Research: ZENI and HIGGINSON,

Listed in Issue 202

Abstract

ZENI and HIGGINSON, Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA. jzenijr@gmail.com  evaluated how knee OA and walking speed affect total support moment and individual joint contributions to the total support moment.

Background

Alterations in lower extremity kinetics have been shown to exist in persons with knee osteoarthritis (OA), however few investigations have examined how the inter-segmental coordination of the lower extremity kinetic chain varies in the presence of knee joint pathology.

Methodology

Fifteen healthy subjects and 30 persons with knee OA participated in 3D walking analysis at constrained (1.0 m/s), self-selected and fastest tolerable walking speeds. Individual joint contributions to total support moment were analyzed using separate ANOVAs with one repeated measure (walking speed). Linear regression analysis was used to evaluate the relationship between walking speed and joint contribution.

Results

Persons with knee OA reduced the contribution of the knee joint when walking at constrained (p = 0.04) and self-selected walking speeds (p = 0.009). There was a significant increase in the ankle contribution and a significant decrease in the hip contribution when walking speed was increased (p < 0.004), however individual walking speeds were not significantly related to joint contributions.

Conclusion

This suggests that the relationship between walking speed and joint contribution is dependent on the individual's control strategy and we cannot estimate the joint contribution solely based on walking speed. The slower gait speed observed in persons with knee OA is not responsible for the reduction in knee joint moments, rather this change is likely due to alterations in the neuromuscular strategy of the lower extremity kinetic chain in response to joint pain or muscle weakness.

References

Zeni JA and Higginson JS. Knee osteoarthritis affects the distribution of joint moments during gait. Source Knee. 18(3): 156-9. Jun 2011. Other ID Source: NLM. NIHMS200619 [Available on 06/01/12] Source: NLM. PMC2970742 [Available on 06/01/12]

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