Minimum Detectable Change in Medial Tibiofemoral Contact Force Parameters: Derivation and Application to a Load-Altering Intervention

Medial tibiofemoral joint contact forces can be estimated using musculoskeletal models. To assess change in these forces that accompany load-modifying interventions, minimum detectable change (MDC) thresholds must be established. The primary study purpose was to derive MDCs for medial tibiofemoral peak force and force impulse during walking. The secondary purpose was to identify the proportions of individuals exhibiting reductions greater than these MDCs when walking with lateral foot wedging. Eight healthy individuals provided 3-dimensional gait data over 3 test sessions to serve as inputs for an inverse dynamics-driven medial tibiofemoral contact force model, from which MDCs for peak force and impulse were derived. The MDC was 0.246 BW (8.7%) for peak force and 0.0385 BW.s (3.7%) for impulse. Then, 25 healthy individuals provided gait data by walking with and without 6 degrees laterally wedged foot orthoses, and the proportion of individuals exhibiting changes in medial tibiofemoral contact peak force and impulse values exceeding the MDC threshold was determined. For impulse and peak force, 52% and 4% of participants exhibited a decrease exceeding the MDC, respectively. In summary, medial tibiofemoral contact force MDCs were derived, with impulse showing greater sensitivity than peak force to the effects of a biomechanical intervention.