T L Sparling1, D Schmitt2, C E Miller3, F Guilak4, T J Somers5, F J Keefe6, R M Queen7. 1. Michael W. Krzyzewski Human Performance Research Laboratory, DUMC 3435 Duke University Medical Center, Durham, NC 27710, USA; Department of Orthopedic Surgery, Duke University Medical Center Box 3956, Durham NC 27710, USA. Electronic address: tlsparling@me.com. 2. Department of Evolutionary Anthropology, Duke University, Durham, NC, USA. Electronic address: Daniel.schmitt@duke.edu. 3. Department of Evolutionary Anthropology, Duke University, Durham, NC, USA. Electronic address: charlotte.miller@duke.edu. 4. Department of Orthopedic Surgery, Duke University Medical Center Box 3956, Durham NC 27710, USA; Department of Biomedical Engineering, Duke University, Durham, NC, USA. Electronic address: farshid.guilak@duke.edu. 5. Duke Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address: tamara.somers@dm.duke.edu. 6. Duke Pain Prevention and Treatment Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. Electronic address: francis.keefe@dm.duke.edu. 7. Michael W. Krzyzewski Human Performance Research Laboratory, DUMC 3435 Duke University Medical Center, Durham, NC 27710, USA; Department of Orthopedic Surgery, Duke University Medical Center Box 3956, Durham NC 27710, USA.
Abstract
OBJECTIVE: Pathological gaits have been shown to limit transfer between potential (PE) and kinetic (KE) energy during walking, which can increase locomotor costs. The purpose of this study was to examine whether energy exchange would be limited in people with knee osteoarthritis (OA). METHODS: Ground reaction forces during walking were collected from 93 subjects with symptomatic knee OA (self-selected and fast speeds) and 13 healthy controls (self-selected speed) and used to calculate their center of mass (COM) movements, PE and KE relationships, and energy recovery during a stride. Correlations and linear regressions examined the impact of energy fluctuation phase and amplitude, walking velocity, body mass, self-reported pain, and radiographic severity on recovery. Paired t-tests were run to compare energy recovery between cohorts. RESULTS: Symptomatic knee OA subjects displayed lower energetic recovery during self-selected walking speeds than healthy controls (P = 0.0018). PE and KE phase relationships explained the majority (66%) of variance in recovery. Recovery had a complex relationship with velocity and its change across speeds was significantly influenced by the self-selected walking speed of each subject. Neither radiographic OA scores nor subject self-reported measures demonstrated any relationship with energy recovery. CONCLUSIONS: Knee OA reduces effective exchange of PE and KE, potentially increasing the muscular work required to control movements of the COM. Gait retraining may return subjects to more normal patterns of energy exchange and allow them to reduce fatigue.
OBJECTIVE: Pathological gaits have been shown to limit transfer between potential (PE) and kinetic (KE) energy during walking, which can increase locomotor costs. The purpose of this study was to examine whether energy exchange would be limited in people with knee osteoarthritis (OA). METHODS: Ground reaction forces during walking were collected from 93 subjects with symptomatic knee OA (self-selected and fast speeds) and 13 healthy controls (self-selected speed) and used to calculate their center of mass (COM) movements, PE and KE relationships, and energy recovery during a stride. Correlations and linear regressions examined the impact of energy fluctuation phase and amplitude, walking velocity, body mass, self-reported pain, and radiographic severity on recovery. Paired t-tests were run to compare energy recovery between cohorts. RESULTS: Symptomatic knee OA subjects displayed lower energetic recovery during self-selected walking speeds than healthy controls (P = 0.0018). PE and KE phase relationships explained the majority (66%) of variance in recovery. Recovery had a complex relationship with velocity and its change across speeds was significantly influenced by the self-selected walking speed of each subject. Neither radiographic OA scores nor subject self-reported measures demonstrated any relationship with energy recovery. CONCLUSIONS: Knee OA reduces effective exchange of PE and KE, potentially increasing the muscular work required to control movements of the COM. Gait retraining may return subjects to more normal patterns of energy exchange and allow them to reduce fatigue.
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