J E Naili1, E W Broström2, B Clausen3, A Holsgaard-Larsen4. 1. Department of Women's and Children's Health, Karolinska Institutet, 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, Q2:07, Karolinska University Hospital, 171 76, Stockholm, Sweden. Electronic address: eva.brostrom@ki.se. 3. Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Fælledvej 7, 4200 Slagelse, Denmark. Electronic address: brian_clausen@hotmail.com. 4. Department of Women's and Children's Health, Karolinska Institutet, Q2:07, Karolinska University Hospital, 171 76, Stockholm, Sweden; Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark & Odense University Hospital, Heden 18, 5000 Odense C, Denmark. Electronic address: AHLarsen@health.sdu.dk.
Abstract
BACKGROUND: Pain reports show at most weak to moderate relationship with structural findings of knee osteoarthritis (OA). Less is known about the relationship between measures of knee and gait function and structural findings of knee OA. RESEARCH QUESTION: To test the hypothesis that patient-reported, performance-based and three-dimensional knee and gait measures can distinguish between individuals with varying degrees of radiographic knee OA severity. METHODS: To increase the spectrum of radiographic severity baseline data of individuals included in a cohort study and in a randomized controlled trial respectively were included in this cross-sectional study. Individuals completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Single Limb Mini Squat (SLMS) test, and three-dimensional gait analysis. Radiographic severity was dichotomized into mild (Kellgren Lawrence (KL) 1-2) or severe (KL 3-4) knee OA. Proxies for medial knee joint loading were peak knee adduction moment (KAM) and KAM impulse, and summary measures of overall gait function were the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic). Area under the receiver operating characteristic curves (AUC) and logistic regressions were used to evaluate whether KOOS-scores, SLMS test, peak KAM, KAM impulse, and GDI-scores could discriminate radiographic severity of knee OA. RESULTS: The sample (n = 115) consisted of 60% women, mean age 61 years (SD 8). Good discriminating abilities (AUC > 0.7) were demonstrated for all measures of knee function and gait, except for GDI and GDI-kinetic (0.62 and 0.36, respectively). Odds ratios from logistic regressions largely supported the AUC findings. SIGNIFICANCE: With the exception of gait summary measures, discriminating abilities were demonstrated by all measures of knee and gait function. Given the interest in interpreting OA as a multi-factorial disease, this information may assist researchers in selecting the most appropriate outcomes for biomechanical studies.
BACKGROUND:Pain reports show at most weak to moderate relationship with structural findings of knee osteoarthritis (OA). Less is known about the relationship between measures of knee and gait function and structural findings of knee OA. RESEARCH QUESTION: To test the hypothesis that patient-reported, performance-based and three-dimensional knee and gait measures can distinguish between individuals with varying degrees of radiographic knee OA severity. METHODS: To increase the spectrum of radiographic severity baseline data of individuals included in a cohort study and in a randomized controlled trial respectively were included in this cross-sectional study. Individuals completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Single Limb Mini Squat (SLMS) test, and three-dimensional gait analysis. Radiographic severity was dichotomized into mild (Kellgren Lawrence (KL) 1-2) or severe (KL 3-4) knee OA. Proxies for medial knee joint loading were peak knee adduction moment (KAM) and KAM impulse, and summary measures of overall gait function were the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic). Area under the receiver operating characteristic curves (AUC) and logistic regressions were used to evaluate whether KOOS-scores, SLMS test, peak KAM, KAM impulse, and GDI-scores could discriminate radiographic severity of knee OA. RESULTS: The sample (n = 115) consisted of 60% women, mean age 61 years (SD 8). Good discriminating abilities (AUC > 0.7) were demonstrated for all measures of knee function and gait, except for GDI and GDI-kinetic (0.62 and 0.36, respectively). Odds ratios from logistic regressions largely supported the AUC findings. SIGNIFICANCE: With the exception of gait summary measures, discriminating abilities were demonstrated by all measures of knee and gait function. Given the interest in interpreting OA as a multi-factorial disease, this information may assist researchers in selecting the most appropriate outcomes for biomechanical studies.
Authors: Eefje M van Helvoort; Diana Hodgins; Simon C Mastbergen; Anne Karien Marijnissen; Hans Guehring; Marieke Loef; Margreet Kloppenburg; Francisco Blanco; Ida K Haugen; Francis Berenbaum; Floris P J G Lafeber; Paco M J Welsing Journal: Rheumatology (Oxford) Date: 2021-08-02 Impact factor: 7.580