Effects of an Exercise Therapy Targeting Knee Kinetics on Pain, Function, and Gait Kinetics in Patients With Knee Osteoarthritis: A Randomized Clinical Trial

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  • 1 Ahvaz Jundishapur University of Medical Sciences
  • | 2 University of Alberta
  • | 3 Sharif University of Technology
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In this study, the effects of an exercise therapy comprising yoga exercises and medial-thrust gait (YogaMT) on lower-extremity kinetics, pain, and function in patients with medial knee osteoarthritis were investigated. Fifty-nine patients were randomly allocated to three treatment groups: (a) the YogaMT group practiced yoga exercises and medial thrust gait, (b) the knee-strengthening group performed quadriceps- and hamstring-strengthening exercises, and (c) the treadmill walking group practiced normal treadmill walking in 12 supervised sessions. The adduction and flexion moments of the hip, knee, and ankle; pain intensity; and 2-min walking test were assessed before and after treatment and at 1-month follow-up. The YogaMT group experienced a significant reduction in knee adduction moment. All groups showed significant improvement in pain and function. The YogaMT may reduce medial knee load in patients with knee osteoarthritis in the short term. A larger clinical trial is required to investigate the long-term outcomes of this intervention.

Bokaeian, Esfandiarpour, Zahednejad, and Mohammadi are with the Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Esfandiarpour is also with the Dept. of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada. Farahmand is with the Djavad Mowafaghian Research Center of Intelligent Neuro-Rehabilitation Technologies, Sharif University of Technology, Tehran, Iran.

Esfandiarpour (fateme@ualberta.ca) is corresponding author.
  • Adouni, M., & Shirazi-Adl, A. (2014). Partitioning of knee joint internal forces in gait is dictated by the knee adduction angle and not by the knee adduction moment. Journal of Applied Biomechanics, 47(7), 16961703. https://doi.org/10.1016/j.jbiomech.2014.02.028

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Alghadir, A.H., Anwer, S., Iqbal, A., & Iqbal, Z.A. (2018). Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of Pain Research, 11, 851856. https://doi.org/10.2147/JPR.S158847

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Andriacchi, T.P., & Favre, J. (2014). The nature of in vivo mechanical signals that influence cartilage health and progression to knee osteoarthritis. Current Rheumatology Reports, 16(11), 463. PubMed ID: 25240686 https://doi.org/10.1007/s11926-014-0463-2

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bell, A.L., Pedersen, D.R., & Brand, R.A. (1990). A comparison of the accuracy of several hip center location prediction methods. Journal of Applied Biomechanics, 23(6), 617621. https://doi.org/10.1016/0021-9290(90)90054-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bennell, K.L., Kyriakides, M., Metcalf, B., Egerton, T., Wrigley, T.V., Hodges, P.W., … Hinman, R.S. (2014). Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: A randomized controlled trial. Arthritis & Rheumatology, 66(4), 950959. PubMed ID: 24757146 https://doi.org/10.1002/art.38317

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bennett, H.J., Zhang, S., Shen, G., Weinhandl, J.T., Paquette, M.R., Reinbolt, J., & Coe, D.P. (2017). Effects of toe-in and wider step width in stair ascent with different knee alignments. Medicine & Science in Sports & Exercise, 49(3), 563572. PubMed ID: 28222057 https://doi.org/10.1249/MSS.0000000000001140

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bokaeian, H.R., Bakhtiary, A.H., Mirmohammadkhani, M., & Moghimi, J. (2016). The effect of adding whole body vibration training to strengthening training in the treatment of knee osteoarthritis: A randomized clinical trial. Journal of Bodywork and Movement Therapies, 20(2), 334340. PubMed ID: 27210851 https://doi.org/10.1016/j.jbmt.2015.08.005

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Bokaeian, H.R., Bakhtiary, A.H., Mirmohammadkhani, M., & Moghimi, J. (2018). Quadriceps strengthening exercises may not change pain and function in knee osteoarthritis. Journal of Bodywork and Movement Therapies, 22(2), 528533. PubMed ID: 29861261 https://doi.org/10.1016/j.jbmt.2017.06.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brenneman, E.C., Kuntz, A.B., Wiebenga, E.G., & Maly, M.R. (2015). A yoga strengthening program designed to minimize the knee adduction moment for women with knee osteoarthritis: A proof-of-principle cohort study. PLoS One, 10(9), e0136854. PubMed ID: 26367862 https://doi.org/10.1371/journal.pone.0136854

