Kim Allison1, Michelle Hall2, Paul W Hodges3, Tim V Wrigley4, Bill Vicenzino5, Yong-Hao Pua6, Ben Metcalf7, Alison Grimaldi8, Kim L Bennell9. 1. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Parkville, Australia. Electronic address: kim.allison@unimelb.edu.au. 2. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Parkville, Australia. Electronic address: halm@unimelb.edu.au. 3. School of Health & Rehabilitation Sciences, University of Queensland, Saint Lucia, Australia. Electronic address: p.hodges@uq.edu.au. 4. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Parkville, Australia. Electronic address: timw@unimelb.edu.au. 5. School of Health & Rehabilitation Sciences, University of Queensland, Saint Lucia, Australia. Electronic address: b.vicenzino@uq.edu.au. 6. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Parkville, Australia; School of Health & Rehabilitation Sciences, University of Queensland, Saint Lucia, Australia; Department of Physiotherapy, Singapore General Hospital, Singapore. Electronic address: puayonghao@gmail.com. 7. Department of Physiotherapy, Singapore General Hospital, Singapore. Electronic address: b.metcalf@unimelb.edu.au. 8. School of Health & Rehabilitation Sciences, University of Queensland, Saint Lucia, Australia. Electronic address: info@dralisongrimaldi.com. 9. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Parkville, Australia. Electronic address: k.bennell@unimelb.edu.au.
Abstract
BACKGROUND: Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. METHODS: Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. RESULTS: Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. CONCLUSION: Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT.
BACKGROUND:Gluteal tendinopathy (GT) and hip osteoarthritis (OA) are the most common causes of hip pain and associated disability in older adults. Pain and altered walking biomechanics are common to both conditions. This study aimed to compare three-dimensional walking biomechanics between individuals with unilateral, symptomatic GT and HOA. METHODS: Sixty individuals with symptomatic unilateral GT confirmed by magnetic-resonance-imaging and 73 individuals with symptomatic unilateral HOA (Kellgren-Lawrence Grade ≥ 2) underwent three-dimensional gait analysis. Maximum and minimum values of the external sagittal hip moment, the first peak, second peak and mid-stance minimum of the hip adduction moment (HAM), sagittal plane hip excursion and hip joint angles, pelvic obliquity and trunk lean, at the three HAM time points during stance phase of walking were compared between groups. RESULTS: Compared to individuals with HOA, those with GT exhibited a greater hip peak extension moment (P < 0.001) and greater HAM throughout the stance phase of walking (P = 0.01-P < 0.001), greater hip adduction (P < 0.001) and internal rotation (P < 0.01-P < 0.001) angles and lower hip flexion angles and excursion (P = 0.02 - P < 0.001). Individuals with HOA exhibited a greater forward trunk lean (P ≤ 0.001) throughout stance, and greater ipsilateral trunk lean in the frontal plane (P < 0.001) than those with GT. CONCLUSION: Despite presence of pain in both conditions, hip kinematics and kinetics differ between individuals with symptomatic unilateral GT and those with symptomatic unilateral HOA. These condition-specific impairments may be targets for optimization of management of HOA and GT.
Authors: Ajay C Lall; Garrett R Schwarzman; Muriel R Battaglia; Sarah L Chen; David R Maldonado; Benjamin G Domb Journal: Arthrosc Tech Date: 2019-08-01