Philp, FD, Leboeuf, F, Pandyan, A ORCID: https://orcid.org/0000-0002-2180-197X and Stewart, C (2019) “Dynamic knee valgus” – are we measuring what we think we’re measuring? An evaluation of static and functional knee calibration methods for application in gait and clinical screening tests of the overhead squat and hurdle step. Gait and Posture. (In Press)

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Abstract

Background
Dynamic “knee valgus” has been identified as a risk factor for significant knee injuries, however, the limits and sources of error associated with existing 3D motion analysis methods have not been well established.

Research question
What effect does the use of differing static and functional knee axis orientation methods have on the observed knee angle outputs for the activities of gait, overhead squatting and a hurdle step?

Methods
A pre-existing dataset collected from one season (September 2015–May 2016) as part of a prospective observational longitudinal study was used. A secondary analysis of data for 24 male footballers, from a single British University football team, was conducted in order to evaluate the effect of static (conventional gait model) and dynamic (constrained and unconstrained mDynaKAD) methods on knee joint kinematics for flexion-extension and valgus-varus angles.

Results
No single calibration method consistently achieved both the highest flexion and lowest valgus angle for all tests. The constrained and unconstrained mDynaKAD methods achieved superior alignment of the knee medio-lateral axis compared to the conventional gait model, when the movement activity served as its own calibration. The largest mean difference between methods for sagittal and coronal plane kinematics was less than 4⁰ and 14⁰ respectively. Cross-talk could not account for all variation within the results, highlighting that soft tissue artefact, associated with larger muscle volumes and movements, can influence kinematics results.

Significance
When considering the trade-off between achieving maximum flexion and minimal valgus angle, the results indicate that the mDynaKAD methods performed best when the selected movement activity served as its own calibration method for all activities. Clinical decision making processes obtained through use of these methods should be considered in light of the model errors associated with cross-talk and effect of soft tissue artefact.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://doi.org/10.1016/j.gaitpost.2019.03.006 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Kinematics, motion analysis, injury screening, knee biomechanics, dynamic knee valgus
Subjects: R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
R Medicine > RM Therapeutics. Pharmacology > Physical medicine. Physical therapy. Including massage, exercise, occupational therapy, hydrotherapy, phototherapy, radiotherapy, thermotherapy, electrotherapy
Divisions: Faculty of Medicine and Health Sciences > School of Health and Rehabilitation
Depositing User: Symplectic
Date Deposited: 13 Mar 2019 14:51
Last Modified: 13 Mar 2019 14:51
URI: http://eprints.keele.ac.uk/id/eprint/6048

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