Effects of Workloads and Cadences on Frontal

Plane Knee Biomechanics in Cycling

YING FANG1, EUGENE C. FITZHUGH1, SCOTT E. CROUTER1, JACOB K. GARDNER2, and SONGNING ZHANG1
1
Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN; 2Department of
Kinesiology, Health, and Physical Education, Biola University, La Mirada, CA

ABSTRACT
FANG, Y., E. C. FITZHUGH, S. E. CROUTER, J. K. GARDNER, and S. ZHANG. Effects of Workloads and Cadences on Frontal
Plane Knee Biomechanics in Cycling. Med. Sci. Sports Exerc., Vol. 48, No. 2, pp. 260–266, 2016. Although effects of workload and
cadence on sagittal plane knee biomechanics in cycling have been widely studied, few studies have examined their impact on the frontal
plane. Purpose: The purpose of this study was to investigate the effects of different workloads and cadences on knee sagittal and frontal
plane biomechanics. Methods: Eighteen healthy participants (age, 55.7 T 11.0 yr) volunteered for this study. A motion analysis
system and a custom instrumented pedal were used to collect five cycles of three-dimensional kinematics (240 Hz) and pedal reaction
force (PRF, 1200 Hz) during 2 min of cycling in each of eight testing conditions, including five workload conditions of 0.5, 1, 1.5, 2, and
2.5 kg at 60 rpm, and three cadence conditions of 70, 80, and 90 rpm with 1-kg workload. Two one-way repeated measures analyses of
variance were used to examine the influence of cadence and workload on selected variables (P G 0.05). Results: Increased workloads
with constant rpm caused an increased peak knee abduction moment from 5.82 to 14.36 NIm and peak knee extension moment from
11.61 to 37.16 NIm. Increased workloads also significantly increased peak medial and vertical PRF. Increased cadences at the constant
workload had no effects on peak knee abduction moment but caused increased peak anterior and vertical PRF and peak knee flexion
moment. Conclusions: The findings of this study indicate that increasing workload at constant cadence significantly increased peak
knee abduction moment. Further study may be needed to demonstrate the efficacy of appropriate levels of workload and cadence in
knee osteoarthritis and other populations with knee problems. Key Words: KNEE ABDUCTION MOMENT, KNEE ADDUCTION
MOMENT, KNEE FLEXION MOMENT, KNEE OSTEOARTHRITIS, CYCLING ERGOMETER

C
ycling is a popular recreational activity that can pro-
vide health benefits and improve cardiovascular fit-
ness (27). Compared with walking or jogging,
cycling allows an individual to work on muscle strength and
lower extremity mobility while avoiding high impact loading
to the lower extremity joints (21,22,31). Peak knee contact
force can reach 0.5 to 1.6 body weight in cycling compared
with 2.5 body weight in walking (22). Cycling is also a
recommended exercise for individuals with knee osteo-
arthritis (OA) and other knee pathologies (22,23,25). Despite
its potential benefits, literature on knee biomechanics, espe-
cially the frontal plane, in stationary cycling is rather limited.
In cycling, knee biomechanics in the sagittal plane has
been widely studied. Most driving power and force comes
from knee extension during the power phase and flexion
APPLIED SCIENCES
during the recovery phase (15). Cycling workload and ca-
dence are two variables that can influence the pedal reac-
tion force (PRF) and further affect knee load. A number of
research studies have examined the effects of workload
and cadence on sagittal plane knee kinematics and kinetics
(4–6,9,10,12,13,24,29). It has been shown in most studies
that changes in workload and cadence have little effect on
changes in knee range of motion (ROM), peak knee angles
(5,10,12), and increasing workload results in increased knee
moment (13,26). However, the effects of cadence on peak
knee moments are varied in the literature (13,29). Redfield
and Hull (29) reported unchanged knee extension moment
and flexion moment with increased cadence at a constant
work rate, whereas Ericson et al. (13) found increased knee
flexion moments and unchanged knee extension moments

