Elham Esfandiari1, Mohammad Ali Sanjari2, Ali Ashraf Jamshidi3, Mojtaba Kamyab4, Hamid Reza Yazdi5. 1. Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada; Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 2. Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address: sanjarima@iums.ac.ir. 3. Department of Physical Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 4. Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. 5. Department of Orthopedic Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND: People with knee osteoarthritis are at higher risk of postural deficits and locomotor adaptations which could be manifested in transient tasks like gait initiation. To better understand the effect of early knee osteoarthritis on gait initiation, we measured the gait initiation in two groups of early knee osteoarthritis and healthy age-matched controls and assessed the effect of lateral wedge insole in knee osteoarthritis group. METHODS: Twenty-one individuals with early knee osteoarthritis, mean (SD) age = 53.1 (7.4, years), and 19 age- and sex-matched asymptomatic healthy individuals, mean (SD) age = 47.5 (11.2, years), participated. Centre of pressure trajectories were used to quantify the two phases of gait initiation in barefoot condition: anticipatory postural adjustment, and locomotor phase. The immediate and four-week effect of lateral wedge insole and shod condition were also compared for individuals in knee osteoarthritis group. FINDINGS: Longer duration of anticipatory postural adjustment phase (P = 0.046), locomotor phase (P = 0.049), and total duration of gait initiation (P = 0.035) with lower length and velocity of the center of pressure trajectories in anticipatory postural adjustment phase (P = 0.002, and 0.008, respectively) were observed in knee osteoarthritis group compared to controls. Lateral wedge insole could increase the length and velocity of the centre of pressure in locomotor phase compared to barefoot condition (P = 0.001, and 0.002, respectively). INTERPRETATION: Our study outlined that people with early knee osteoarthritis adopt different gait initiation strategies mainly in postural preparation phase. The potential effect of lateral wedge insole was shown with better performance of the locomotor phase. CLINICAL TRIAL REGISTRY NUMBER: IRCT2016060628310N1.
BACKGROUND:People with knee osteoarthritis are at higher risk of postural deficits and locomotor adaptations which could be manifested in transient tasks like gait initiation. To better understand the effect of early knee osteoarthritis on gait initiation, we measured the gait initiation in two groups of early knee osteoarthritis and healthy age-matched controls and assessed the effect of lateral wedge insole in knee osteoarthritis group. METHODS: Twenty-one individuals with early knee osteoarthritis, mean (SD) age = 53.1 (7.4, years), and 19 age- and sex-matched asymptomatic healthy individuals, mean (SD) age = 47.5 (11.2, years), participated. Centre of pressure trajectories were used to quantify the two phases of gait initiation in barefoot condition: anticipatory postural adjustment, and locomotor phase. The immediate and four-week effect of lateral wedge insole and shod condition were also compared for individuals in knee osteoarthritis group. FINDINGS: Longer duration of anticipatory postural adjustment phase (P = 0.046), locomotor phase (P = 0.049), and total duration of gait initiation (P = 0.035) with lower length and velocity of the center of pressure trajectories in anticipatory postural adjustment phase (P = 0.002, and 0.008, respectively) were observed in knee osteoarthritis group compared to controls. Lateral wedge insole could increase the length and velocity of the centre of pressure in locomotor phase compared to barefoot condition (P = 0.001, and 0.002, respectively). INTERPRETATION: Our study outlined that people with early knee osteoarthritis adopt different gait initiation strategies mainly in postural preparation phase. The potential effect of lateral wedge insole was shown with better performance of the locomotor phase. CLINICAL TRIAL REGISTRY NUMBER: IRCT2016060628310N1.