Physical Therapy Korea
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Phys. Ther. Korea 2023; 30(2): 110-119
Published online May 20, 2023
https://doi.org/10.12674/ptk.2023.30.2.110
© Korean Research Society of Physical Therapy
Effects of the Patellar Tendon Strap on Kinematics, Kinetic Data and Muscle Activity During Gait in Patients With Chronic Knee Osteoarthritis
Eun-Ji Lee1 
, PT, BPT, Ki-Song Kim2 , PT, PhD, Young-In Hwang2 , PT, PhD
1Department of Physical Therapy, The Graduate School, College of Life and Health Science, Hoseo University, 2Department of Physical Therapy, College of Life and Health Sciences, Hoseo University, Asan, Korea
Correspondence to: Young-In Hwang
E-mail: young123@hoseo.edu
https://orcid.org/0000-0002-7314-1678
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis.
Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed.
Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased.
Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.
Keywords: Gait, Knee joint, Musculoskeletal disease, Osteoarthritis
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Original Article
Phys. Ther. Korea 2023; 30(2): 110-119
Published online May 20, 2023 https://doi.org/10.12674/ptk.2023.30.2.110
Copyright © Korean Research Society of Physical Therapy.
Effects of the Patellar Tendon Strap on Kinematics, Kinetic Data and Muscle Activity During Gait in Patients With Chronic Knee Osteoarthritis
Eun-Ji Lee1 , PT, BPT, Ki-Song Kim2 , PT, PhD, Young-In Hwang2 , PT, PhD
1Department of Physical Therapy, The Graduate School, College of Life and Health Science, Hoseo University, 2Department of Physical Therapy, College of Life and Health Sciences, Hoseo University, Asan, Korea
Correspondence to:Young-In Hwang
E-mail: young123@hoseo.edu
https://orcid.org/0000-0002-7314-1678
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Osteoarthritis is a common condition with an increasing prevalence and is a common cause of disability. Osteoarthritic pain decreases the quality of life, and simple gait training is used to alleviate it. Knee osteoarthritis limits joint motion in the sagittal and lateral directions. Although many recent studies have activated orthotic research to increase knee joint stabilization, no study has used patellar tendon straps to treat knee osteoarthritis. Objects: This study aimed to determine the effects of patellar tendon straps on kinematic, mechanical, and electromyographic activation in patients with knee osteoarthritis.
Methods: Patients with knee osteoarthritis were selected. After creating the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), leg length difference, Q-angle, and thumb side flexion angle of the foot were measured. Kinematic, kinetic, and muscle activation data during walking before and after wearing the orthosis were viewed.
Results: After wearing the patellar tendon straps, hip adduction from the terminal stance phase, knee flexion from the terminal swing phase, and ankle plantar flexion angle increased during the pre-swing and initial swing phases. The cadence of spatiotemporal parameters and velocity increased, and step time, stride time, and foot force duration decreased.
Conclusion: Based on the results of this study, the increase in plantar flexion after strap wearing is inferred by an increase due to neurological mechanisms, and adduction at the hip joint is inferred by an increase in adduction due to increased velocity. The increase in cadence and velocity and the decrease in gait speed and foot pressure duration may be due to joint stabilization. It can be inferred that joint stabilization is increased by wearing knee straps. Thus, wearing a patellar tendon strap during gait in patients with knee osteoarthritis influences kinematic changes in the sagittal plane of the joint.
Keywords: Gait, Knee joint, Musculoskeletal disease, Osteoarthritis
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Table 1 . Characteristics of subjects (N = 9).
Variable Value Age (y) 75.89 ± 7.08 Height (cm) 154.76 ± 5.95 Weight (kg) 60.82 ± 4.74 BMI (kg/m2) 25.43 ± 2.33 Q-angle Lt. (°) 172.6 ± 2.65 Q-angle Rt. (°) 171.8 ± 3.16 Leg length Lt. (cm) 75.76 ± 2.47 Leg length Rt. (cm) 75.83 ± 3.35 Hallux valgus Lt. (°) 20.03 ± 6.95 Hallux valgus Rt. (°) 22.30 ± 7.87 Values are presented as mean ± standard deviation. Lt., left; Rt., right..
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Table 2 . WOMAC scores of subjects (N = 9).
Variable Value WOMAC pain 8.77 ± 3.27 WOMAC stiffness 2.23 ± 1.32 WOMAC function 29.66 ± 7.41 WOMAC total 40.77 ± 10.72 WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index..
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Table 3 . Kinematic data of subjects with and without patellar tendon strap during walking (N = 9).
Gait cycle Variable Pre Post p-value Terminal stance Lt. Maximum hip abduction (°) –3.71 ± 2.82 –4.53 ± 2.58 0.045* Pre swing Rt. Minimum ankle dorsiflexion (°) –13.82 ± 7.94 –15.87 ± 7.74 0.041* Initial swing Rt. Minimum ankle dorsiflexion (°) –16.26 ± 7.79 –18.25 ± 7.77 0.015* Terminal swing Rt. Maximum knee flexion (°) 24.80 ± 6.01 26.63 ± 6.48 0.016* Values are presented as mean ± standard deviation. Lt., left; Rt., right. *p < 0.05..
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Table 4 . Spatiotemporal parameters of subjects with and without patellar tendon straps (N = 9).
Subject Pre Post p-value Cadence (steps/min) 97.85 ± 12.17 105.86 ± 9.06 0.032* Velocity (m/s) 2.51 ± 0.61 2.85 ± 0.36 0.026* Lt. Step time (ms) 628.93 ± 97.90 573.88 ± 46.19 0.021* Rt. Step time (ms) 634.38 ± 103.32 565.30 ± 46.34 0.008* Stride time (ms) 1,251.75 ± 188.66 1,142.63 ± 94.61 0.011* Values are presented as mean ± standard deviation. Lt., left; Rt., right. *p < 0.05..
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Table 5 . Foot force duration of subjects with and without patellar tendon straps (N = 9).
Subject Pre Post p-value Lt. Midfoot force duration (%) 80.47 ± 2.31 78.60 ± 2.40 0.013* Rt. Midfoot force duration (%) 80.39 ± 2.88 78.96 ± 2.20 0.048* Rt. Hindfoot force duration (%) 72.58 ± 3.88 69.59 ± 2.04 0.022* Values are presented as mean ± standard deviation. Lt., left; Rt., right. *p < 0.05..