Quadriceps Femoris Strength and Sagittal-Plane Knee Biomechanics During Stair Ascent in Individuals With Articular Cartilage Defects in the Knee

in Journal of Sport Rehabilitation
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Context:

Few objective data are available regarding strength and movement patterns in individuals with articular cartilage defects (ACDs) of the knee.

Objectives:

To test the following hypotheses: (1) The involved limb of individuals with ACDs would demonstrate lower peak knee-flexion angle, peak internal knee-extension moment, and peak vertical ground-reaction force (vGRF) than the contralateral limb and healthy controls. (2) On the involved limb of individuals with ACDs, quadriceps femoris strength would positively correlate with peak knee-flexion angle, peak internal knee-extension moment, and peak vGRF.

Design:

Cross-sectional.

Setting:

Biomechanics research laboratory.

Participants:

11 individuals with ACDs in the knee who were eligible for surgical cartilage restoration and 10 healthy controls.

Methods:

Quadriceps femoris strength was quantified as peak isometric knee-extension torque via an isokinetic dynamometer. Sagittal-plane knee kinematics and kinetics were measured during the stance phase of stair ascent with 3-dimensional motion analysis.

Main Outcome Measures:

Quadriceps strength and knee biomechanics during stair ascent were compared between the involved and contralateral limbs of participants with ACD (paired t tests) and with a control group (independent-samples t tests). Pearson correlations evaluated relationships between strength and stair-ascent biomechanics.

Results:

Lower quadriceps strength and peak internal knee-extension moments were observed in the involved limb than in the contralateral limb (P < .01) and the control group (P < .01). For the involved limb of the ACD group, quadriceps femoris strength was strongly correlated (r = .847) with involved-limb peak internal knee-extension moment and inversely correlated (r = −.635) with contralateral peak vGRF. Conclusions: Individuals with ACDs demonstrated deficits in quadriceps femoris strength with associated alterations in movement patterns during stair ascent. The results of this study are not comprehensive; further research is needed to understand the physiological characteristics, activity performance, and movement quality in this population.

Thoma is with the School of Health and Rehabilitation Sciences; Flanigan and Chaudhari, the Dept of Orthopaedics; Siston, the Dept of Mechanical and Aerospace Engineering; Best, the Dept of Family Medicine; and Schmitt, the Div of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH. Address author correspondence to Laura C. Schmitt at laura.schmitt@osumc.edu.