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Effects of severity of osteoarthritis on the temporospatial gait parameters in patients with knee osteoarthritis

Year 2014, Volume: 48 Issue: 6, 635 - 641, 16.01.2015

Abstract

Objective: The aim of this study was to investigate the differences in temporospatial parameters in according to severity of knee osteoarthritis (OA).

Methods: The study included a total of 110 subjects with no orthopedic or neurologic disease that might affect gait were divided into three study and one control groups. Eighty subjects (mean age: 53.13±6.78 years) were diagnosed with bilateral knee OA and divided into groups according to Kellgren-Lawrence radiologic scale: the Phase 1 group included 29 subjects, Phase 2, 28 subjects, and Phase 3, 23 subjects. The control group was composed of 30 healthy subjects (25 females, 5 males; mean age: 41.50±5.79 years). Temporospatial gait data were evaluated using a gait analysis system.

Methods: There were no significant differences in all temporospatial parameters between the control group and the Phase 1 and 2 OA groups (p>0.05). There was a significant decrease in cadence, gait velocity, stride length and step length (p<0.008) and a significant increase in stride time, double support time, step time, single support time and stance phase length in patients with Phase 3 knee OA compared to the other groups (p<0.008).

Conclusion: Changes in temporospatial parameters of patients with Phase 3 knee OA may be correlated with loss of gait stabilization and increase in risk of falling. In subjects with knee OA, gait stabilization and balance loss must be examined and evaluated in terms of risk of falling and necessary precautions must be taken.

References

  • Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: new in- sights. Part 2: treatment approaches. Ann Intern Med 2000;133:726-37.
  • Baliunas AJ, Hurwitz DE, Ryals AB, Karrar A, Case JP, Block JA, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthritis Cartilage 2002;10:573-9.
  • Mündermann A, Dyrby CO, Hurwitz DE, Sharma L, Andriacchi TP. Potential strategies to reduce medial com- partment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum 2004;50:1172-8.
  • Henriksen M, Simonsen EB, Alkjaer T, Lund H, Graven- Nielsen T, Danneskiold-Samsİe B, et al. Increased joint loads during walking-a consequence of pain relief in knee osteoarthritis. Knee 2006;13:445-50.
  • Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Bio- mechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Ort- hop Res 2008;26:332-41.
  • Huang SC, Wei IP, Chien HL, Wang TM, Liu YH, Chen HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis. Med Eng Phys 2008;30:997-1003.
  • Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 2011;21:695-703.
  • Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN. Gait characteristics of patients with knee osteoarthritis. J Biomech 2001;34:907-15.
  • 9 Mündermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteo- arthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum 2005;52:2835-44.
  • Hamacher D, Singh NB, Van Dieën JH, Heller MO, Tay- lor WR. Kinematic measures for assessing gait stability in elderly individuals: a systematic review. J R Soc Interface 2011;8:1682-98.
  • Barrett RS, Mills PM, Begg RK. A systematic review of the effect of ageing and falls history on minimum foot cle- arance characteristics during level walking. Gait Posture 2010;32:429-35.
  • Huang MH, Brown SH. Age differences in the control of postural stability during reaching tasks. Gait Posture 2013;38:837-42.
  • Davis RB, Öunpuu S, Tyburski DJ, Gage JR. A gait analy- sis data collection and reduction technique. Hum Mov Sci 1991;10:575-87.
  • Kirtley C. Three-dimensional gait analysis. Clinical gait analysis: Theory and practice. 1st ed. Edinburgh: Elsevier Churchill Livingstone; 2006.
  • Harding GT, Hubley-Kozey CL, Dunbar MJ, Stanish WD, Astephen Wilson JL. Body mass index affects knee joint mechanics during gait differently with and witho- ut moderate knee osteoarthritis. Osteoarthritis Cartilage 2012;20:1234-42.
  • Solak AS, Kentel B, Ateş Y. Does bilateral total knee art- hroplasty affect gait in women?: comparison of gait analyses before and after total knee arthroplasty compared with nor- mal knees. J Arthroplasty 2005;20:745-50.
  • Kiliçoğlu O, Dönmez A, Karagülle Z, Erdoğan N, Akalan E, Temelli Y. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int 2010;30:739-47.
  • Andriacchi TP, Ogle JA, Galante JO. Walking speed as a ba- sis for normal and abnormal gait measurements. J Biomech 1977;10:261-8.
  • Möckel G, Perka C, Labs K, Duda G. The influence of wal- king speed on kinetic and kinematic parameters in patients with osteoarthritis of the hip using a force-instrumented treadmill and standardised gait speeds. Arch Orthop Trau- ma Surg 2003;123:278-82.
  • Zeni JA Jr, Higginson JS. Differences in gait parameters bet- ween healthy subjects and persons with moderate and severe knee osteoarthritis: a result of altered walking speed? Clin Biomech (Bristol, Avon) 2009;24:372-8.
  • Kirtley C, Whittle MW, Jefferson RJ. Influence of walking speed on gait parameters. J Biomed Eng 1985;7:282-8.
  • Lelas JL, Merriman GJ, Riley PO, Kerrigan DC. Predicting peak kinematic and kinetic parameters from gait speed. Gait Posture 2003;17:106-12.
  • Baert IA, Jonkers I, Staes F, Luyten FP, Truijen S, Verschue- ren SM. Gait characteristics and lower limb muscle strength in women with early and established knee osteoarthritis. Clin Biomech (Bristol, Avon) 2013;28:40-7.
  • McAndrew Young PM, Dingwell JB. Voluntary changes in step width and step length during human walking affect dynamic margins of stability. Gait Posture 2012;36:219-24.
  • Hannan MT, Felson DT, Pincus T. Analysis of the discor- dance between radiographic changes and knee pain in oste- oarthritis of the knee. J Rheumatol 2000;27:1513-7.
  • Dieppe PA. Relationship between symptoms and structural change in osteoarthritis. what are the important targets for osteoarthritis therapy? J Rheumatol Suppl 2004;70:50-3.
  • Henriksen M, Graven-Nielsen T, Aaboe J, Andriacchi TP, Bliddal H. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain. Arthritis Care Res (Hoboken) 2010;62:501-9.
  • Nagano Y, Naito K, Saho Y, Torii S, Ogata T, Nakazawa K, Akai M, Fukubayashi T. Association between in vivo knee kinematics during gait and the severity of knee osteoarthri- tis. Knee 2012;19:628-32.

Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri

Year 2014, Volume: 48 Issue: 6, 635 - 641, 16.01.2015

Abstract

Amaç: Bu çalışmanın amacı, diz osteoartriti (OA) şiddetinin yürüyüşün zaman mesafe parametrelerinde ortaya çıkardığı değişikliklerin incelenmesi idi.

Çalışma planı: Çalışmaya, yürüyüşü etkileyebilecek ortopedik veya nörolojik hastalığı olmayan 110 birey dahil edilerek üç çalışma ve bir kontrol grubuna ayrıldı. Yaş ortalaması 53.13±6.78 yıl olan 80 olgu çalışma grubunda yer aldı. Bu olgulardan Kellgren-Lawrence radyolojik skalasına göre bilateral OA tanısı konan 29’u Evre 1, 28’i Evre 2 ve 23’ü Evre 3 grubunu teşkil ettiler. Kontrol grubu yaş ortalaması 41.50±5.79 yıl olan 30 sağlıklı (25 kadın, 5 erkek) bireyden oluşturuldu. Yürüyüşün zaman mesafe verileri yürüme analizi sistemleri kullanılarak değerlendirildi.

Bulgular: Tüm zaman mesafe parametrelerinde sağlıklı grup ile Evre 1 ve 2 diz OA’sına sahip bireyler arasında anlamlı bir farklılık olmadığı saptandı (p>0.05). Tempo, yürüme hızı, çift adım uzunluğu ve tek adım uzunluğu parametrelerinde Evre 3 diz OA’lı bireylerde diğer gruplara göre azalma olduğu (p<0.008), çift adım zamanı, çift destek zamanı, tek adım zamanı, tek destek zamanı ve duruş fazı uzunluğu parametrelerinde ise belirgin artma olduğu bulundu (p<0.008).

