Knee joint moments during high flexion movements: Timing of peak moments and the effect of safety footwear.
OBJECTIVE
(1) Characterize knee joint moments and peak knee flexion moment timing during kneeling transitions, with the intent of identifying high-risk postures. (2) Determine whether safety footwear worn by kneeling workers (construction workers, tile setters, masons, roofers) alters high flexion kneeling mechanics.


METHODS
Fifteen males performed high flexion kneeling transitions. Kinetics and kinematics were analyzed for differences in ascent and descent in the lead and trail legs.


RESULTS
Mean±standard deviation peak external knee adduction and flexion moments during transitions ranged from 1.01±0.31 to 2.04±0.66% body weight times height (BW∗Ht) and from 3.33 to 12.6% BW∗Ht respectively. The lead leg experienced significantly higher adduction moments compared to the trail leg during descent, when work boots were worn (interaction, p=0.005). There was a main effect of leg (higher lead vs. trail) on the internal rotation moment in both descent (p=0.0119) and ascent (p=0.0129) phases.


CONCLUSIONS
Peak external knee adduction moments during transitions did not exceed those exhibited during level walking, thus increased knee adduction moment magnitude is likely not a main factor in the development of knee OA in occupational kneelers. Additionally, work boots only significantly increased the adduction moment in the lead leg during descent. In cases where one knee is painful, diseased, or injured, the unaffected knee should be used as the lead leg during asymmetric bilateral kneeling. Peak flexion moments occurred at flexion angles above the maximum flexion angle exhibited during walking (approximately 60°), supporting the theory that the loading of atypical surfaces may aid disease development or progression.
University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada. Electronic address: hcchong@uwaterloo.ca.
Helen C
HC
Chong
University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada. Electronic address: lmtennan@uwaterloo.ca.
Liana M
LM
Tennant
University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada. Electronic address: david.kingston@uwaterloo.ca.
David C
DC
Kingston
University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, Canada. Electronic address: stacey.acker@uwaterloo.ca.
Stacey M
SM
Acker
D001696:Biomechanical Phenomena; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D009068:Movement / Q000502:physiology*; D011481:Protective Clothing / Q000009:adverse effects*; D016059:Range of Motion, Articular / Q000502:physiology*; D012775:Shoes / Q000009:adverse effects; D055815:Young Adult
High flexion; Joint moments; Kinematics; Kinetics; Kneeling