TY - JOUR
T1 - Changes in knee moments with contralateral versus ipsilateral cane usage in females with knee osteoarthritis
AU - Chan, Grace N.Y.
AU - Smith, Andrew W.
AU - Kirtley, Chris
AU - Tsang, William W.N.
N1 - Funding Information:
The authors express their gratitude to Professor David A. Winter and Dr Chien Ping for their comments on the study. Our sincere gratitude is extended to Dr Sing Kai Lo for his assistance with the statistical analysis. We also thank the Hong Kong Polytechnic University for its financial support.
PY - 2005/5
Y1 - 2005/5
N2 - Background. Conservative treatment for osteoarthritis often involves educating the patient in methods of decreasing the load transmitted through the diseased joint. The use of a cane is one such method and the correct placement of the cane with respect to an abnormal knee joint is crucial. The purpose of this study was to compare effects on knee moments of force of contralateral versus ipsilateral cane usage in female subjects with osteoarthritic knees. Methods. A convenience sample of 14 subjects volunteered for this study. Subjects walked over force platforms while ground reaction force and three-dimensional kinematic data were captured using a Vicon 370 System. The subjects were tested walking: (a) unaided, (b) with ipsilateral cane, and (c) with contralateral cane. Inverse dynamics were employed to calculate temporal-spatial, kinematic and kinetic variables. Dependent variables included hip and knee frontal plane and sagittal plane moments of force, walking speed, cadence and stride length. Repeated measures ANOVA assessed differences among walking conditions. Findings. Subjects walked significantly faster in the unaided gait condition owing to a higher cadence. Ipsilateral cane use resulted in significantly larger hip (versus contralateral P = 0.018; versus unaided P = 0.036) and knee (versus contralateral P = 0.043; versus unaided P = 0.030) frontal plane peak moments during gait. Contralateral cane placement was associated with the smallest peak knee abductor (P = <0.001) and flexor (P = <0.001) moments. Knee deformity (varus or valgus) did not have any significant effect on any variable possibly due to small sample size. Interpretation. The results suggest that as is the case for the hip contralateral cane placement is the most efficacious for persons with knee osteoarthritis. In fact, no cane use may be preferable to ipsilateral cane usage as the latter resulted in the highest knee moments of force, a situation which may exacerbate pain and deformity.
AB - Background. Conservative treatment for osteoarthritis often involves educating the patient in methods of decreasing the load transmitted through the diseased joint. The use of a cane is one such method and the correct placement of the cane with respect to an abnormal knee joint is crucial. The purpose of this study was to compare effects on knee moments of force of contralateral versus ipsilateral cane usage in female subjects with osteoarthritic knees. Methods. A convenience sample of 14 subjects volunteered for this study. Subjects walked over force platforms while ground reaction force and three-dimensional kinematic data were captured using a Vicon 370 System. The subjects were tested walking: (a) unaided, (b) with ipsilateral cane, and (c) with contralateral cane. Inverse dynamics were employed to calculate temporal-spatial, kinematic and kinetic variables. Dependent variables included hip and knee frontal plane and sagittal plane moments of force, walking speed, cadence and stride length. Repeated measures ANOVA assessed differences among walking conditions. Findings. Subjects walked significantly faster in the unaided gait condition owing to a higher cadence. Ipsilateral cane use resulted in significantly larger hip (versus contralateral P = 0.018; versus unaided P = 0.036) and knee (versus contralateral P = 0.043; versus unaided P = 0.030) frontal plane peak moments during gait. Contralateral cane placement was associated with the smallest peak knee abductor (P = <0.001) and flexor (P = <0.001) moments. Knee deformity (varus or valgus) did not have any significant effect on any variable possibly due to small sample size. Interpretation. The results suggest that as is the case for the hip contralateral cane placement is the most efficacious for persons with knee osteoarthritis. In fact, no cane use may be preferable to ipsilateral cane usage as the latter resulted in the highest knee moments of force, a situation which may exacerbate pain and deformity.
KW - Canes and joint moment
KW - Osteoarthritis knee
UR - http://www.scopus.com/inward/record.url?scp=14344258055&partnerID=8YFLogxK
U2 - 10.1016/j.clinbiomech.2004.12.005
DO - 10.1016/j.clinbiomech.2004.12.005
M3 - Article
C2 - 15737447
AN - SCOPUS:14344258055
SN - 0268-0033
VL - 20
SP - 396
EP - 404
JO - Clinical Biomechanics
JF - Clinical Biomechanics
IS - 4
ER -