull movement. In particular, athletes with previous or current injuries should perceive a careful contiguity of the ratio of the biceps femoris to the rectus femoris. This shows that athletes can exert five times greater force than the injury threshold in contrast to the inversion moment of the ankle, which is actively performed for a powerful last pull motion and is positively considered in terms of intentional motion. It is activated by excessive adduction and internal rotation moment to avoid excessive abduction and external rotation of the knee at lockout motion. It is an injury risk to muscles and ligaments, causing large adduction moment and internal rotation moment at the knee. Adduction moment in the elbow joint increased to higher than the injury threshold at ST (60% level) in the lockout phase. Hence, all athletes are indicated to be at a high risk of injury of the elbow adductor muscle. Lockout motion is similar to the "high five" posture, and repetitive training in this motion increases the likelihood of injuries because of occurrence of strong internal rotation and adduction of the shoulder. Training volume of lockout motion has to be considered when developing a training program. Conclusion: The important factors related to injury at snatch include B/R rate, muscles to activate the adduction moment and internal rotation moment at the elbow joint in the lockout phase, and muscles to activate the internal rotation moment at the shoulder joint in the lockout phase.

• Physical Therapy Korea
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• v.25 no.3
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• pp.19-26
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• 2018

Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade III, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level ${\alpha}$ be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.