title: Effects of methods of descending stairs forwards versus backwards on knee joint force in patients with osteoarthritis of the knee: a clinical controlled study.
abstract: BACKGROUND
  The aim of this study was to investigate the kinetic characteristics of compensatory backward descending movement performed by patients with osteoarthritis of the knee.
  
  
  METHODS
  Using a three-dimensional motion analysis system, we investigated lower extremity joint angles, joint moments, joint force of the support leg in forward and backward descending movements on stairs, and joint force of the leading leg at landing in 7 female patients with osteoarthritis of the knee.
  
  
  RESULTS
  Compared with the forward descending movement, knee joint angle, joint moment and joint force of the support leg all decreased in the backward descending movement. Joint force of the leading leg at landing was also reduced in the backward descending movement. In addition, we confirmed that the center of body mass was mainly controlled by the knee and ankle joints in the forward descending movement, and by the hip joint in the backward descending movement.
  
  
  CONCLUSIONS
  Since it has been reported that knee flexion angle and extensor muscle strength are decreased in patients with osteoarthritis of the knee, we believe that backward descending movement is an effective method to use the hip joint to compensate for these functional defects. In addition, due to the decreased knee joint force both in the leading and support legs in backward descending movement, the effectiveness of compensatory motion for pain control and knee joint protection was also suggested.
authors.affiliation: Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara City, Hiroshima 723-0053, Japan.|Department of Rehabilitation Science, Kobe University Graduate School of Medicine, 7-10-2 Tomogaoka, Suma-ku, Kobe City, Hyogo 654-0142, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Department of Rehabilitation Science, Kobe University Graduate School of Medicine in Hyogo Rehabilitation Center, 1070 Akebono-Cho, Nishi-Ku, Kobe City, Hyogo 651-2181, Japan.
authors.forename: Takaaki
authors.initials: T
authors.lastname: Chin
authors.affiliation: Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara City, Hiroshima 723-0053, Japan.|Department of Orthopedic Surgery, Kousei General Hospital, 2-5-1 Enichi-cho, Mihara City, Hiroshima 723-8686, Japan.
authors.forename: Sadaaki
authors.initials: S
authors.lastname: Oki
authors.affiliation: Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara City, Hiroshima 723-0053, Japan.
authors.forename: Shusaku
authors.initials: S
authors.lastname: Kanai
authors.affiliation: Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-cho, Mihara City, Hiroshima 723-0053, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Shimatani
authors.affiliation: Department of Rehabilitation Science, Kobe University Graduate School of Medicine, 7-10-2 Tomogaoka, Suma-ku, Kobe City, Hyogo 654-0142, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Shimada