Kinematic changes in patients with severe knee osteoarthritis are a result of reduced walking speed rather than disease severity.


Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
06 2020
Historique:
received: 28 01 2020
revised: 06 05 2020
accepted: 11 05 2020
pubmed: 28 5 2020
medline: 4 3 2021
entrez: 28 5 2020
Statut: ppublish

Résumé

Kinematic changes in patients with knee osteoarthritis (OA) have been extensively studied. Concerns have been raised whether the measured spatiotemporal and kinematic alterations are associated with disease progression or merely a result of reduced walking speed. The purpose of this study was to investigate the effect of walking speed on kinematic parameters in patients with knee OA using statistical parametric mapping (SPM). Twenty-three patients with unilateral knee OA scheduled for a total knee replacement and 28 age matched control subjects were included in this study. Spatiotemporal parameters and sagittal plane kinematics were measured in the hip, knee, and ankle using the inertial sensors system RehaGait® while walking at a self-selected normal (patients and controls) and slow walking speed (controls) for a distance of 20 m. Gait parameters were compared between groups for self-selected walking speed and for matched walking speed using SPM with independent sample t tests. At self-selected walking speed, patients had significantly lower knee flexion during stance (maximum difference, -6.8°) and during swing (-11.0°), as well as higher ankle dorsiflexion during stance phase (+12.5°) and lower peak hip extension at the end of stance compared to controls (+4.2°). At matched speed, there were no significant differences in joint kinematics between groups. Differences in sagittal plane gait kinematics between patients with knee OA and asymptomatic controls appear to be mainly a result of reduced walking speed. These results emphasize the importance of considering walking speed in research on gait kinematics in patients with knee OA and in clinical trials using gait parameters as outcome measures.

Sections du résumé

BACKGROUND
Kinematic changes in patients with knee osteoarthritis (OA) have been extensively studied. Concerns have been raised whether the measured spatiotemporal and kinematic alterations are associated with disease progression or merely a result of reduced walking speed.
RESEARCH QUESTION
The purpose of this study was to investigate the effect of walking speed on kinematic parameters in patients with knee OA using statistical parametric mapping (SPM).
METHODS
Twenty-three patients with unilateral knee OA scheduled for a total knee replacement and 28 age matched control subjects were included in this study. Spatiotemporal parameters and sagittal plane kinematics were measured in the hip, knee, and ankle using the inertial sensors system RehaGait® while walking at a self-selected normal (patients and controls) and slow walking speed (controls) for a distance of 20 m. Gait parameters were compared between groups for self-selected walking speed and for matched walking speed using SPM with independent sample t tests.
RESULTS
At self-selected walking speed, patients had significantly lower knee flexion during stance (maximum difference, -6.8°) and during swing (-11.0°), as well as higher ankle dorsiflexion during stance phase (+12.5°) and lower peak hip extension at the end of stance compared to controls (+4.2°). At matched speed, there were no significant differences in joint kinematics between groups.
SIGNIFICANCE
Differences in sagittal plane gait kinematics between patients with knee OA and asymptomatic controls appear to be mainly a result of reduced walking speed. These results emphasize the importance of considering walking speed in research on gait kinematics in patients with knee OA and in clinical trials using gait parameters as outcome measures.

Identifiants

pubmed: 32460135
pii: S0966-6362(20)30157-0
doi: 10.1016/j.gaitpost.2020.05.008
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

256-261

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare no conflict of interest.

Auteurs

Petros Ismailidis (P)

Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland. Electronic address: petrosismailidis@gmail.com.

Christian Egloff (C)

Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland.

Lea Hegglin (L)

Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.

Geert Pagenstert (G)

Department of Clinical Research, University of Basel, Basel, Switzerland; CLARAHOF Clinic of Orthopaedic Surgery, Clarahofweg 19a, 4058 Basel, Switzerland.

Rolf Kernen (R)

Clinic for Orthopaedics Claraortho, Claragraben 82, 4058 Basel, Switzerland.

Anke Eckardt (A)

ENDO-Team Hirslanden Klinik Birshof, Reinacherstrasse 28, 4142 Münchenstein, Switzerland.

Thomas Ilchmann (T)

ENDO-Team Hirslanden Klinik Birshof, Reinacherstrasse 28, 4142 Münchenstein, Switzerland.

Annegret Mündermann (A)

Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland.

Corina Nüesch (C)

Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland.

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