The effect of sustained static kneeling on knee joint gait parameters
Epidemiological studies have identified kneeling as an occupational risk factor for knee
joint osteoarthritis (KOA), but direct biomechanical evidence for this relationship is lacking. We
hypothesize one mechanism by which prolonged static kneeling may cause KOA is by
compromising the integrity of the knee joint thereby increasing knee joint instability, which
manifests as altered ambulatory loading profiles. Therefore, the purpose of this exploratory study
was to investigate the effect of sustained static kneeling on knee joint gait parameters.
Ten healthy male subjects (24.1 years ± 3.5) volunteered for this study. Each subject’s
dominant leg was instrumented with markers to track lower limb motion and with surface
electromyography electrodes to record quadriceps, hamstrings, and gastrocnemius muscle
activity. Subjects performed ten walking trials at a self-selected normal pace over a force plate
embedded in the floor. They then performed a kneeling protocol of three bouts of ten minutes of
kneeling, each separated by a five minute seated rest period. Subsequently, a set of ten walking
trials were performed after a short rest and equipment verification period.
The ground reaction force and motion data were used to calculate the peak knee
adduction moments, knee flexion moments, and knee flexion angles during the stance phase. The
total muscle activity for each muscle during a single gait cycle as well as the co-contraction of the
medial thigh muscles and the lateral thigh muscles were calculated from the surface
electromyography data. One-sample t-tests were run on the absolute value of the pre- and postkneeling
outcome measures. All outcome measures were different across conditions indicating
that the loading patterns were altered, in no specific direction, as a result of the static kneeling
These results offer preliminary evidence to support the epidemiological findings that
thirty minutes of daily occupational kneeling is associated with a higher prevalence of KOA.
Further investigation is required to explore the importance of post-kneeling recovery, postureinduced
blood occlusion, and cartilage stress due to cumulative loading while kneeling, as well as
to test the clinical significance of the present findings.
Advisor:Queen's University (Kingston, Ont.). Theses (Queen's University (Kingston, Ont.)); Patrick Costigan; Kinesiology & Health Studies
Source Type:Master's Thesis
Keywords:kneeling knee osteoarthritis occupation
Date of Publication:08/11/2008