Clinically assessed mediolateral knee motion: Impact on gait

Objective: Mediolateral knee movement can be assessed visually with clinical tests. A knee-medial-to-foot position is associated with an increased risk of knee injuries and pathologies. However, the implications of such findings on daily tasks are not well understood. The aim of this study was to investigate if a knee-medial-to-foot position assessed during a clinical test was associated with altered hip and knee joint kinematics and knee joint kinetics during gait compared with those with a knee-over-foot position.

Design: Participants were visually assessed during a single-limb mini squat test and classified by a physiotherapist as exhibiting either a knee-medial-to-foot or knee-over-foot position. A comparison of 3-dimensional hip and knee gait kinematics and kinetics between the knee-over-foot and knee-medial-to-foot classifications was performed.

Setting: Research laboratory.

Participants: Twenty-five healthy participants were recruited and visually assessed as either knee-over-foot (n = 15; 26.2 ± 6.1 years) or knee-medial-to-foot (n = 10; 24.8 ± 4.1 years).

Main Outcome Measures: Peak knee valgus angle and peak internal hip rotation during normal gait.

Results: No differences were observed in peak knee valgus angle [3.6 (3.7) vs 5.2 (2.5) degrees; P = 0.19], peak internal hip rotation [8.4 (7.0) vs 4.3 (8.1) degrees; P = 0.21], or knee joint kinetics between groups.

Conclusions: A knee-medial-to-foot position observed during the single-limb mini squat was not reflected during gait measured by 3-dimensional motion analysis in knee healthy individuals. Furthermore, those assessed to have a knee-medial-to-foot position did not display increased loading of the knee joint compared with the knee-over-foot group. Care should be taken when extrapolating results from one movement to another.