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brisson, N.M., Wiebenga, E.G., Stratford, P.W., Beattie, K.A., Totterman, S., Tamez-Pena, J.G., … Maly, M.R. (2017). Baseline knee adduction moment interacts with body mass index to predict loss of medial tibial cartilage volume over 2.5 years in knee osteoarthritis. Journal of Orthopaedic Research, 35(11), 24762483. PubMed ID: 28323351 https://doi.org/10.1002/jor.23564

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Brosseau, L., Yonge, K.A., Robinson, V., Marchand, S., Judd, M., Wells, G., & Tugwell, P. (2003). Thermotherapy for treatment of osteoarthritis. The Cochrane Database of Systematic Reviews, 2003(4), CD004522. https://doi.org/10.1002/14651858.CD004522

    • Search Google Scholar
    • Export Citation
  • Buchner, A., Erdfelder, E., Faul, F., & Lang, A.-G. (2020). G*Power: Statistical power analyses for Windows and Mac. Heinrich-Heine-Universität Düsseldorf. https://www.psychologie.hhu.de/arbeitsgruppen/allgemeine-psychologie-und-arbeitspsychologie/gpower.html

    • Search Google Scholar
    • Export Citation
  • Chehab, E.F., Favre, J., Erhart-Hledik, J.C., & Andriacchi, T.P. (2014). Baseline knee adduction and flexion moments during walking are both associated with 5 year cartilage changes in patients with medial knee osteoarthritis. Osteoarthritis and Cartilage, 22(11), 18331839. PubMed ID: 25211281 https://doi.org/10.1016/j.joca.2014.08.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cheung, R.T.H., Ho, K.K.W., Au, I.P.H., An, W.W., Zhang, J.H.W., Chan, Z.Y.S., … Rainbow, M.J. (2018). Immediate and short-term effects of gait retraining on the knee joint moments and symptoms in patients with early tibiofemoral joint osteoarthritis: A randomized controlled trial. Osteoarthritis and Cartilage, 26(11), 14791486. PubMed ID: 30081075 https://doi.org/10.1016/j.joca.2018.07.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Collins, N.J., Hart, H.F., & Mills, K.A.G. (2019). Osteoarthritis year in review 2018: Rehabilitation and outcomes. Osteoarthritis and Cartilage, 27(3), 378391. PubMed ID: 30529739 https://doi.org/10.1016/j.joca.2018.11.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Cucchiarini, M., de Girolamo, L., Filardo, G., Oliveira, J.M., Orth, P., Pape, D., & Reboul, P. (2016). Basic science of osteoarthritis. Journal of Experimental Orthopaedics, 3(1), 22. PubMed ID: 27624438https://doi.org/10.1186/s40634-016-0060-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Davis, R.B., Õunpuu, S., Tyburski, D., & Gage, J.R. (1991). A gait analysis data collection and reduction technique. Human Movement Science, 10(5), 575587. https://doi.org/10.1016/0167-9457(91)90046-Z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Day, M.L., McGuigan, M.R., Brice, G., & Foster, C. (2004). Monitoring exercise intensity during resistance training using the session RPE scale. Journal of Strength and Conditioning Research, 18(2), 353358. PubMed ID: 15142026 https://doi.org/10.1519/r-13113.1

    • Search Google Scholar
    • Export Citation
  • Derrick, T.R., van den Bogert, A.J., Cereatti, A., Dumas, R., Fantozzi, S., & Leardini, A. (2020). ISB recommendations on the reporting of intersegmental forces and moments during human motion analysis. Journal of Applied Biomechanics, 99, 109533. https://doi.org/10.1016/j.jbiomech.2019.109533

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Duffell, L.D., Hope, N., & McGregor, A.H. (2014). Comparison of kinematic and kinetic parameters calculated using a cluster-based model and Vicon’s plug-in gait. Proceedings of the Institution of Mechanical Engineers, Part H, 228(2), 206210. https://doi.org/10.1177/0954411913518747

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Duffell, L.D., Jordan, S.J., Cobb, J.P., & McGregor, A.H. (2017). Gait adaptations with aging in healthy participants and people with knee-joint osteoarthritis. Gait & Posture, 57, 246251. PubMed ID: 28672154 https://doi.org/10.1016/j.gaitpost.2017.06.015

