Hiroshige Tateuchi1, Haruhiko Akiyama2, Koji Goto3, Kazutaka So4, Yutaka Kuroda3, Noriaki Ichihashi5. 1. Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: tateuchi.hiroshige.8x@kyoto-u.ac.jp. 2. Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan. 3. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 4. Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan. 5. Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Abstract
OBJECTIVE: To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). DESIGN: Prospective cohort study. SETTING: Clinical biomechanics laboratory of a university. PARTICIPANTS: Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). MAIN OUTCOME MEASURES: Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. RESULTS: Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: -0.52 [-0.88 to -0.17]) and limited external rotation angles (-0.51 [-0.85 to -0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (-0.54 [-0.99 to -0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. CONCLUSIONS: Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
OBJECTIVE: To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). DESIGN: Prospective cohort study. SETTING: Clinical biomechanics laboratory of a university. PARTICIPANTS: Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). MAIN OUTCOME MEASURES: Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. RESULTS: Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: -0.52 [-0.88 to -0.17]) and limited external rotation angles (-0.51 [-0.85 to -0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (-0.54 [-0.99 to -0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. CONCLUSIONS: Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
Authors: Shogo Misu; Tsuyoshi Asai; Shunsuke Murata; Ryo Nakamura; Tsunenori Isa; Yamato Tsuboi; Kensuke Oshima; Shota Koyama; Ryuichi Sawa; Yoshihiro Fukumoto; Rei Ono Journal: Int J Environ Res Public Health Date: 2022-03-01 Impact factor: 3.390