Josefine E Naili1, Anna-Clara Esbjörnsson2, Maura D Iversen3, Michael H Schwartz4, Margareta Hedström5, Charlotte K Häger6, Eva W Broström2. 1. Department of Women's and Children's Health, Karolinska Institutet, MotorikLab, Q2:07, Karolinska University Hospital, 171 76 Stockholm, Sweden. Electronic address: josefine.naili@ki.se. 2. Department of Women's and Children's Health, Karolinska Institutet, MotorikLab, Q2:07, Karolinska University Hospital, 171 76 Stockholm, Sweden. 3. Department of Women's and Children's Health, Karolinska Institutet, MotorikLab, Q2:07, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Physical Therapy, Movement & Rehabilitation Sciences, Bouve College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA; Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 4. Gillette Children's Specialty Healthcare, 200 University Avenue East, St Paul, MN 55101, USA; Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA; Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA. 5. Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Orthopedics, Karolinska University Hospital, 141 86 Stockholm, Sweden. 6. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 901 87 Umeå, Sweden.
Abstract
BACKGROUND: Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance-based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. METHODS: Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease-specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. RESULTS: Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r=-0.42) and 5STS (r=-0.33), while on the OA limb with TUG (r=-0.68), 5STS (r=-0.38), SLMS (r=-0.38), activities of daily living (r=0.35) and Knee-related Quality of Life (r=0.35). No significant associations existed between kinematic GDI scores, PBMs and PROs. CONCLUSION: The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.
BACKGROUND: Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance-based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. METHODS: Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease-specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. RESULTS:Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r=-0.42) and 5STS (r=-0.33), while on the OA limb with TUG (r=-0.68), 5STS (r=-0.38), SLMS (r=-0.38), activities of daily living (r=0.35) and Knee-related Quality of Life (r=0.35). No significant associations existed between kinematic GDI scores, PBMs and PROs. CONCLUSION: The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.