Çıkarımlar: Evre 3 diz OA’lı grubun zaman mesafe parametrelerindeki değişikliklerin, yürüme stabilitesi kaybı ve düşme riskindeki artış ile ilişkili olabileceği düşünüldü. Diz OA’lı bireylerin yürüme stabilitesi ve denge kaybı sorgulanarak, bireyler düşme riski yönünden değerlendirilmeli ve risk içeren bireylerde gerekli koruyucu önlemler alınmalıdır.

References

  • Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, et al. Osteoarthritis: new in- sights. Part 2: treatment approaches. Ann Intern Med 2000;133:726-37.
  • Baliunas AJ, Hurwitz DE, Ryals AB, Karrar A, Case JP, Block JA, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthritis Cartilage 2002;10:573-9.
  • Mündermann A, Dyrby CO, Hurwitz DE, Sharma L, Andriacchi TP. Potential strategies to reduce medial com- partment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum 2004;50:1172-8.
  • Henriksen M, Simonsen EB, Alkjaer T, Lund H, Graven- Nielsen T, Danneskiold-Samsİe B, et al. Increased joint loads during walking-a consequence of pain relief in knee osteoarthritis. Knee 2006;13:445-50.
  • Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Bio- mechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Ort- hop Res 2008;26:332-41.
  • Huang SC, Wei IP, Chien HL, Wang TM, Liu YH, Chen HL, et al. Effects of severity of degeneration on gait patterns in patients with medial knee osteoarthritis. Med Eng Phys 2008;30:997-1003.
  • Kiss RM. Effect of severity of knee osteoarthritis on the variability of gait parameters. J Electromyogr Kinesiol 2011;21:695-703.
  • Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN. Gait characteristics of patients with knee osteoarthritis. J Biomech 2001;34:907-15.
  • 9 Mündermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteo- arthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum 2005;52:2835-44.
  • Hamacher D, Singh NB, Van Dieën JH, Heller MO, Tay- lor WR. Kinematic measures for assessing gait stability in elderly individuals: a systematic review. J R Soc Interface 2011;8:1682-98.
  • Barrett RS, Mills PM, Begg RK. A systematic review of the effect of ageing and falls history on minimum foot cle- arance characteristics during level walking. Gait Posture 2010;32:429-35.
  • Huang MH, Brown SH. Age differences in the control of postural stability during reaching tasks. Gait Posture 2013;38:837-42.
  • Davis RB, Öunpuu S, Tyburski DJ, Gage JR. A gait analy- sis data collection and reduction technique. Hum Mov Sci 1991;10:575-87.
  • Kirtley C. Three-dimensional gait analysis. Clinical gait analysis: Theory and practice. 1st ed. Edinburgh: Elsevier Churchill Livingstone; 2006.
  • Harding GT, Hubley-Kozey CL, Dunbar MJ, Stanish WD, Astephen Wilson JL. Body mass index affects knee joint mechanics during gait differently with and witho- ut moderate knee osteoarthritis. Osteoarthritis Cartilage 2012;20:1234-42.
  • Solak AS, Kentel B, Ateş Y. Does bilateral total knee art- hroplasty affect gait in women?: comparison of gait analyses before and after total knee arthroplasty compared with nor- mal knees. J Arthroplasty 2005;20:745-50.
  • Kiliçoğlu O, Dönmez A, Karagülle Z, Erdoğan N, Akalan E, Temelli Y. Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee. Rheumatol Int 2010;30:739-47.
  • Andriacchi TP, Ogle JA, Galante JO. Walking speed as a ba- sis for normal and abnormal gait measurements. J Biomech 1977;10:261-8.
  • Möckel G, Perka C, Labs K, Duda G. The influence of wal- king speed on kinetic and kinematic parameters in patients with osteoarthritis of the hip using a force-instrumented treadmill and standardised gait speeds. Arch Orthop Trau- ma Surg 2003;123:278-82.
  • Zeni JA Jr, Higginson JS. Differences in gait parameters bet- ween healthy subjects and persons with moderate and severe knee osteoarthritis: a result of altered walking speed? Clin Biomech (Bristol, Avon) 2009;24:372-8.
  • Kirtley C, Whittle MW, Jefferson RJ. Influence of walking speed on gait parameters. J Biomed Eng 1985;7:282-8.
  • Lelas JL, Merriman GJ, Riley PO, Kerrigan DC. Predicting peak kinematic and kinetic parameters from gait speed. Gait Posture 2003;17:106-12.
  • Baert IA, Jonkers I, Staes F, Luyten FP, Truijen S, Verschue- ren SM. Gait characteristics and lower limb muscle strength in women with early and established knee osteoarthritis. Clin Biomech (Bristol, Avon) 2013;28:40-7.
  • McAndrew Young PM, Dingwell JB. Voluntary changes in step width and step length during human walking affect dynamic margins of stability. Gait Posture 2012;36:219-24.
  • Hannan MT, Felson DT, Pincus T. Analysis of the discor- dance between radiographic changes and knee pain in oste- oarthritis of the knee. J Rheumatol 2000;27:1513-7.
  • Dieppe PA. Relationship between symptoms and structural change in osteoarthritis. what are the important targets for osteoarthritis therapy? J Rheumatol Suppl 2004;70:50-3.
  • Henriksen M, Graven-Nielsen T, Aaboe J, Andriacchi TP, Bliddal H. Gait changes in patients with knee osteoarthritis are replicated by experimental knee pain. Arthritis Care Res (Hoboken) 2010;62:501-9.
  • Nagano Y, Naito K, Saho Y, Torii S, Ogata T, Nakazawa K, Akai M, Fukubayashi T. Association between in vivo knee kinematics during gait and the severity of knee osteoarthri- tis. Knee 2012;19:628-32.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Original Article
Authors

