Abstract
BackgroundThe control of the dynamic functional leg alignment (dFLA) and biomechanical load are important joint-related aspects regarding the development of osteoarthritis (OA). Research on level walking with feedback on load-related parameters has provided innovative treatment possibilities. With regard to walking on sloped surfaces, fundamental biomechanical knowledge exists. However, comprehensive data on the agreement of kinematics and kinetics of self-paced ramp versus sloped treadmill walking is lacking. Further, deeper insights into the control of the dFLA during decline walking and the usefulness of real-time feedback are missing.Methods/designThirty healthy participants aged between 18 and 35 years will be included. They will complete a three-dimensional gait analysis walking self-paced up and down on a 5-m ramp with a 10° inclination. Subsequently, speed-matched to ramp-up walking and self-paced 10° incline split-belt treadmill walking will be assessed. Afterwards, the participants will be observed under four different conditions of 10° declined walking on the same treadmill (a) self-paced walking, (b) self-paced walking with an internal focus of attention, (c) self-paced walking with real-time feedback, and (d) condition c speed-matched walking. The primary outcome parameter will be the frontal knee range of motion (fKROM). Secondary outcomes include the ground reaction force loading rate, spatial-temporal parameters, as well as sagittal, frontal and transversal kinematics, and kinetics for the lower extremities.DiscussionThe findings aim at improving the understanding of the effects of real-time feedback on the control of the dFLA and lower limb loading. Following clinical practicable methods for effective feedback devices can be developed and evaluated. Additionally, the first dataset comparing kinematic and kinetic parameters for decline and incline ramp walking versus walking on an instrumented treadmill will be available for appropriate intervention planning.Trial registrationClinicalTrials.govNCT04763850. Prospectively registered on 21 February 2021.
Highlights
The control of the dynamic functional leg alignment and biomechanical load are important joint-related aspects regarding the development of osteoarthritis (OA)
The findings aim at improving the understanding of the effects of real-time feedback on the control of the dynamic functional leg alignment (dFLA) and lower limb loading
The first dataset comparing kinematic and kinetic parameters for decline and incline ramp walking versus walking on an instrumented treadmill will be available for appropriate intervention planning
Summary
The control of the dynamic functional leg alignment (dFLA) and biomechanical load are important joint-related aspects regarding the development of osteoarthritis (OA). Biomechanical loading has been identified as one of the highly relevant parameters concerning the development of knee OA and the management of conservative OA therapy [2, 3] In this context, kinematic and kinetic parameters have been studied thoroughly during level walking. An inappropriate control of the dynamic functional leg alignment (dFLA) during decline walking would result in an increased frontal knee range of motion (fKROM) leading to inadequate shifted joint compression forces. These consequences are to be stressed, as the lateral knee compartment is more exposed to local pressure at initial contact than the medial one [13]
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