TY - JOUR
T1 - Objective parameters to measure (in)stability of the knee joint during gait
T2 - A review of literature
AU - Schrijvers, Jim C
AU - van den Noort, Josien C
AU - van der Esch, Martin
AU - Dekker, Joost
AU - Harlaar, Jaap
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - Biomechanical Phenomena
KW - Electromyography
KW - Gait/physiology
KW - Humans
KW - Joint Instability/diagnosis
KW - Kinetics
KW - Knee Joint/physiopathology
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063225483&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30909003
U2 - https://doi.org/10.1016/j.gaitpost.2019.03.016
DO - https://doi.org/10.1016/j.gaitpost.2019.03.016
M3 - Article
C2 - 30909003
SN - 0966-6362
VL - 70
SP - 235
EP - 253
JO - Gait and Posture
JF - Gait and Posture
ER -