Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia: Vancouver, BC, Canada.
Motion Analysis and Biofeedback Laboratory, University of British Columbia: Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia: Vancouver, BC, Canada.
Osteoarthritis Cartilage. 2021 May;29(5):678-686. doi: 10.1016/j.joca.2021.02.003. Epub 2021 Feb 12.
To examine the nature of differences in the relationship between frontal plane rearfoot kinematics and knee adduction moment (KAM) magnitudes.
Cross-sectional study resulting from a combination of overground walking biomechanics data obtained from participants with medial tibiofemoral osteoarthritis at two separate sites. Statistical models were created to examine the relationship between minimum frontal plane rearfoot angle (negative values = eversion) and different measures of the KAM, including examination of confounding, mediation, and effect modification from knee pain, radiographic disease severity, static rearfoot alignment, and frontal plane knee angle.
Bivariable relationships between minimum frontal plane rearfoot angle and the KAM showed consistent negative correlations (r = -0.411 to -0.447), indicating higher KAM magnitudes associated with the rearfoot in a more everted position during stance. However, the nature of this relationship appears to be mainly influenced by frontal plane knee kinematics. Specifically, frontal plane knee angle during gait was found to completely mediate the relationship between minimum frontal plane rearfoot angle and the KAM, and was also an effect modifier in this relationship. No other variable significantly altered the relationship.
While there does appear to be a moderate relationship between frontal plane rearfoot angle and the KAM, any differences in the magnitude of this relationship can likely be explained through an examination of frontal plane knee angle during walking. This finding suggests that interventions derived distal to the knee should account for the effect of frontal plane knee angle to have the desired effect on the KAM.
研究足的额状面后足运动学与膝内收力矩（KAM）大小之间关系的差异性质。
这是一项来自两个不同地点患有内侧胫骨股骨骨关节炎患者的地面行走生物力学数据的横断面研究的组合。创建了统计模型来检查最小额状面后足角度（负值=外翻）与 KAM 的不同测量值之间的关系，包括检查膝痛、放射影像学疾病严重程度、静态后足对线和额状面膝角的混杂、中介和效应修饰作用。
最小额状面后足角度与 KAM 之间的双变量关系显示出一致的负相关（r=-0.411 至-0.447），表明在站立期后足处于更外翻位置时 KAM 幅度更高。然而，这种关系的性质似乎主要受到额状面膝关节运动学的影响。具体来说，发现步态时的额状面膝关节角度完全中介了最小额状面后足角度与 KAM 之间的关系，并且也是该关系的效应修饰因子。没有其他变量显著改变这种关系。
尽管额状面后足角度与 KAM 之间似乎存在中度关系，但这种关系的幅度的任何差异都可以通过检查行走时的额状面膝关节角度来解释。这一发现表明，源自膝关节以下的干预措施应该考虑额状面膝关节角度的影响，以便对 KAM 产生预期的效果。