across cadences at a constant workload. The discrepancy in

these results may be partially related to two different types
Address for correspondence: Songning Zhang, Ph.D., Biomechanics/Sports
of cycle ergometers used in different studies. Both weighted
Medicine Lab, Department of Kinesiology, Recreation, & Sport Studies,
The University of Tennessee, 1914 Andy Holt Avenue, Knoxville, TN; brake and electromagnetically braked systems have been
E-mail: szhang@utk.edu. widely used. For the latter, the workload decreases as the
Submitted for publication August 2014. cadence increases to maintain a given work rate, which can
Accepted for publication August 2015. explain the unchanged knee moment results (29).
0195-9131/16/4802-0260/0 For patients with medial compartment knee OA and other
MEDICINE & SCIENCE IN SPORTS & EXERCISEÒ knee pathologies, it is important to understand not only the
Copyright Ó 2015 by the American College of Sports Medicine sagittal plane knee joint kinetics (e.g., joint moment), which
DOI: 10.1249/MSS.0000000000000759 dictates the overall loading level to the knee, but also the

260

Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
frontal plane knee abduction moment that reflects loading to
the medial knee compartment during cycling (2,7,25). There
are limited studies examining the frontal plane knee kinetics,
which show varied results with the knee abduction moment
and adduction moment ranging from 7.8 to 24.5 NIm and 2.9
to 11.2 NIm, respectively (11,18,20,30). The difference in
magnitude of knee frontal plane moment seen across these
studies may be related to the different cadence and workload
used in these studies. In addition, these studies used partic-
ipants with differing levels of cycling experiences, for ex-
ample, recreational cyclists (14), competitive cyclists (20),
both recreational and competitive cyclists (30), knee OA
patients, and healthy participants (18).
To our knowledge, there are no previous cycling studies
that have examined the influences of different workloads and
cadences on frontal plane knee kinematics and kinetics. Fur-
thermore, previous studies have primarily used young healthy
male participants or knee patients (1,4–6,9–13), whereas cy-
cling data in middle-age and older populations are lacking.
Thus, studies are needed to examine the effects of workload
and cadence on frontal plane knee variables, especially in-
ternal knee abduction moment, to provide research evidence
for prescribing cycling as a therapy for knee orthopedic pa-
tients. Therefore, the purpose of this study was to examine the
effects of different cycling workloads and cadences on knee
sagittal and frontal plane biomechanics in middle-age and
older adults. It was hypothesized that increased workload at a
constant cadence would increase peak knee abduction mo-
ment and peak knee extension moment in cycling and that
increased cadence at a constant workload would not change
peak knee abduction moment or peak knee extension moment.
METHODS
Participants
Eighteen healthy male and female participants between 40
and 79 yr of age (age, 55.8 T 11.0 yr, height: 1.80 T 0.10 m,
weight: 78.8 T 16.3 kg) with recreational cycling experience
participated in this study. The participants were free from
lower extremity injuries within the past 6 months and were
able to ride a stationary bike without any aid. A sample size
of 16 was estimated in a power analysis for a repeated
measures analyses of variance with a conservative and small
effect size of 0.25, a A level of 0.8, and > level of 0.05
(G*Power 3.1) (16). Each participant was asked to read and
sign an informed consent approved by the institutional re-
view board before testing.
Instrumentation
A nine-camera motion analysis system (240 Hz; Vicon
Motion Analysis Inc., UK) was used to collect three-
dimensional (3D) kinematic and kinetic data. Reflective
anatomical markers were placed bilaterally on the partici-
pant at the first and fifth metatarsals, medial and lateral
malleoli, medial and lateral epicondyles, great trochanters,
CYCLING WORKLOAD ON KNEE BIOMECHANICS
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
iliac crests, and acromion processes. A pedal anatomical
marker was placed on the midpoint of the front edge of both
pedals. Semirigid thermoplastic shells with four noncol-
linear reflective tracking markers were attached to the trunk,
pelvis, thighs, and shanks. Reflective tracking markers were
placed on the outer surface of the shoe at the superior, infe-
rior, and lateral heel. Three pedal tracking markers were
placed on the lateral side of both pedals, and a crank tracking
marker was placed on the crank axis of both cranks. The
participants wore standard lab shoes (Noveto, Adidas).
A Monark Ergometer (Model 818E, Monark, Varberg,
Sweden) was used for the cycle testing. The ergometer was
equipped with a weighted brake so that the workload could
be fixed as the pedal cadence changes. The handlebar and
seat height (adjustable upward and downward and anteriorly
and posteriorly) were adjusted to fit each rider. The seat
height was set so that the participant_s knee angle was at
150- of flexion when the crank was at the bottom dead
center (3,34). The position of the handlebars was modified
so that the angle between the participant_s trunk and thigh
was 90- when the crank is at 90-.
A customized bike pedal instrumented with two 3D force
sensors (1200 Hz, Type 9027C; Kistler, Switzerland) coupled
with two industrial charge amplifiers (Type 5073A and 5072A;
Kistler) was placed on the left side of the ergometer to mea-
sure 3D forces and moments (18). The PRF data from the
instrumented pedal was recorded by the Vicon system and its
Nexus software simultaneously with the 3D kinematic data. A
dummy pedal with the same mass and design was used on the
right side. To ensure the pedal coordinate system aligned with
the global coordinate system (origin set at the corner of the
left force platform), a customized jig was used to secure the
front support base of the bike on two predrilled parallel
holes of the right force platform. This ensured that the y-axis
of the pedal coordinate system was set parallel to the y-axis
of the global coordinate system (Fig. 1).
Experimental Protocol
Upon arrival to the laboratory, participants cycled for
3 min to warm up and get used to the cycle ergometer and
cycling position. Following the warm-up, participants cy-
cled for 2 min at each of 8 testing conditions that included
five workload conditions (0.5, 1, 1.5, 2, and 2.5 kg) at 60 rpm APPLIED SCIENCES
and four cadence conditions (60, 70, 80, and 90 rpm) at a
workload of 1 kg. The cycling conditions were randomized.
Data were collected for at least five consecutive pedaling
cycles defined from top dead center (0-) to top dead center
(360-), which began during the last 30 s of each condition.
Participants were given sufficient amount of time (a minimum
of 2 min) to rest between conditions.
Data and Statistical Analysis
The consecutive pedal cycles were separated to obtain
five individual trials from top dead center (0-) to top dead
Medicine & Science in Sports & Exercised 261
 majority of the participant_s weight was carried by the seat
and handlebars.
Two separate one-way repeated measures analyses of var-
iance were used to examine the influence of cadence and
workload on each variable, respectively (IBM SPSS Statistics
20, Chicago, IL). If a main effect was significant, post hoc
analysis was performed using pairwise t tests with Bonferroni
adjustments. An alpha level of 0.05 was set a priori.

