Publications by authors named "Kerry Costello"

Recent advancements in computer vision and machine learning enable autonomous measurement of total knee arthroplasty kinematics through single-plane fluoroscopy. However, symmetric components present challenges in optimization routines, causing "symmetry traps" and ambiguous poses. Achieving clinically robust kinematics measurement requires addressing this issue.

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Background: People with knee osteoarthritis walk with excessive muscle co-contraction that can accelerate disease progression. Central pain sensitization is common in people with knee osteoarthritis and may be related to walking patterns. The objective of this study was to examine the relation of central pain sensitization with muscle co-contraction during walking in people with knee osteoarthritis.

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Objective: To (1) develop and evaluate a machine learning model incorporating gait and physical activity to predict medial tibiofemoral cartilage worsening over 2 years in individuals without advanced knee osteoarthritis and (2) identify influential predictors in the model and quantify their effect on cartilage worsening.

Design: An ensemble machine learning model was developed to predict worsened cartilage MRI Osteoarthritis Knee Score at follow-up from gait, physical activity, clinical and demographic data from the Multicenter Osteoarthritis Study. Model performance was evaluated in repeated cross-validations.

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Objective: To examine changes in physical activity, sleep, pain and mood in people with knee osteoarthritis (OA) during the ongoing COVID-19 pandemic by leveraging an ongoing randomized clinical trial (RCT).

Methods: Participants enrolled in a 12-month parallel two-arm RCT (NCT03064139) interrupted by the COVID-19 pandemic wore an activity monitor (Fitbit Charge 3) and filled out custom weekly surveys rating knee pain, mood, and sleep as part of the study. Data from 30 weeks of the parent study were used for this analysis.

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Background: With the increasing adoption of high-speed internet and mobile technologies by older adults, digital health is a promising modality to enhance clinical care for people with knee osteoarthritis (KOA), including those with knee replacement (KR).

Objective: This study aimed to summarize the current use, cost-effectiveness, and patient and clinician perspectives of digital health for intervention delivery in KOA and KR.

Methods: In this narrative review, search terms such as mobile health, smartphone, mobile application, mobile technology, ehealth, text message, internet, knee osteoarthritis, total knee arthroplasty, and knee replacement were used in the PubMed and Embase databases between October 2018 and February 2021.

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Background: Measuring and modifying movement-related joint loading is integral to the management of lower extremity osteoarthritis (OA). Although traditional approaches rely on measurements made within the laboratory or clinical environments, inertial sensors provide an opportunity to quantify these outcomes in patients' natural environments, providing greater ecological validity and opportunities to develop large data sets of movement data for the development of OA interventions.

Objective: This narrative review aimed to discuss and summarize recent developments in the use of inertial sensors for assessing movement during daily activities in individuals with hip and knee OA and to identify how this may translate to improved remote health care for this population.

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Objective: Although gait analysis provides an estimate of joint loading magnitude and patterns during a typical step, accelerometry provides information about loading frequency. Understanding the relationships between these components of loading and knee osteoarthritis (OA) progression may improve conservative management, as gait interventions may need to account for physical activity levels or vice versa. The primary objective was to examine relationships between gait patterns that have previously been associated with OA progression and accelerometer-derived metrics of loading frequency.

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Objective: To determine associations between knee moment features linked to osteoarthritis (OA) progression, gait muscle activation patterns, and strength.

Design: Cross-sectional secondary analysis.

Setting: Gait laboratory.

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Podcasts are portable digital audio files that have become a powerful medium in higher education and an indispensable tool in continuing medical education. This article reviews the best sources for educational podcasts on osteoarthritis (OA) and various aspects of synovial joint biology. It highlights the potential of podcasting for disseminating research findings, providing continuing medical education for healthcare professionals and educating patients about self-managing their condition.

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Background: Varus thrust during walking, visualized as excessive frontal plane knee motion during weight acceptance, is a modifiable risk factor for progression of knee osteoarthritis. However, visual assessment does not capture thrust severity and quantification with optical motion capture is often not feasible. Inertial sensors may provide a convenient alternative to optical motion capture.

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Varus thrust during walking is common in people with knee osteoarthritis (OA) and can increase the risk of disease progression. Lower limb muscle strength, particularly isokinetic strength, may play a role in varus thrust. The purpose of this study was to investigate the relationships between varus thrust and isokinetic strength knee extensors and flexors in people with and without knee OA .

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Article Synopsis
  • Both structural and clinical changes related to knee osteoarthritis progression can occur independently, and understanding mechanical factors involved may enhance conservative treatment strategies.
  • A study assessed gait differences in patients over an average of 7 years, revealing that muscle activation and knee moments differed significantly between those who progressed and those who did not, depending on which progression indicators were used (radiographic and arthroplasty).
  • Findings suggest that prolonged muscle activation could be linked to the need for total knee replacement, while radiographic changes are more associated with how much load is placed on the knee during movement.
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Objective: To determine if baseline quadriceps and hamstrings muscle activity patterns differed between those with medial-compartment knee osteoarthritis (OA) who advanced to total knee arthroplasty (TKA) and those who did not advance to TKA, and to examine associations between features extracted from principal component analysis (PCA) and discrete measures.

Methods: Surface electromyograms of the vastus lateralis and medialis, rectus femoris, and lateral and medial hamstrings during walking were collected from 54 individuals with knee OA. Amplitude and temporal characteristics from PCA, co-contraction indices (CCI) for lateral and medial muscle pairs, and root mean square (RMS) amplitudes for early, mid, late, and overall stance were calculated from electromyographic waveforms.

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Purpose: Currently there are many functional knee braces but very few designed to treat the posterior cruciate ligament (PCL). No PCL braces have been biomechanically validated to demonstrate that they provide stability with proper force distribution to the PCL-deficient knee. The purpose of this review was to evaluate the history and current state of PCL bracing and to identify areas where further progress is required to improve patient outcomes and treatment options.

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Background: Human balance during quiet standing is influenced by adding mass to the body with a backpack, with symmetrically-applied loads to the trunk, or with obesity. Adding mass to the body increases both the weight and inertia of the body, which theoretically could provide counteracting effects on body dynamics and balance. Understanding the independent effects of adding weight and inertia on balance may provide additional insight into human balance that could lead to novel advancements in balance training and rehabilitation.

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Osteoarthritis (OA) is a risk factor for physical inactivity and impaired mobility, but it is not well understood how these locomotor behaviors are affected by the age of onset of OA and disease severity. Male mice homozygous for a Col9a1 gene inactivation (Col9a1(-/-)) develop early onset knee OA, increased tactile pain sensitivity, and gait alterations by 9 mo of age. We hypothesized that aged Col9a1(-/-) mice would reduce joint pain by adopting locomotor behaviors that reduce both the magnitude and daily frequency of joint loading.

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