This study analyzed forces in the tibiofemoral and pa tellofemoral joints during isokinetic exercise using an analytical biomechanical model. The results show that isokinetic exercise can produce large loads on these joints, especially during extension exercises. The tibio femoral compressive force (4.0 body weight) is approx imately equal to that obtained during walking but it occurs at 55° of knee flexion. Anterior shear forces (resisting force to anterior drawer) exist during exten sion exercise at less than 40° of knee flexion, with a maximum of 0.3 body weight. Posterior shear forces (resisting force to posterior drawer) exist during exten sion exercise at knee joint angles greater than 40° and during the flexion portion of isokinetic exercise. The maximum posterior shear force is 1.7 body weight. The patellofemoral joint can encounter loads as high as 5.1 body weight which are 10 times higher than during straight leg raises. These results suggest that isokinetic exercise should be used cautiously in patients with knee lesions.
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References
1.
Ahmed AM, Burke DL, Hyder A. Force analysis of the patellar mechanism J Orthop Res569-85, 1987
2.
An KN, Kwak BM, Chao EY, et al Determination of muscle and joint forces A new technique to solve the indeterminate problem Trans ASME106364-367, 1984
3.
Andnacchi TP , Andersson Gbj, Ortengren R., et al A study of factors influencing muscle activity about the knee joint J Orthop Res1266-275, 1984
4.
Arms SW, Pope MH, Johnson RJ, et al The biomechanics of anterior cruciate ligament rehabilitation and reconstruction Am J Sports Med128-18, 1984
5.
Bak MJ, Loeb GC A pulsed integrator for EMG analysis Electroencephalogr Clin Neurophysiol47738-741, 1979
6.
Blacharski PA , Somerset JH, Murray DG Three dimensional expenmental assessment of knee ligament patterns Orthop Trans7247, 1983
7.
Brand RA, Crowninshield RD, Wittstock CE, et al A model of lower extremity muscular anatomy J Biomech Eng104304-310, 1982
8.
Butler DL, Noyes FR, Grood ES Ligamentous restraints to anterior-posterior drawer in the human knee A biomechanical study J Bone Joint Surg62A259-270, 1980
9.
Carlsoo S., Fohlin L., Skoglund G. Studies of co-contraction of knee muscles, in Desmedt JE (ed) New Developments in Electromyography and Clinical Neurophysiology Vol 1 Basel, Karger 1973, pp 648-655
10.
Chao Eys Justification of triaxial goniometer for the measurement of joint rotation J Biomech13989-1006, 1980
11.
Chao Eys, Hoffman RR Instrumental measurement of human joint motion ISA Trans1713-19, 1978
12.
Craven P., Wahba G. Smoothing noisy data with spline functions Numerische Mathematik31377, 1979
13.
Dahlkvist NJ , Mayo P., Seedhom BB Forces during squatting and rising from a deep squat Eng Med1169-76, 1982
14.
Draganich LF , Andnacchi TP, Andersson Gbj Interaction between intrinsic knee mechanics and the knee extensor mechanism J Orthop Res5539-547,1987
15.
Draganich LF , Jaeger R., Kralj A. EMG activity of the quadriceps and hamstrings during monoarticular knee extension and flexion Trans Orthop Res Soc12283, 1987
16.
Draganich LF , Vahey JW An in-vitro study of anterior cruciate ligament strain nduced by quadriceps and hamstring forces. Trans Orthop Res Soc 13. 203, 1988
17.
Ellis MI, Seedhom BB, Amis AA, et al Forces in the knee joint whilst rising from normal and motonzed chairs Eng Med833-40, 1979
18.
Ellis MI, Seedhom BB, Wnght V. Forces in the knee joint whilst rising from a seated position J Biomed Eng6: 113-120, 1984
19.
Ellis MI, Seedhom BB, Wnght V., et al An evaluation of the ratio between the tensions along the quadriceps tendon and the patellar ligament Eng Med9189-194, 1980
20.
Encson MO, Nisell R. Tibiofemoral joint forces during ergometer cycling Am J Sports Med14285-290, 1986
21.
Grabiner MD , Campbell KR, Hawthorne DL, et al Electromyographic study of the anterior cruciate ligament-hamstrings synergy during isometric knee extension J Orthop Res7152-155, 1989
22.
Good ES, Suntay WJ, Noyes FR, et al Biomechanics of the knee-extension exercise Effect of cutting the anterior cruciate ligament J Bone Joint Surg66A725-734, 1984
23.
Haffajee DU , Moritz U., Svantesson G. Isometric knee extension strength as a function of joint angle, muscle length and motor unit activity Acta Orthop Scand43. 138-147, 1972
24.
Harnngton IJ : A bioengineering analysis of force actions at the knee in normal and pathological gait Biomed Eng11167-172, 1976
25.
Hatze H. Myocybemetic Control Models of Skeletal Muscle Pretoria , University of South Afnca, 1981
26.
Henning CE, Lynch MA, Glick KR An in vivo strain gage study of elongation of the anterior cruciate ligament Am J Sports Med1322-26, 1985
27.
Huberti HH, Hayes WC Patellofemoral contact pressures The influence of q-angle and tendofemoral contact J Bone Joint Surg66A715-724, 1984
28.