FIGURE 1—Testing equipment setup. The global coordinate system is
illustrated with its origin set at the corner of the left force platform (A).
A customized jig (B) was used to secure the front support base of the
bike on the two predrilled parallel holes on the right force platform (C)
to align the y-axis of the bike_s (and pedal_s) coordinate system with the
y-axis of the global coordinate system.
center (360-) in Vicon Nexus. The raw kinematic and ki-
netic data were filtered using a low-pass fourth order
Butterworth filter with zero lag at a cutoff frequency of 6 Hz
(18–21). Visual 3D (C-Motion Inc.) was used to com-
pute PRFs and joint kinematics and kinetics. The X–Y–Z
Cardan rotation sequence was used in computing joint
angles. A right-hand rule was used to determine the polar-
ity of the joint angles and joint kinetic data. All moments
were computed as internal moments. Peak angles, velocities,
moments, and powers were determined using a customized
program (VB_V3D, MS VisualBASIC 6.0), and selected
variables were further organized for statistical analysis and
reports using another customized program (VB_Table, MS
VisualBASIC 6.0). It should be noted that the pedal force
and joint moment variables were not normalized as the
RESULTS
Effects of Workload on Knee Biomechanics
Increased workload significantly increased peak knee ab-
duction moment (F(3,4) = 10.944, P = 0.039), which was
smaller in 0.5 kg compared with 1.5 (P = 0.027, effect size
(ES) = 1.00) and 2.5 kg (P = 0.007, ES = 1.70) and in both 1
(P = 0.028, ES = 0.80) and 1.5 (P = 0.031, ES = 0.72) than
2.5 kg (Table 1). There was a significant effect of workload
on peak medial PRF (F(4,13) = 11.8, P G 0.001). The post hoc
comparisons showed that the medial PRF was smaller in 0.5
than 1 kg (P = 0.047, ES = 0.70), 1.5 kg (P = 0.002, ES =
1.05), 2 kg (P = 0.002, ES = 0.95), and 2.5 kg (P G 0.001,
ES = 1.16) and smaller in 1 kg than 1.5 kg (P = 0.01, ES =
0.43) and 2 kg (P = 0.001, ES = 0.77). Increased workload
also caused increased peak vertical PRF (F(4,13) = 47.90, P G
0.001), and significant increases existed between each pair
of the workloads (P G 0.001, ES = 0.70–2.49).
Peak knee extension moment significantly increased with
increased workload (F(4,14) = 33.043, P G 0.001). Significant
increases were seen between all pairs of workloads from 0.5
to 2.5 kg (P o 0.003, ES = 0.70–2.44), except for difference
between 2 and 2.5 kg (Table 1). In addition, there was a sig-
nificant workload effect for knee extension ROM (F(4,14) =
7.78, P = 0.002, ES = 0.23–0.54).
Effects of Cadence on Knee Biomechanics
There was no significant effect of cadence on peak knee
abduction moment or peak medial PRF. Peak knee flexion
moment significantly increased with increasing cadence

