{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:23:54Z","timestamp":1760145834097,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82272115"],"award-info":[{"award-number":["82272115"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Purpose: Knee adduction, flexion moment, and adduction angle are often used as surrogate parameters of knee medial force. To verify whether these parameters are suitable as surrogates under different walking states, we investigated the correlation between knee medial loading with the surrogates during walking and turning. Methods: Sixteen healthy subjects were recruited to complete straight walk (SW), step turn (ST), and crossover turn (CT). Knee joint moments were obtained using inverse dynamics, and knee medial force was computed using a previously validated musculoskeletal model, Freebody. Linear regression was used to predict the peak of knee medial force with the peaks of the surrogate parameters and walking speed. Results: There was no significant difference in walking speed among these three tasks. The peak knee adduction moment (pKAM) was a significant predictor of the peak knee medial force (pKMF) for SW, ST, and CT (p &lt; 0.001), while the peak knee flexion moment (pKFM) was only a significant predictor of the pKMF for SW (p = 0.034). The statistical analysis showed that the pKMF increased, while the pKFM and the peak knee adduction angle (pKAA) decreased significantly during CT compared to those of SW and ST (p &lt; 0.001). The correlation analysis indicated that the knee parameters during SW and ST were quite similar. Conclusions: This study investigated the relationship between knee medial force and some surrogate parameters during walking and turning. KAM was still the best surrogate parameter for SW, ST, and CT. It is necessary to consider the type of movement when comparing the surrogate predictors of knee medial force, as the prediction equations differ significantly among movement types.<\/jats:p>","DOI":"10.3390\/s24175595","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T08:01:47Z","timestamp":1724918507000},"page":"5595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Estimation of Knee Medial Force with Substitution Parameters during Walking and Turning"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4638-5420","authenticated-orcid":false,"given":"Shizhong","family":"Liu","sequence":"first","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China"},{"name":"Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China"}]},{"given":"Ziyao","family":"Wang","sequence":"additional","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China"}]},{"given":"Jingwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-7582","authenticated-orcid":false,"given":"Rui","family":"Xu","sequence":"additional","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China"}]},{"given":"Dong","family":"Ming","sequence":"additional","affiliation":[{"name":"Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","first-page":"w13583","article-title":"Biomechanics and pathomechanisms of osteoarthritis","volume":"142","author":"Egloff","year":"2012","journal-title":"Swiss Med. Wkly."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1007\/s00167-016-4090-5","article-title":"Sport and early osteoarthritis: The role of sport in aetiology, progression and treatment of knee osteoarthritis","volume":"24","author":"Vannini","year":"2016","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_3","first-page":"2271","article-title":"Prevalence of knee osteoarthritis in the United States: Arthritis data from the Third National Health and Nutrition Examination Survey 1991\u20131994","volume":"33","author":"Dillon","year":"2006","journal-title":"J. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.joca.2015.02.005","article-title":"External knee adduction and flexion moments during gait and medial tibiofemoral disease progression in knee osteoarthritis","volume":"23","author":"Chang","year":"2015","journal-title":"Osteoarthr. Cartil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1002\/jor.25219","article-title":"The relationship between knee loading during gait and cartilage thickness in nontraumatic and posttraumatic knee osteoarthritis","volume":"40","author":"Teoli","year":"2022","journal-title":"J. Orthop. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.gaitpost.2020.03.012","article-title":"Effect of guided growth intervention on static leg alignment and dynamic knee contact forces during gait","volume":"78","author":"Holder","year":"2020","journal-title":"Gait Posture"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1186\/s13075-016-1155-2","article-title":"Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking","volume":"18","author":"Rane","year":"2016","journal-title":"Arthritis Res. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1109\/TBME.2007.891934","article-title":"Design of patient-specific gait modifications for knee osteoarthritis rehabilitation","volume":"54","author":"Fregly","year":"2007","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/jor.22240","article-title":"Changes in in vivo knee contact forces through gait modification","volume":"31","author":"Kinney","year":"2013","journal-title":"J. Orthop. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Shu, L., Yamamoto, K., Yoshizaki, R., Yao, J., Sato, T., and Sugita, N. (2022). Multiscale finite element musculoskeletal model for intact knee dynamics. Comput. Biol. Med., 141.","DOI":"10.1016\/j.compbiomed.2021.105023"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.medengphy.2020.09.004","article-title":"Influence of musculoskeletal model parameter values on prediction of accurate knee contact forces during walking","volume":"85","author":"Kinney","year":"2020","journal-title":"Med. Eng. Phys."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bowd, J., Van Rossom, S., Williams, D., Elson, D., Wilson, C., Whatling, G., Holt, C., and Jonkers, I. (2023). Using musculoskeletal modelling to estimate knee joint loading pre and post high tibial osteotomy. Clin. Biomech., 101.","DOI":"10.1016\/j.clinbiomech.2022.105855"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Frigo, C.A., and Donno, L. (2021). The Effects of External Loads and Muscle Forces on the Knee Joint Ligaments during Walking: A Musculoskeletal Model Study. Appl. Sci., 11.","DOI":"10.3390\/app11052356"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1002\/jor.1100090114","article-title":"Interaction between active and passive knee stabilizers during level walking","volume":"9","author":"Schipplein","year":"1991","journal-title":"J. Orthop. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1002\/jor.20379","article-title":"Correlation between the knee adduction torque and medial contact force for a variety of gait patterns","volume":"25","author":"Zhao","year":"2007","journal-title":"J. Orthop. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1002\/jor.25403","article-title":"High tibial osteotomy effectively redistributes compressive knee loads during walking","volume":"41","author":"Pagenstert","year":"2023","journal-title":"J. Orthop. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1002\/jor.21142","article-title":"Decreased knee adduction moment does not guarantee decreased medial contact force during gait","volume":"28","author":"Walter","year":"2010","journal-title":"J. Orthop. Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zeighami, A., Dumas, R., and Aissaoui, R. (2021). Knee loading in OA subjects is correlated to flexion and adduction moments and to contact point locations. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-87978-2"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.gaitpost.2014.04.205","article-title":"Knee adduction moment and medial knee contact force during gait in older people","volume":"40","author":"Ogaya","year":"2014","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1016\/j.joca.2018.04.011","article-title":"Relationship between knee joint contact forces and external knee joint moments in patients with medial knee osteoarthritis: Effects of gait modifications","volume":"26","author":"Richards","year":"2018","journal-title":"Osteoarthr. Cartil."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Holder, J., van Drongelen, S., Uhlrich, S.D., Herrmann, E., Meurer, A., and Stief, F. (2023). Peak knee joint moments accurately predict medial and lateral knee contact forces in patients with valgus malalignment. Sci. Rep., 13.","DOI":"10.1038\/s41598-023-30058-4"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.joca.2015.02.779","article-title":"A more informed evaluation of medial compartment loading: The combined use of the knee adduction and flexor moments","volume":"23","author":"Manal","year":"2015","journal-title":"Osteoarthr. Cartil."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.gaitpost.2019.02.006","article-title":"Sensitivity of medial-lateral load sharing to changes in adduction moments or angles in an asymptomatic knee joint model during gait","volume":"70","author":"Marouane","year":"2019","journal-title":"Gait Posture"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.gaitpost.2006.04.003","article-title":"Video task analysis of turning during activities of daily living","volume":"25","author":"Glaister","year":"2007","journal-title":"Gait Posture"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1109\/TNSRE.2023.3345006","article-title":"Multi-Action. Knee Contact Force Prediction by Domain Adaptation","volume":"32","author":"Loi","year":"2024","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Valente, G., Grenno, G., Fabbro, G.D., Zaffagnini, S., and Taddei, F. (2023). Medial and lateral knee contact forces during walking, stair ascent and stair descent are more affected by contact locations than tibiofemoral alignment in knee osteoarthritis patients with varus malalignment. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1254661"},{"key":"ref_27","unstructured":"Winter, D.A. (2004). Biomechanics and Motor Control of Human Movement, John Wiley & Sons, Inc.. [4th ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"140449","DOI":"10.1098\/rsos.140449","article-title":"The development of a segment-based musculoskeletal model of the lower limb: Introducing FREEBODY","volume":"2","author":"Cleather","year":"2015","journal-title":"R. Soc. Open Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ding, Z., Nolte, D., Tsang, C.K., Cleather, D.J., Kedgley, A.E., and Bull, A.M.J. (2016). In Vivo Knee Contact Force Prediction Using Patient-Specific Musculoskeletal Geometry in a Segment-Based Computational Model. J. Biomech. Eng., 138.","DOI":"10.1115\/1.4032412"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1016\/j.jbiomech.2014.02.028","article-title":"Partitioning of knee joint internal forces in gait is dictated by the knee adduction angle and not by the knee adduction moment","volume":"47","author":"Adouni","year":"2014","journal-title":"J. Biomech."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1016\/j.joca.2010.08.013","article-title":"Dynamic knee loading is related to cartilage defects and tibial plateau bone area in medial knee osteoarthritis","volume":"18","author":"Creaby","year":"2010","journal-title":"Osteoarthr. Cartil."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.humov.2005.07.005","article-title":"A three-dimensional biomechanical comparison between turning strategies during the stance phase of walking","volume":"24","author":"Taylor","year":"2005","journal-title":"Hum. Mov. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1002\/jor.20362","article-title":"In vivo medial and lateral tibial loads during dynamic and high flexion activities","volume":"25","author":"Zhao","year":"2007","journal-title":"J. Orthop. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.gaitpost.2006.10.008","article-title":"The influence of foot progression angle on the knee adduction moment during walking and stair climbing in pain free individuals with knee osteoarthritis","volume":"26","author":"Guo","year":"2007","journal-title":"Gait Posture"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Kutzner, I., Trepczynski, A., Heller, M.O., and Bergmann, G. (2013). Knee adduction moment and medial contact force\u2014Facts about their correlation during gait. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081036"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1002\/1529-0131(199807)41:7<1233::AID-ART14>3.0.CO;2-L","article-title":"Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis","volume":"41","author":"Sharma","year":"1998","journal-title":"Arthritis Rheum."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"119","DOI":"10.37190\/ABB-02199-2023-02","article-title":"Correlation between rotational moments of the knee and other joints during gait, including the free moment of patients with a medial meniscus tear","volume":"24","author":"Ibara","year":"2022","journal-title":"Acta Bioeng. Biomech."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/17\/5595\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:44:52Z","timestamp":1760111092000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/24\/17\/5595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":37,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["s24175595"],"URL":"https:\/\/doi.org\/10.3390\/s24175595","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}