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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Effects of Hip Osteoarthritis on Lower Extremity Joint Contact Forces

Lyons, Percie Jewell 09 September 2021 (has links)
People with osteoarthritis (OA) suffer from joint degeneration and pain as well as difficulty performing daily activities. Joint contact forces (JCF) are important for understanding individual joint loading, however, these contact force cannot be directly measured without instrumented implants. Musculoskeletal modeling is a tool for estimating JCF without the need for surgery. The results from these models can be very different due to different approaches used in the development of a model that was used for simulation. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which lower extremity JCF were calculated at the hip, knee, and ankle in 10 participants with hip OA (H-OA) and 10 healthy control participants using OpenSim 4.0 [simtk.org, 23]. The generic gait2392 model was scaled to participant demographics, then the inverse kinematics (IK) solution and kinetic data were input into the Residual Reduction Algorithm (RRA) to reduce modeling errors. Kinematic solutions from RRA were used in the Computed Muscle Control (CMC) tool to compute muscle forces, then JCF were estimated using the Joint Reaction Analysis tool. Validation included JCF comparisons to published data of similar participant samples during level walking, and movement simulation quality was assessed with residual forces and moments applied at the pelvis, joint reserve actuators, and kinematic tracking errors. The computed JCFs were similar to the overall trends of published JCF results from similar participant samples, however the values of the computed JCFs were anywhere from 0.5 times body weight (BW) to 3BW larger than those in published studies. Simulation quality assessment resulted in low residual forces and moments, and low tracking errors. Most of the reserve actuators were small as well, besides pelvis rotation and hip rotation. The computed JCF were then used in the second portion of this study to determine the effect of group and side on JCF during both the weight acceptance and push-off phases of level walking. It was determined that there was a significant difference in the knee and ankle JCF during the weight acceptance portion of stance phase and at all joints during the push-off phase when comparing the H-OA and control groups on the affected limb. A significant interaction between group and limb was found for the peak hip JCF timing (% stance) during the push-off portion of the stance phase (p=0.009). These results demonstrate that H-OA participants experience an earlier peak hip JCF during propulsion on their affected limb. Based on previous research in OA that has examined spatiotemporal measures, this finding suggests that H-OA participants may use step or stride length changes as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences in H-OA participants, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs. / Master of Science / People with osteoarthritis suffer from joint degeneration and pain as well as difficulty performing daily activities, like walking. It is important to understand the forces and loading within individual joints. Musculoskeletal modeling is one way that researchers can estimate these joint contact forces (JCF) without needing a joint replacement implant that can measure these forces. When it comes to modeling simulations, there is a wide variety of results. Therefore, the first purpose of this study was to develop and validate a musculoskeletal model in which JCFs were calculated at the hip, knee, and ankle in 10 participants with hip osteoarthritis and 10 healthy adults. Validation of the model was completed through a comparison between computed results and published data of similar participant samples during level walking. The computed results were similar to the overall trends of published JCF results, however the numerical values themselves were larger than those in published studies. The computed JCFs were then used in the second portion of this study to determine how the two groups and limbs differ during level walking. There was a significant difference in the knee and ankle JCF during the first half of the stance phase and in all joints during the second half of stance when comparing the two groups. The hip osteoarthritis participants also experience an earlier peak hip JCF during the second half of stance phase on their affected limb. This finding suggests that hip osteoarthritis participants may change the way they take a step as a strategy to decrease or limit pain and loading on the affected limb. Knowledge of potential JCF differences, such as timing of the peaks in either portion of the stance phase, could provide useful insight to clinicians and therapists to make decisions on how to proceed with treatment or rehabilitation programs.

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