TABLE 1. Peak PRF, knee kinematics, and peak knee kinetics variables at different workloads and 60 rpm (mean T SD).
Variable 0.5 kg 1 kg 1.5 kg 2 kg 2.5 kg P
APPLIED SCIENCES

PRF
Medial PRF (N) 7.97 T 19.83a,b,c,d 20.44 T 15.53b,c 27.58 T 17.58 34.82 T 21.37 36.01 T 27.84 G0.001
Anterior PRF (N) 35.21 T 12.30 34.25 T 12.40 32.80 T 11.39 32.58 T 11.40 34.56 T 11.86 0.128
Vertical PRF (N) 153.02 T 42.34a,b,c,d 194.16 T 51.76b,c,d 229.90 T 59.61c,d 272.46 T 65.50d 304.00 T 74.76 G0.001
Knee kinematics
Extension ROM (-) 76.87 T 5.33b,c,d 77.74 T 5.68c 78.93 T 6.23c 80.31 T 5.89 79.93 T 5.95 0.002
Peak adduction angle (-) 5.89 T 6.44 5.83 T 5.80 6.56 T 5.88 6.64 T 5.69 7.16 T 5.96 0.076
Knee kinetics
Extension moment (NIm) 11.61 T 6.84a,b,c,d 20.23 T 7.82b,c,d 26.04 T 8.68c,d 34.23 T 10.90 37.16 T 13.11 G0.001
Flexion moment (NIm) j17.41 T 9.60 j16.69 T 8.15 j17.02 T 9.17 j16.57 T 9.30 j19.70 T 8.96 0.189
Abduction moment (NIm)* j5.82 T 3.26b,d j9.50 T 5.92d j10.18 T 5.21d j11.60 T 6.74 j14.36 T 6.30 0.039
Adduction moment (NIm)** 9.52 T 10.32 6.12 T 7.09 9.09 T 8.37 12.68 T 12.04 16.00 T 13.50 0.266
ROM, range of motion; aSignificantly different from 1 kg; bSignificantly different from 1.5 kg; cSignificantly different from 2 kg; dSignificantly different from 2.5 kg; all P G 0.05.
*Seven subjects of 18 showed this pattern; **Ten subjects of 18 showed this pattern. Positive values refer to medial, anterior, or vertical PRF, knee extension and adduction angle, and
knee extension and adduction moment.

