Balance and gait adaptations in patients with early knee osteoarthritis

Lynsey D Duffell, Dominic F L Southgate, Vivek Gulati, Alison H McGregor, Lynsey D Duffell, Dominic F L Southgate, Vivek Gulati, Alison H McGregor

Abstract

Gait adaptations in people with severe knee osteoarthritis (OA) have been well documented, with increased knee adduction moments (KAM) the most commonly reported parameter. Neuromuscular adaptations have also been reported, including reduced postural control. However these adaptations may be the result of morphological changes in the joint, rather than the cause. This study aimed to determine if people with early OA have altered gait parameters and neuromuscular adaptations. Gait and postural tasks were performed by 18 people with early medial knee OA and 18 age and gender-matched control subjects. Parameters measured were kinematics and kinetics during gait and postural tasks, and centre of pressure and electromyographic activity during postural tasks. OA subjects showed no differences in the gait parameters measured, however they demonstrated postural deficits during one-leg standing on both their affected and unaffected sides and altered hip adduction moments compared with controls. Increased activity of the gluteus medius of both sides (p<0.05), and quadriceps and hamstrings of the affected side (p<0.05) during one-leg standing compared with controls were also noted. This study has demonstrated that gait adaptations commonly associated with OA do not occur in the early stages, while neuromuscular adaptations are evident. These results may be relevant for early interventions to delay or prevent osteoarthritis in its early stages.

Keywords: Gait; Knee; Muscle; Osteoarthritis; Posture.

Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
Mean (SD) centre of trajectory path length for controls (black) and early OA subjects (grey) during quiet standing with eyes open (QSEO) and eyes closed (QSEC) and one leg standing on the left (controls) or unaffected (OA) side (OLS L/Unaff) and right (controls) or affected (OA) side (OLS R/Aff). * denotes significant difference between groups (p < 0.05).
Fig. 2
Fig. 2
Mean (SD) hip adduction moment for controls (black) and early OA subjects (grey) during one leg standing on the left (controls) or unaffected (OA) side (L/Unaff) and right (controls) or affected (OA) side (R/Aff). * denotes significant difference between groups (p < 0.05).
Fig. 3
Fig. 3
Mean (SD) activity of the gluteus medius muscle for controls (black) and early OA subjects (grey) of the (a) left (controls) or unaffected (OA) side and (b) right (controls) or affected (OA) side for quiet standing with eyes open (QSEO) and eyes closed (QSEC) and one leg standing (OLS). * denotes significant difference between groups (p < 0.05).

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Source: PubMed

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