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Developing a cumulative knee loading...

Robbins, Shawn M. K.

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Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors./
Author:	Robbins, Shawn M. K.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2010,
Description:	174 p.
Notes:	Source: Dissertation Abstracts International, Volume: 72-07, Section: B, page: 3986.
Contained By:	Dissertation Abstracts International72-07B.
Subject:	Kinesiology. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR73526
ISBN:	9780494735268

Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors.
Robbins, Shawn M. K.

Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors. - Ann Arbor : ProQuest Dissertations & Theses, 2010 - 174 p.

Source: Dissertation Abstracts International, Volume: 72-07, Section: B, page: 3986.

Thesis (Ph.D.)--The University of Western Ontario (Canada), 2010.

When studying knee osteoarthritis, previous proxies for knee loading, including the peak external knee adduction moment (KAM), only considered the magnitude of loading. However, the frequency of loading also influences the disease process. A measure of daily cumulative knee loading was developed that incorporated both the magnitude and frequency of loading. The KAM impulse, measured using three dimensional motion analysis, served as a proxy for the magnitude of medial compartment knee loading. The frequency of loading was represented by the number of steps/day captured with an accelerometer. The cumulative knee adductor load (CKAL) was created by multiplying the KAM impulse by the steps/day for one leg. The test-retest reliability of the CKAL was determined in healthy participants (n=30) using intraclass correlation coefficients (ICC) (type 2, 1). CKAL demonstrated acceptable test-rest reliability [ICC(2, 1)=0.84]. Factors that influence the magnitude of loading were also investigated. The influence of gait speed on the KAM was examined as participants (n=32) ambulated at three speeds: fast, slow and self-selected. Statistical analysis included a one-way repeated measures analysis of variance. The faster gait speeds increased the peak KAM and slower gait speeds increased the KAM impulse. In addition, the clinical utility of presenting the peak KAM as non-normalized and normalized to body mass or body weight times height was investigated in a sample with knee osteoarthritis (n=233) using Receiver Operating Characteristic curve analysis. Non-normalized peak KAM values were found to be more sensitive at distinguishing between knee osteoarthritis severity levels than normalized values, although the differences were small. Finally, the relationship of the CKAL to pain and self-report physical function, measured using the Knee Injury and Osteoarthritis Score, was investigated using regression analysis in participants with knee osteoarthritis (n=38). CKAL significantly explained some of the variance in pain (9.7%) but not physical function after controlling for age, sex, and knee extensor torque. Increased CKAL was associated with increased pain severity. In summary, a reliable measure of cumulative knee loading was developed that significantly explained some of the variance in pain. Future work should examine the role of cumulative knee loading on osteoarthritis incidence and progression.

ISBN: 9780494735268Subjects--Topical Terms:

517627
Kinesiology.

Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors.
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245 1 0 $a Developing a cumulative knee loading measure for the study of osteoarthritis and examining influencing factors.
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300 $a 174 p.
500 $a Source: Dissertation Abstracts International, Volume: 72-07, Section: B, page: 3986.
502 $a Thesis (Ph.D.)--The University of Western Ontario (Canada), 2010.
520 $a When studying knee osteoarthritis, previous proxies for knee loading, including the peak external knee adduction moment (KAM), only considered the magnitude of loading. However, the frequency of loading also influences the disease process. A measure of daily cumulative knee loading was developed that incorporated both the magnitude and frequency of loading. The KAM impulse, measured using three dimensional motion analysis, served as a proxy for the magnitude of medial compartment knee loading. The frequency of loading was represented by the number of steps/day captured with an accelerometer. The cumulative knee adductor load (CKAL) was created by multiplying the KAM impulse by the steps/day for one leg. The test-retest reliability of the CKAL was determined in healthy participants (n=30) using intraclass correlation coefficients (ICC) (type 2, 1). CKAL demonstrated acceptable test-rest reliability [ICC(2, 1)=0.84]. Factors that influence the magnitude of loading were also investigated. The influence of gait speed on the KAM was examined as participants (n=32) ambulated at three speeds: fast, slow and self-selected. Statistical analysis included a one-way repeated measures analysis of variance. The faster gait speeds increased the peak KAM and slower gait speeds increased the KAM impulse. In addition, the clinical utility of presenting the peak KAM as non-normalized and normalized to body mass or body weight times height was investigated in a sample with knee osteoarthritis (n=233) using Receiver Operating Characteristic curve analysis. Non-normalized peak KAM values were found to be more sensitive at distinguishing between knee osteoarthritis severity levels than normalized values, although the differences were small. Finally, the relationship of the CKAL to pain and self-report physical function, measured using the Knee Injury and Osteoarthritis Score, was investigated using regression analysis in participants with knee osteoarthritis (n=38). CKAL significantly explained some of the variance in pain (9.7%) but not physical function after controlling for age, sex, and knee extensor torque. Increased CKAL was associated with increased pain severity. In summary, a reliable measure of cumulative knee loading was developed that significantly explained some of the variance in pain. Future work should examine the role of cumulative knee loading on osteoarthritis incidence and progression.
520 $a Keywords: cumulative loading, knee, osteoarthritis, physical activity, knee adduction moment, accelerometer, motion analysis, reliability, speed, normalization, pain, physical function.
590 $a School code: 0784.
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650 4 $a Physical therapy. $3 588713
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710 2 $a The University of Western Ontario (Canada). $3 1017622
773 0 $t Dissertation Abstracts International $g 72-07B.
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856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=NR73526