Joint contact forces when minimizing the external knee adduction moment by gait modification: A computer simulation study.

摘要: Abstract Background and purpose Gait modification is often used to reduce the external knee adduction moment (KAM) in human walking, but relationship between KAM reduction changes medial joint contact force (JCF) not well established. Our was examine limiting case of KAM-based gait modification: reducing as much possible, resulting effects on JCF. Methods We musculoskeletal modeling perform three optimal control simulations: normal a modified that reduced theoretically possible (Min(KAM) simulation), second minimized plus metabolic cost transport (Min(KAM+CoT) simulation). Results The two gaits both peak from walking (− 82% for Min(KAM) simulation, − 74% Min(KAM+CoT) simulation) by increasing trunk lean, toe-out, step width, flexion. Even though simulation had larger KAM, it greater JCF (− 27%) than (− 15%) because using less muscle activity. These results were qualitatively robust sensitivity analysis model, magnitude varied an order magnitude. Conclusions suggest (i) can benefit considering whole-body motion rather single adjustments, (ii) accurate interpretation requires consideration forces, (iii) subject-specific models are needed accurately determine