Non-driving intersegmental knee moments in cycling computed using a model that includes three-dimensional kinematics of the shank/foot and the effect of simplifying assumptions

Assessing the importance of non-driving intersegmental knee moments (i.e. varus/valgus and internal/external axial moments) on over-use knee injuries in cycling requires the use of a three-dimensional (3-D) model to compute these loads. The objectives of this study were: (1) to develop a complete, 3-D model of the lower limb to calculate the 3-D knee loads during pedaling for a sample of the competitive cycling population, and (2) to examine the effects of simplifying assumptions on the calculations of the non-driving knee moments. The non-driving knee moments were computed using a complete 3-D model that allowed three rotational degrees of freedom at the knee joint, included the 3-D inertial loads of the shank/foot, and computed knee loads in a shank-fixed coordinate system. All input data, which included the 3-D segment kinematics and the six pedal load components, were collected from the right limb of 15 competitive cyclists while pedaling at 225 W and 90 rpm. On average, the peak varus and internal axial moments of 7.8 and 1.5 N m respectively occurred during the power stroke whereas the peak valgus and external axial moments of 8.1 and 2.5 N m respectively occurred during the recovery stroke. However, the non-driving knee moments were highly variable between subjects; the coefficients of variability in the peak values ranged from 38.7% to 72.6%. When it was assumed that the inertial loads of the shank/foot for motion out of the sagittal plane were zero, the root-mean-squared difference (RMSD) in the non-driving knee moments relative to those for the complete model was 12% of the peak varus/valgus moment and 25% of the peak axial moment. When it was also assumed that the knee joint was revolute with the flexion/extension axis perpendicular to the sagittal plane, the RMSD increased to 24% of the peak varus/valgus moment and 204% of the peak axial moment. Thus, the 3-D orientation of the shank segment has a major affect on the computation of the non-driving knee moments, while the inertial contributions to these loads for motions out of the sagittal plane are less important.