Serkan Tas This is me

Sinem Guneri This is me

Aysun Baki This is me

Tezel Yildirim This is me

Bayram Kaymak This is me

Zafer Erden This is me

Publication Date January 16, 2015
Published in Issue Year 2014 Volume: 48 Issue: 6

Cite

APA Tas, S., Guneri, S., Baki, A., Yildirim, T., et al. (2015). Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri. Acta Orthopaedica Et Traumatologica Turcica, 48(6), 635-641. https://doi.org/10.3944/AOTT.2014.13.0071
AMA Tas S, Guneri S, Baki A, Yildirim T, Kaymak B, Erden Z. Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri. Acta Orthopaedica et Traumatologica Turcica. January 2015;48(6):635-641. doi:10.3944/AOTT.2014.13.0071
Chicago Tas, Serkan, Sinem Guneri, Aysun Baki, Tezel Yildirim, Bayram Kaymak, and Zafer Erden. “Diz Osteoartriti şiddetinin yürüyüşün Zaman Mesafe Parametreleri üzerine Etkileri”. Acta Orthopaedica Et Traumatologica Turcica 48, no. 6 (January 2015): 635-41. https://doi.org/10.3944/AOTT.2014.13.0071.
EndNote Tas S, Guneri S, Baki A, Yildirim T, Kaymak B, Erden Z (January 1, 2015) Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri. Acta Orthopaedica et Traumatologica Turcica 48 6 635–641.
IEEE S. Tas, S. Guneri, A. Baki, T. Yildirim, B. Kaymak, and Z. Erden, “Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri”, Acta Orthopaedica et Traumatologica Turcica, vol. 48, no. 6, pp. 635–641, 2015, doi: 10.3944/AOTT.2014.13.0071.
ISNAD Tas, Serkan et al. “Diz Osteoartriti şiddetinin yürüyüşün Zaman Mesafe Parametreleri üzerine Etkileri”. Acta Orthopaedica et Traumatologica Turcica 48/6 (January 2015), 635-641. https://doi.org/10.3944/AOTT.2014.13.0071.
JAMA Tas S, Guneri S, Baki A, Yildirim T, Kaymak B, Erden Z. Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri. Acta Orthopaedica et Traumatologica Turcica. 2015;48:635–641.
MLA Tas, Serkan et al. “Diz Osteoartriti şiddetinin yürüyüşün Zaman Mesafe Parametreleri üzerine Etkileri”. Acta Orthopaedica Et Traumatologica Turcica, vol. 48, no. 6, 2015, pp. 635-41, doi:10.3944/AOTT.2014.13.0071.
Vancouver Tas S, Guneri S, Baki A, Yildirim T, Kaymak B, Erden Z. Diz osteoartriti şiddetinin yürüyüşün zaman mesafe parametreleri üzerine etkileri. Acta Orthopaedica et Traumatologica Turcica. 2015;48(6):635-41.