Hungerford DS, Barry M. Biomechanics of the patellofemoral joint Clin Orthop1449-15, 1979
29.
Inman VT, Ralston HJ, Todd F. Human Walking. Baltimore, Williams & Wilkins, 1981, p 154
30.
lseki F., Tomatsu T. The biomechanics of the knee joint with special reference to the contact area Keio J Med2537-44, 1976
31.
Johnson D. Controlling anterior shear during isokinetic knee extension J Orthop Sports Phys Ther423-31, 1982
32.
Jurist KA, Otis JC Anteropostenor tibiofemoral displacements during isometric extension efforts Am J Sports Med13254-258, 1985
33.
Kaufman KR, An KN Chao Eys Incorporation of muscle architecture into the muscle length-tension relationship J Biomech22943-948, 1989
34.
Kaufman KR, An KN, Chao Eys, et al : Comparison of muscle force estimates using linear and nonlinear programming Trans Orthop Res Soc 14 317, 1989
35.
Kaufman KR, An KN, Chao Eys A dynamic mathematical model of the knee joint applied to isokinetic exerase , in Spilker RL, Simon BR (eds). Computational Methods in Bioengineering New York, ASME, pp 157-167, 1988
36.
Lew WD, Lewis JL: An anthropometnc scaling method with application to the knee J Biomech10171-181, 1977
37.
Lieb FJ, Perry J. Quadnceps function An electromyographic study under isometric conditions J Bone Joint Surg53A749-758, 1971
38.
Lieb FJ, Perry J. Quadnceps function An anatomical and mechanical study using amputated limbs J Bone Joint Surg50A1535-1547, 1968
39.
Lindahl O., Movin A. The mechanics of extension of the knee joint Acta Orthop Scand38226-234, 1967
40.
Malcom L., Daniel D. A mechanical substitution technique for cruciate ligament force determinations Trans Orthop Res Soc5303, 1980
41.
Mandt PR, Daniel DM, Biden E., et al Tibial translation with quadnceps force An in-vitro study of the effect of load placement, flexion angle and ACL sectioning Trans Orthop Res Soc 12 243, 1987
42.
Morrison JB The mechanics of the knee joint in relation to normal walking J Biomech3. 51-61, 1970
43.
Mornson JB: Function of the knee joint in various activities. Biomed Eng4573-580,1969
44.
Nisell R., Encson MO, Németh G., et al Tibiofemoral joint forces during isokinetic knee extension Am J Sports Med1749-54, 1989
45.
Noyes FR, Butler DL, Grood ES, et al Biomechanical analysis of human ligament grafts used in knee ligament repairs and reconstructions J Bone Joint Surg66A344-352, 1984
46.
O'Connor JJ , Goodfellow JW, Young SK, et al Mechanical interactions between the muscles and the cruciate ligaments in the knee Trans Orthop Res Soc 10 140, 1985
47.
Otis JC, Gould JD The effect of external load on torque production by knee extensors J Bone Joint Surg68A65-70, 1986
48.
Patriarco AJ The predictions of individual muscle forces during human movement PhD Thesis, Harvard University, Cambndge, MA, 1982
49.
Paulos L., Noyes FR, Grood ES, et al Knee rehabilitation after anterior cruciate ligament reconstruction and repair Am J Sports Med9140-149, 1981
50.
Reilly DT, Martens M. Experimental analysis of the quadnceps muscle force and patello-femoral joint reaction force for various activities Acta Orthop Scand43126-137, 1972
51.
Renstrom P. , Arms SW, Stanwyck TS, et al Strain within the anterior cruciate ligament during hamstring and quadriceps activity. Am J Sports Med1483-87, 1986
52.
Smidt GL Biomechanical analysis of knee flexion and extension J Biomech679-92, 1973
53.
Smith AJ Estimates of muscle and joint force at the knee and ankle during jumping activities J Human Movement Stud178-86, 1975
54.
Smith MJ: Muscle fiber types Their relationship to athletic training and rehabilitation Orthop Clin North Am14403-411, 1983
55.
Solomonow M. , Baratta R., D'Ambrosia R., et al Electromyography of the anterior cruciate deficient knee Trans Orthop Res Soc 13 318, 1988
56.
van Eijden Tmgj, DeBoer W., Weijs WA The orientation of the distal part of the quadnceps femons muscle as a function of the knee flexion-extension angle J Biomech18803-809, 1985
57.
van Eijden Tmgj, Kouwenhoven E., Verburg J., et al: A mathematical model of the patellofemoral joint J Biomech19219-229, 1986
58.
Winter DA, Wells RP, Orr GW Errors in the use of isokinetic dynamometers Eur J Appl Physiol46397-408, 1981
59.
Woittiez RD , Huijing PA, Boom Hbk, et al A three-dimensional muscle model A quantified relation between form and function of skeletal muscles J Morphol18295-113, 1984
60.
Woltring HJ A Fortran package for generalized, cross-validatory spline smoothing and differentiation Adv Eng Software8104-113, 1986
61.
Yasuda K., Sasaki T. Muscle exercise after anterior cruciate ligament reconstruction Clin Orthop220266-283, 1987
62.
Zernicke RF , Garhammer J., Jobe FW Human patellar-tendon rupture A kinetic analysis. J Bone Joint Surg59A. 179-183, 1977
