Graduation Semester and Year

Summer 2025

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Kinesiology

Department

Kinesiology

First Advisor

Dr. Mark Ricard

Second Advisor

Dr. Merideth Decker

Third Advisor

Dr. Micheal Torry

Fourth Advisor

Dr. Thomas Kernozek

Abstract

Knee osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage deterioration, chronic pain, and reduced mobility. Alterations in gait mechanics, particularly increased knee adduction moment (KAM) and tibial shock, are strongly associated with OA onset and progression. These biomechanical markers reflect abnormal joint loading and provide valuable insights for developing non-invasive interventions. This dissertation investigates how modifiable external factors, specifically walking slope, footwear type, and walking speed, influence knee joint loading patterns. The goal is to inform rehabilitation strategies that can decrease joint stress, alleviate symptoms, and slow disease progression.

Study 1 examines the effects of walking slope (uphill 10 degrees, level, and downhill 10 degrees) on knee joint biomechanics. Using three-dimensional gait analysis, the study quantifies changes in KAM and tibial shock in response to slope variation in individuals with and without OA. Results indicate that uphill walking significantly reduces medial compartment loading by increasing hip and knee flexion and promoting extensor muscle activation. In contrast, downhill walking markedly increases mechanical stress through elevated KAM and vertical ground reaction forces, highlighting its potential to aggravate cartilage degeneration. These findings suggest that slope-specific walking recommendations may serve as a targeted intervention for OA management.

Study 2 investigates the combined effects of footwear type and walking speed on knee joint loading. Participants walked in two footwear conditions (barefoot, Hoka One One) at three walking speeds (0.5m/s, 0.8 m/s, and 1.2m/s). Findings show that minimalist and biomechanically-modified footwear can reduce KAM compared to conventional shoes, particularly at higher walking speeds. However, the effectiveness of each footwear type varied with speed, indicating that the interaction between these two factors is not simply additive. This combined analysis emphasizes the need for personalized gait interventions, where footwear choice and walking speed are considered together to maximize biomechanical benefit and reduce OA-related joint stress.

These findings provide a comprehensive evaluation of how walking slope, footwear type, and walking speed affect knee joint loading in individuals with and without osteoarthritis. By identifying how each of these modifiable factors influences key biomechanical markers such as KAM and tibial shock, this dissertation aims to uncover practical strategies for reducing harmful joint forces during walking. The overarching goal is to inform the design of personalized, biomechanically-informed interventions, such as tailored walking programs, footwear recommendations, and rehabilitation protocols, that can optimize joint loading, alleviate pain, improve mobility, and ultimately slow the progression of knee osteoarthritis. These findings are intended to bridge a critical gap between biomechanical theory and clinical application, offering actionable insights for clinicians, therapists, and individuals managing OA through conservative, non-invasive means.

Keywords

Knee, Osteoarthritis, Knee adduction moment, Tibial Compression, Tibial Shock, Footwear, Grade, Speed

Disciplines

Life Sciences

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Included in

Life Sciences Commons

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