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ebrahimzadeh, M.H., Makhmalbaf, H., Birjandinejad, A., Keshtan, F.G., Hoseini, H.A., & Mazloumi, S.M. (2014). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian speaking patients with knee osteoarthritis. The Archives of Bone and Joint Surgery, 2(1), 5762. PubMed ID: 25207315

    • Search Google Scholar
    • Export Citation
  • Erhart-Hledik, J.C., Favre, J., & Andriacchi, T.P. (2015). New insight in the relationship between regional patterns of knee cartilage thickness, osteoarthritis disease severity, and gait mechanics. Journal of Applied Biomechanics, 48(14), 38683875. https://doi.org/10.1016/j.jbiomech.2015.09.033

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 11491160. PubMed ID: 19897823 https://doi.org/10.3758/BRM.41.4.1149

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Favre, J., Erhart-Hledik, J.C., Chehab, E.F., & Andriacchi, T.P. (2016). General scheme to reduce the knee adduction moment by modifying a combination of gait variables. Journal of Orthopaedic Research, 34(9), 15471556. PubMed ID: 26744298 https://doi.org/10.1002/jor.23151

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ferreira, G.E., Robinson, C.C., Wiebusch, M., Viero, C.C., da Rosa, L.H., & Silva, M.F. (2015). The effect of exercise therapy on knee adduction moment in individuals with knee osteoarthritis: A systematic review. Clinical Biomechanics, 30(6), 521527. https://doi.org/10.1016/j.clinbiomech.2015.03.028

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ferrigno, C., Wimmer, M.A., Trombley, R.M., Lundberg, H.J., Shakoor, N., & Thorp, L.E. (2016). A reduction in the knee adduction moment with medial thrust gait is associated with a medial shift in center of plantar pressure. Medical Engineering & Physics, 38(7), 615621. PubMed ID: 27158051 https://doi.org/10.1016/j.medengphy.2016.03.008

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Foroughi, N., Smith, R.M., Lange, A.K., Baker, M.K., Fiatarone Singh, M.A., & Vanwanseele, B. (2011). Lower limb muscle strengthening does not change frontal plane moments in women with knee osteoarthritis: A randomized controlled trial. Clinical Biomechanics, 26(2), 167174. https://doi.org/10.1016/j.clinbiomech.2010.08.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fregly, B.J., D’Lima, D.D., & Colwell, C.W., Jr. (2009). Effective gait patterns for offloading the medial compartment of the knee. Journal of Orthopaedic Research, 27(8), 10161021. https://doi.org/10.1002/jor.20843

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Fregly, B.J., Reinbolt, J.A., Rooney, K.L., Mitchell, K.H., & Chmielewski, T.L. (2007). Design of patient-specific gait modifications for knee osteoarthritis rehabilitation. IEEE Transactions on Biomedical Engineering, 54(9), 16871695. PubMed ID: 17867361 https://doi.org/10.1109/TBME.2007.891934

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Geenen, R., Overman, C.L., Christensen, R., Åsenlöf, P., Capela, S., Huisinga, K.L., … Bergman, S. (2018). EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases, 77(6), 797807. PubMed ID: 29724726 https://doi.org/10.1136/annrheumdis-2017-212662

    • Search Google Scholar
    • Export Citation
  • Gerbrands, T.A., Pisters, M.F., Theeven, P.J.R., Verschueren, S., & Vanwanseele, B. (2017). Lateral trunk lean and medializing the knee as gait strategies for knee osteoarthritis. Gait & Posture, 51, 247253. PubMed ID: 27838568 https://doi.org/10.1016/j.gaitpost.2016.11.014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hanada, K., Hara, M., Hirakawa, Y., Hoshi, K., Ito, K., & Gamada, K. (2018). Immediate effects of leg-press exercises with tibial internal rotation on individuals with medial knee osteoarthritis. Physiotherapy Research International, 23(4), e1725. PubMed ID: 29962098 https://doi.org/10.1002/pri.1725

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Henrotin, Y., Pesesse, L., & Sanchez, C. (2012). Subchondral bone and osteoarthritis: Biological and cellular aspects. Osteoporosis International, 23(Suppl. 8), 847851. https://doi.org/10.1007/s00198-012-2162-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hunt, M.A., Birmingham, T.B., Giffin, J.R., & Jenkyn, T.R. (2006). Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis. Journal of Applied Biomechanics, 39(12), 22132220. https://doi.org/10.1016/j.jbiomech.2005.07.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hunt, M.A., Charlton, J.M., Krowchuk, N.M., Tse, C.T.F., & Hatfield, G.L. (2018). Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: A randomized controlled trial. Osteoarthritis and Cartilage, 26(7), 903911. PubMed ID: 29709498 https://doi.org/10.1016/j.joca.2018.04.010