262 Official Journal of the American College of Sports Medicine http://www.acsm-msse.org

Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
TABLE 2. Peak PRF, knee kinematics, and peak knee kinetics variables at different cadences and 1 kg workload (mean T SD).
Variable 60 rpm 70 rpm 80 rpm 90 rpm P
PRF
Medial PRF (N) 21.67 T 15.94 23.32 T 17.18 20.81 T 15.95 20.03 T 12.16 0.398
Anterior PRF (N) 34.25 T 12.40a,b,c 38.85 T 12.57b,c 44.18 T 13.84c 52.04 T 17.70 G0.001
Vertical PRF (N) 196.50 T 51.18 202.50 T 55.08 202.16 T 51.45 203.60 T 50.93 0.316
Knee kinematics
Extension ROM (-) 77.74 T 5.68 78.38 T 5.33 77.54 T 5.60 76.04 T 7.99 0.15
Peak adduction angle (-) 5.35 T 5.95 5.42 T 5.89 6.21 T 6.27 5.96 T 5.97 0.094
Knee kinetics
Extension moment (NIm) 20.23 T 7.82 22.26 T 8.79 22.33 T 7.98 24.50 T 10.63 0.126
Flexion moment (NIm) j16.69 T 8.15b,c j18.07 T 7.82c j20.67 T 8.62 j21.51 T 8.42 G0.001
Abduction moment (NIm)* j9.49 T 5.92 j7.07 T 3.53 j7.03 T 4.30 j7.54 T 4.57 0.754
Adduction moment (NIm)** 6.12 T 7.09 5.92 T 9.41 7.64 T 8.98 8.34 T 7.05 0.396
ROM, range of motion; rpm, revolutions per minute; aSignificantly different from 70 rpm; bSignificantly different from 80 rpm; cSignificantly different from 90 rpm, all P G 0.005.
*Seven subjects of 18 showed this pattern; **Ten subjects of 18 showed this pattern. Positive values refer to medial, anterior, or vertical PRF, knee extension and adduction angle, and
knee extension and adduction moment.

(F(3,15) = 12.52, P G 0.001). It was significantly smaller at main contributing factor to this discrepancy may be related to
60 rpm than 80 rpm (P G 0.001, ES = 0.47) and 90 rpm (P = the direction of the PRF in relation to the knee in frontal
0.003, ES = 0.58) and at 70 rpm compared with 90 rpm (P = plane. When the PRF vector is directed toward the medial
0.001, ES = 0.42; Table 2). Increased cadence also introduced side of the knee, it generates an external knee adduction (in-
greater peak anterior PRF (F(3,15) = 26.52, P G 0.001, ES = ternal abduction) moment (Fig. 3A). In contrast, when the
0.37–1.16). vector is directed toward the lateral side of knee joint, it
generates an external knee abduction (internal adduction)
DISCUSSION moment (Fig. 3B). As for the PRF vector, two variables may
The purpose of this study was to examine the effects of influence its direction in cycling, ankle and knee positions in
cycling cadence and workload on knee biomechanics, es-
pecially in the frontal plane. The hypotheses were that
increased workload at a constant cadence would cause in-
creased peak knee abduction moment and peak knee exten-
sion moment and increased cadence at a constant workload
would not change peak knee abduction moment or peak
knee extension moment. The hypothesis related to increased
workload was supported by our results.

Effects of Workload on Knee Biomechanics

Peak knee abduction moments increased with augmented
workloads, which included 63%, 7%, 14%, and 24% increases
of the moment for workload changes from 0.5 to 1 kg, 1 to
1.5 kg, 1.5 to 2 kg, and 2 to 2.5 kg, respectively. The increased
abduction moment indicated higher loading to the medial knee
compartment when the workload increased. These increases
should be examined in conjunction with the overall loading
changes reflected in peak knee extension moments. The
change of workload from 0.5 to 1 kg showed the most dra-
matic effect on the peak knee abduction moment. This may
APPLIED SCIENCES
be related to the fact that the workload of 0.5 kg posted very
little load to the knee, and the subjects saw a dramatic in-
creased demand with the workload changed from 0.5 to 1 kg.
The related increase in the peak knee extension moment was
also the greatest between these two loading conditions (79%)
compared with the changes between the other conditions.
Another interesting finding is that the participants in this
study demonstrated two different frontal plane knee moment
patterns. Seven of the participants showed an abduction mo-
ment (Fig. 2A), whereas the other 11 demonstrated an ad- FIGURE 2—Representative curves of knee abduction moment (A) and
duction moment throughout the power phase (Fig. 2B). The knee adduction moment (B).

