Objective parameters to measure (in)stability of the knee joint during gait

Objective parameters to measure (in)stability of the knee joint during gait: A review of literature

Schrijvers, Jim (Vrije Universiteit Amsterdam)
van den Noort, Josien C. (Vrije Universiteit Amsterdam; Universiteit van Amsterdam)
van der Esch, Martin (Amsterdam Rehabilitation Research Center Reade; Hogeschool van Amsterdam)
Dekker, Joost (Vrije Universiteit Amsterdam)
Harlaar, J. (TU Delft Biomechatronics & Human-Machine Control; Vrije Universiteit Amsterdam)

2019

Background: Instability of the knee joint during gait is frequently reported by patients with knee osteoarthritis or an anterior cruciate ligament rupture. The assessment of instability in clinical practice and clinical research studies mainly relies on self-reporting. Alternatively, parameters measured with gait analysis have been explored as suitable objective indicators of dynamic knee (in)stability. Research question: This literature review aimed to establish an inventory of objective parameters of knee stability during gait. Methods: Five electronic databases (Pubmed, Embase, Cochrane, Cinahl and SPORTDiscuss) were systematically searched, with keywords concerning knee, stability and gait. Eligible studies used an objective parameter(s) to assess knee (in)stability during gait, being stated in the introduction or methods section. Out of 10717 studies, 89 studies were considered eligible. Results: Fourteen different patient populations were investigated with kinematic, kinetic and/or electromyography measurements during (challenged) gait. Thirty-three possible objective parameters were identified for knee stability, of which the majority was based on kinematic (14 parameters) or electromyography (12 parameters) measurements. Thirty-nine studies used challenged gait (i.e. external perturbations, downhill walking) to provoke knee joint instability. Limited or conflicting results were reported on the validity of the 33 parameters. Significance: In conclusion, a large number of different candidates for an objective knee stability gait parameter were found in literature, all without compelling evidence. A clear conceptual definition for dynamic knee joint stability is lacking, for which we suggest : “The capacity to respond to a challenge during gait within the natural boundaries of the knee”. Furthermore biomechanical gait laboratory protocols should be harmonized, to enable future developments on clinically relevant measure(s) of knee stability during gait.

Biomechanics
Gait
Knee
Measurement
Stability

http://resolver.tudelft.nl/uuid:7055c9cb-3f89-4477-a9c5-9ec2b24834d4

https://doi.org/10.1016/j.gaitpost.2019.03.016

2019-09-20

0966-6362

Gait & Posture, 70, 235-253

Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.

Institutional Repository

review

© 2019 Jim Schrijvers, Josien C. van den Noort, Martin van der Esch, Joost Dekker, J. Harlaar