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Hyldahl, R.D., Evans, A., Kwon, S., Ridge, S.T., Robinson, E., Hopkins, J.T., & Seeley, M.K. (2016). Running decreases knee intra-articular cytokine and cartilage oligomeric matrix concentrations: A pilot study. European Journal of Applied Physiology, 116(11–12), 23052314. PubMed ID: 27699484 https://doi.org/10.1007/s00421-016-3474-z

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Juhl, C., Christensen, R., Roos, E.M., Zhang, W., & Lund, H. (2014). Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis & Rheumatology, 66(3), 622636. PubMed ID: 24574223 https://doi.org/10.1002/art.38290

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Klein Horsman, M.D., Koopman, H.F., van der Helm, F.C., Prosé, L.P., & Veeger, H.E. (2007). Morphological muscle and joint parameters for musculoskeletal modelling of the lower extremity. Clinical Biomechanics, 22(2), 239247. https://doi.org/10.1016/j.clinbiomech.2006.10.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kutzner, I., Trepczynski, A., Heller, M.O., & Bergmann, G. (2013). Knee adduction moment and medial contact force—Facts about their correlation during gait. PLoS One, 8(12), e81036. PubMed ID: 24312522 https://doi.org/10.1371/journal.pone.0081036

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lee, A.C., Harvey, W.F., Han, X., Price, L.L., Driban, J.B., Bannuru, R.R., & Wang, C. (2018). Pain and functional trajectories in symptomatic knee osteoarthritis over up to 12 weeks of exercise exposure. Osteoarthritis and Cartilage, 26(4), 501512. PubMed ID: 29391277 https://doi.org/10.1016/j.joca.2018.01.016

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lim, B.W., Hinman, R.S., Wrigley, T.V., Sharma, L., & Bennell, K.L. (2008). Does knee malalignment mediate the effects of quadriceps strengthening on knee adduction moment, pain, and function in medial knee osteoarthritis? A randomized controlled trial. Arthritis & Rheumatology, 59(7), 943951. https://doi.org/10.1002/art.23823

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Longpre, H.S., Brenneman, E.C., Johnson, A.L., & Maly, M.R. (2015). Identifying yoga-based knee strengthening exercises using the knee adduction moment. Clinical Biomechanics, 30(8), 820826. https://doi.org/10.1016/j.clinbiomech.2015.06.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Manal, K., Gardinier, E., Snyder-Mackler, L., & Buchanan, T. (2013). An alternate predictor of peak medial compartment loading: The product of the peak knee extensor and abductor moments. Paper presented at the conference of theAmerican Society of Biomechanics.

    • Search Google Scholar
    • Export Citation
  • McQuade, K.J., & de Oliveira, A.S. (2011). Effects of progressive resistance strength training on knee biomechanics during single leg step-up in persons with mild knee osteoarthritis. Clinical Biomechanics, 26(7), 741748. https://doi.org/10.1016/j.clinbiomech.2011.03.006

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Miyazaki, T., Wada, M., Kawahara, H., Sato, M., Baba, H., & Shimada, S. (2002). Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Annals of the Rheumatic Diseases, 61(7), 617622. PubMed ID: 12079903 https://doi.org/10.1136/ard.61.7.617

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Nair, S.P., Gibbs, S., Arnold, G., Abboud, R., & Wang, W. (2010). A method to calculate the centre of the ankle joint: A comparison with the Vicon Plug-in-Gait model. Clinical Biomechanics, 25(6), 582587. https://doi.org/10.1016/j.clinbiomech.2010.03.004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Newberry, S.J., FitzGerald, J., SooHoo, N.F., Booth, M., Marks, J., Motala, A., Apaydin, E., Chen, C., Raaen, L., Shanman, R., & Shekelle, P.G. (2017, May 2–6). Treatment of osteoarthritis of the knee: An update review. Comparative Effectiveness Review No. 190. (Prepared by the RAND Southern California Evidence-based Practice Center under Contract No. 290-2015-00010-I.) AHRQ Publication No.17-EHC011-EF. Agency for Healthcare Research and Quality. https://doi.org/10.23970/AHRQEPCCER190