CYCLING WORKLOAD ON KNEE BIOMECHANICS Medicine & Science in Sports & Exercised 263

Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
 FIGURE 3—Pedal reaction force vector is directed to the lateral side of the knee, generating external knee abduction moment (internal adduction
moment) (A). Pedal reaction force vector is directed to the medial side of the knee, generating external knee adduction moment (internal abduction
moment) (B).
the frontal plane, as the hip joint is normally constrained by
the seat. Ericson et al. (11) have reported that cycling with
knee joints moving close to the midline of the bicycle can
decrease knee abduction moment. Five of our participants
who cycled with an everted ankle and abducted knee showed
this knee adduction moment pattern. However, there were
also participants who generated knee adduction moments
who cycled with an inverted ankle and abducted knee, or
those who cycled with an inverted ankle and adducted knee.
This indicates that other variables, such as foot position,
pelvis width and hip rotation, might have an influence on the
frontal plane knee moment. Four of our five female partici-
pants showed an abduction moment. Whether the finding is
related to sex difference in pelvis width and Q-angle is cur-
rently unknown in cycling. Further investigations on effects
of these factors on frontal plane knee moments are warranted.
Peak knee extension moments increased with increased
workloads including 74%, 29%, 31%, and 9% increases of
the extension moment for workloads increased from 0.5 to
1.0 kg, 1.0 to 1.5 kg, 1.5 to 2.0 kg, and 2.0 to 2.5 kg, re-
spectively. These results were similar to findings of previous
studies (13,26). Peak knee extension moment was shown to
increase 314% as workload increased from 0 to 2.0 kg in one
study (13), whereas it increased 195% as workload increased
from 0.5 to 2.0 kg in our study. A previous study conducted
APPLIED SCIENCES
in our lab showed an average peak knee extension moment
of 26.27 NIm when cycling at 60 rpm and 80 W, which is
very close to the 26.04 NIm found in our study when cycling
at 60 rpm and 1.5 kg (90 W) (18). Ericson et al. (13) reported
a knee extension moment of 30 NIm when riding at 60 rpm
with a workload of 2 kg, which is also similar to 34.23 NIm
when cycling at 60 rpm and a 2 kg workload in our study. The
knee extension moment increased to overcome the increased
workload, which is also reflected in the increased vertical PRF.
Increased workloads also significantly changed knee exten-
sion ROMs, which contradicts previous studies (5,10). Bini
264 Official Journal of the American College of Sports Medicine
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
et al. (5) reported that knee ROM was not changed when the
workload was set at 0, 0.5, and 1.0 kg. Edline et al. (10) also
reported that knee ROM was not changed when participants
cycled from 100 W to exhaustion at 90 RPM. The changing
knee angle in our study might have been caused by the
slightly increased trunk movement during data collection.
Our results show that both lateral and transverse trunk-pelvic
angle ROM increased with workload, and the increases for
the transverse plane (P = 0.004) were significant. Therefore, it
is likely that some participants tend to increase their trunk
sway and rotation to keep up with the higher workload, which
increased hip joint movement, and in turn increased the knee
extension ROM slightly. Increased lateral trunk movements,
along with increased trunk transverse movement during
walking, have been shown to be associated with pain in knee
OA patients (33). Future studies are warranted to further ex-
amine influences of trunk lateral and rotational movements on
knee frontal plane moments and knee joint pain during cy-
cling among knee OA patients.
Effects of Cadence on Knee Biomechanics
The peak knee extension moment did not increase with
increased cadence during the power phase as expected. How-
ever, the peak knee flexion moment increased with increasing
cadence during the recovery phase, which supports previous
findings. Ericson et al. (13) found that the peak knee flexion
moment increased across the different cadences of 40, 60, 80,
and 100 rpm at a workload of 2 kg. It has been demonstrated
in our study and the study by Ericson et al. (13) that the peak
flexion moment occurred at the beginning of the recovery
phase, as both studies used a weighted brake. Redfield and
Hull (29) reported that the knee flexion moment was not
significantly changed when cycling at 63, 80, and 100 rpm at
98 W; the flexion moment was unchanged because the study
used an electromagnetic brake in the ergometer.
http://www.acsm-msse.org
 An increased knee flexion moment often accompanies
