Megan O'Connell1, Shawn Farrokhi2, G Kelley Fitzgerald3. 1. Solutions Physical Therapy & Sports Medicine, Alexandria, VA, USA. 2. Human Movement Research Laboratory, University of Pittsburgh, Pittsburgh, PA, USA; Departments of Physical Therapy and Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: Farrokhi@pitt.edu. 3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA; Physical Therapy and Clinical and Translational Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
BACKGROUND: The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. METHODS: Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. FINDINGS: The moderate/severe pain group demonstrated worse global pain (P<0.01) and physical function scores (P<0.01) compared to the no pain and the mild pain groups. The moderate/severe pain group also walked with greater knee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). INTERPRETATION: Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait.
BACKGROUND: The association between high mechanical knee joint loading during gait with onset and progression of knee osteoarthritis has been extensively studied. However, less attention has been given to risk factors related to increased pain during gait. The purpose of this study was to evaluate knee joint moments and clinical characteristics that may be associated with gait-related knee pain in patients with knee osteoarthritis. METHODS: Sixty-seven participants with knee osteoarthritis were stratified into three groups of no pain (n=18), mild pain (n=27), or moderate/severe pain (n=22) based on their self-reported symptoms during gait. All participants underwent three-dimensional gait analysis. Quadriceps strength, knee extension range of motion, radiographic knee alignment and self-reported measures of global pain and function were also quantified. FINDINGS: The moderate/severe pain group demonstrated worse global pain (P<0.01) and physical function scores (P<0.01) compared to the no pain and the mild pain groups. The moderate/severe pain group also walked with greater knee flexion moments during the midstance phase of gait compared to the no pain group (P=0.02). Additionally, the moderate/severe pain group demonstrated greater varus knee malalignment (P=0.009), which was associated with higher weight acceptance peak knee adduction moments (P=0.003) and worse global pain (P=0.003) and physical function scores (P=0.006). INTERPRETATION: Greater knee flexion moment is present during the midstance phase of gait in patients with knee osteoarthritis and moderate/severe pain during gait. Additionally, greater varus malalignment may be a sign of increased global knee joint dysfunction that can influence many activities of daily living beyond gait.
Authors: Luiz Fernando Approbato Selistre; Glaucia Helena Gonçalves; Fernando Augusto Vasilceac; Paula Regina Mendes da Silva Serrão; Theresa Helissa Nakagawa; Marina Petrella; Richard Keith Jones; Stela Márcia Mattiello Journal: Braz J Phys Ther Date: 2020-02-26 Impact factor: 3.377
Authors: Glauko Dantas; Isabel C N Sacco; Ana F Dos Santos; Ricky Watari; Alessandra B Matias; Paula R M S Serrao; Henrique Pott-Junior; Tania F Salvini Journal: BMJ Open Date: 2020-09-25 Impact factor: 2.692