    • Crossref
    • Search Google Scholar
    • Export Citation
  • O’Neill, T.W., & Felson, D.T. (2018). Mechanisms of osteoarthritis (OA) pain. Current Osteoporosis Reports, 16(5), 611616. PubMed ID: 30155845 https://doi.org/10.1007/s11914-018-0477-1

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pearle, A.D., Warren, R.F., & Rodeo, S.A. (2005). Basic science of articular cartilage and osteoarthritis. Clinics in Sports Medicine, 24(1), 112. PubMed ID: 15636773 https://doi.org/10.1016/j.csm.2004.08.007

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Peter, W.F., Jansen, M.J., Hurkmans, E.J., Bloo, H., Dekker, J., Dilling, R.G., … Vliet Vlieland, T.P. (2011). Physiotherapy in hip and knee osteoarthritis: Development of a practice guideline concerning initial assessment, treatment and evaluation. Acta Reumatologica Portuguesa, 36(3), 268281. PubMed ID: 22113602

    • Search Google Scholar
    • Export Citation
  • Petersen, S.G., Beyer, N., Hansen, M., Holm, L., Aagaard, P., Mackey, A.L., & Kjaer, M. (2011). Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Archives of Physical Medicine and Rehabilitation, 92(8), 11851193. PubMed ID: 21807137 https://doi.org/10.1016/j.apmr.2011.03.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Richards, R., van den Noort, J.C., van der Esch, M., Booij, M.J., & Harlaar, J. (2018). Gait retraining using real-time feedback in patients with medial knee osteoarthritis: Feasibility and effects of a six-week gait training program. Knee, 25(5), 814824. PubMed ID: 29933935 https://doi.org/10.1016/j.knee.2018.05.014

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ro, D.H., Lee, D.Y., Moon, G., Lee, S., Seo, S.G., Kim, S.H., … Lee, M.C. (2017). Sex differences in knee joint loading: Cross-sectional study in geriatric population. Journal of Orthopaedic Research, 35(6), 12831289. PubMed ID: 27441414 https://doi.org/10.1002/jor.23374

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Schache, A.G., & Baker, R. (2007). On the expression of joint moments during gait. Gait & Posture, 25(3), 440452. PubMed ID: 17011192 https://doi.org/10.1016/j.gaitpost.2006.05.018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Simic, M., Hinman, R.S., Wrigley, T.V., Bennell, K.L., & Hunt, M.A. (2011). Gait modification strategies for altering medial knee joint load: A systematic review. Arthritis Care & Research, 63(3), 405426. https://doi.org/10.1002/acr.20380

    • Search Google Scholar
    • Export Citation
  • Stagg, N.J., Mata, H.P., Ibrahim, M.M., Henriksen, E.J., Porreca, F., Vanderah, T.W., & Philip Malan, T., Jr. (2011). Regular exercise reverses sensory hypersensitivity in a rat neuropathic pain model: Role of endogenous opioids. Anesthesiology, 114(4), 940948. https://doi.org/10.1097/aln.0b013e318210f880

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Suresh, K. (2011). An overview of randomization techniques: An unbiased assessment of outcome in clinical research. Journal of Human Reproductive Sciences, 4(1), 811. PubMed ID: 21772732 https://doi.org/10.4103/0974-1208.82352

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Vicon Motion Systems. (2017). FAQS FOR software. Vicon. www.docs.vicon.com

  • Walter, J.P., D’Lima, D.D., Colwell, C.W., Jr., & Fregly, B.J. (2010). Decreased knee adduction moment does not guarantee decreased medial contact force during gait. Journal of Orthopaedic Research, 28(10), 13481354. PubMed ID: 20839320 https://doi.org/10.1002/jor.21142

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Yuksel, E., Kalkan, S., Cekmece, S., Unver, B., & Karatosun, V. (2017). Assessing minimal detectable changes and test-retest reliability of the timed up and go test and the 2-minute walk test in patients with total knee arthroplasty. Journal of Arthroplasty, 32(2), 426430. PubMed ID: 27639305 https://doi.org/10.1016/j.arth.2016.07.031

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Zhao, D., Banks, S.A., Mitchell, K.H., D’Lima, D.D., Colwell, C.W., & Fregly, B.J. (2007). Correlation between the knee adduction torque and medial contact force for a variety of gait patterns. Journal of Orthopaedic Research, 25(6), 789797. PubMed ID: 17343285 https://doi.org/10.1002/jor.20379

    • Crossref
    • Search Google Scholar
    • Export Citation
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