higher activation of knee flexor muscles. Takaishi et al. (32)
reported an abrupt increase of normalized integrated electro-
myography (iEMG) values for biceps femoris among expe-
rienced cyclists when cadence increased from 75 to 90 and
105 rpm. The iEMG was significantly increased from 75 to
90 rpm at 200 W. However, no increase was seen in non-
cyclists with an increased cadence. They concluded that cy-
clists recruit knee flexor muscles more to deal with higher
cadences. The current study and that of Ericson et al. (13),
which used recreational cyclists, saw increased flexion mo-
ments with increased cadences. However, Ericson et al. (13)
reported knee flexion moments of 11.9 and 15 NIm at 60 and
80 rpm (at 2 kg), which were smaller than the 16 and 20.67 NIm
at 60 and 80 rpm (at 1 kg) in our study. Takaishi et al. (32)
also suggested that the increase of knee flexor muscle activi-
ties might assist knee extensors of the contralateral side. When
the knee flexes at the beginning of the recovery phase, it is also
when the power phase starts on the contralateral side. This may
explain the difference of knee moment magnitude between our
study and the study by Ericson et al. As we found that the net
knee moments of both sides were actually similar between
these two studies, with 40.7 and 45.0 NIm for Ericson et al.
and 36.9 and 43.0 NIm for our study, it may be possible that
subjects in our study used knee flexors more to alleviate the
burden of knee extensors on the contralateral side.
There are a few limitations of this study. As two distinctive
patterns were observed in some variables among our partici-
pants (e.g., knee abduction and adduction moment), the sta-
tistical power was reduced for these variables. Readers are
encouraged to interpret the results with caution. Although all
participants were recreational cyclists, it is unclear if they all
had similar experience in stationary bike riding. The standard
bike fit requirements used in this study may not meet the bike
fit requirement for each participant. Lastly, there seemed to be
some sex differences in knee frontal plane moments which
may warrant further attention in future studies.
Implications for Knee OA
The increased loading to the medial knee compartment
when the workload increased due to the increased peak ab-
duction moment may have clinical implications for certain
patient population, for example, people with medial com-
partment knee OA who may want to avoid cycling at a
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CYCLING WORKLOAD ON KNEE BIOMECHANICS
Copyright © 2016 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
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However, the magnitudes of peak knee abduction moment in
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A review has reported peak external adduction (internal
abduction) moment of 2.23% to 5.1% BW  height (HT) for
knee OA patients and 2.6% to 3.16% BW  HT for healthy
controls in walking (17). In this study, the normalized peak
knee abduction moment was 0.69% to 1.77% BW  HT for
workloads between 0.5 to 2.5 kg, which is much smaller
than the lower bound of knee abduction moment of healthy
participants in walking. In a recent stair ascent study, healthy
participants climbed the stairs using their preferred speed,
and the knee abduction moment was 2.1% BW  HT, which
is higher compared with our results (28). However, the ac-
tual knee joint loading in cycling may be higher because of
greater muscle contractions and high mechanical demands in
the power phase in cycling compared with walking (8).
Further study is needed using musculoskeletal modeling to
estimate the actual knee contact forces in cycling.
CONCLUSIONS
The findings of this study indicate that increased workload
at a constant cadence resulted in greater peak knee abduction
moment, peak knee extension moment, and knee abduction
ROM. Increasing cadence at a constant workload did not
cause any changes in peak knee abduction moments or peak
knee extension moment. This is the first study that examined
the effects of workload and cadence on knee frontal plane ki-
nematics and kinetics. Future studies may be needed to dem-
onstrate efficacy of appropriate levels of workload for knee
OA and populations with other musculoskeletal conditions.
The authors thank all the participants for their contributions.
The study was supported in part by funding from the Opportunity
Fund of the Office of Research, Biomechanics/Sports Medicine En-
richment Fund and College of Education, Health and Sport Sciences
at The University of Tennessee.
This study presents no conflicts of interest.
The results of this study do not constitute endorsement by the
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