Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2009

Open Access 01-12-2009 | Research article

Differences in gait patterns, pain, function and quality of life between males and females with knee osteoarthritis: a clinical trial

Authors: Ronen Debi, Amit Mor, Ofer Segal, Ganit Segal, Eytan Debbi, Gabriel Agar, Nahum Halperin, Amir Haim, Avi Elbaz

Published in: BMC Musculoskeletal Disorders | Issue 1/2009

Login to get access

Abstract

Background

The aim of this study was to gain a deeper understanding of the gender differences in knee osteoarthritis (OA) by evaluating the differences in gait spatio-temporal parameters and the differences in pain, quality of life and function between males and females suffering from knee OA.

Methods

49 males and 85 females suffering from bilateral medial compartment knee OA participated in this study. Each patient underwent a computerized gait test and completed the WOMAC questionnaire and the SF-36 health survey. Independent t-tests were performed to examine the differences between males and females in age, BMI, spatio-temporal parameters, the WOMAC questionnaire and the SF-36 health survey.

Results

Males and females had different gait patterns. Although males and females walked at the same walking speed, cadence and step length, they presented significant differences in the gait cycle phases. Males walked with a smaller stance and double limb support, and with a larger swing and single limb support compared to females. In addition, males walked with a greater toe out angle compared to females. While significant differences were not found in the WOMAC subscales, females consistently reported higher levels of pain and disability.

Conclusion

The spatio-temporal differences between genders may suggest underlying differences in the gait strategies adopted by males and females in order to reduce pain and cope with the loads acting on their affected joints, two key aspects of knee OA. These gender effects should therefore be taken into consideration when evaluating patients with knee OA.

Trial Registration

The study is registered in the NIH clinical trial registration, protocol No. NCT00599729.
Appendix
Available only for authorised users
Literature
1.
Zhang Y, Xu L, Nevitt MC, Aliabadi P, Yu W, Qin M, Lui LY, Felson DT: Comparison of the prevalence of knee osteoarthritis between the elderly Chinese population in Beijing and whites in the United States: The Beijing osteoarthritis study. Arthritis Rheum. 2001, 44: 2065-2071. 10.1002/1529-0131(200109)44:9<2065::AID-ART356>3.0.CO;2-Z.CrossRefPubMed
2.
Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, Fang F, Schwartz TA, Abbate LM, Callahan LF, Kalsbeek WD, Hochberg MC: Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2007, 34: 172-180.PubMed
3.
Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK: Prevalence and burden of osteoarthritis: results from a population survey in Norway. J Rheumatol. 2008, 35: 677-684.PubMed
4.
Dillon CF, Rasch EK, Gu Q, Hirsch R: Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-1994. J Rheumatol. 2006, 33: 2271-2279.PubMed
5.
Yoshimura N, Muraki S, Oka H, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Yoshida H, Suzuki T, Yamamoto S, Ishibashi H, Kawaquchi H, Nakamura K, Akune T: Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab. 2009, 27: 620-628. 10.1007/s00774-009-0080-8.CrossRefPubMed
6.
March LM, Bagga H: Epidemiology of osteoarthritis in Australia. Med J Australia. 2004, 180: S6-10.PubMed
7.
O'Connor MI: Sex differences in osteoarthritis of the hip and knee. J Am Acad Orthop Surg. 2007, 15: 522-525.
8.
Sarikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G: A meta-analysis of the sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis Cartilage. 2005, 13: 769-781. 10.1016/j.joca.2005.04.014.CrossRef
9.
Davis MA, Ettinger WH, Neuhaus JM, Mallon KP: Knee osteoarthritis and physical functioning: evidence from the NHANES I epidemiologic follow up study. J Rheum. 1991, 18: 591-598.PubMed
10.
Weidenhielm L, Svensson OK, Brostrom LA, Mattsson E: Adduction moment of the knee compared to radiological and clinical parameters in moderate medical osteoarthritis of the knee. Ann Chir Gynaecol. 1994, 83: 236-242.PubMed
11.
McKean KA, Landry SC, Hubley-Kozey CL, Dunbar MJ, Stanish WD, Deluzio KJ: Gender differences exist in osteoarthritis gait. Clin Biomec. 2007, 22: 400-409. 10.1016/j.clinbiomech.2006.11.006.CrossRef
12.
Kerrigan DC, Riely PO, Nieto TL, Della CU: Knee joint torques: a comparison between women and men during barefoot walking. Arch Phys Med Rehabil. 2000, 81: 1162-1165. 10.1053/apmr.2000.7172.CrossRefPubMed
13.
Sigward SM, Powers CM: The influence of gender on knee kinematics, kinetics and muscle activation patterns during side-step cutting. Clin Biomech. 2006, 21: 41-48. 10.1016/j.clinbiomech.2005.08.001.CrossRef
14.
Kerrigan DC, Todd MK, Della CU: Gender differences in joint biomechanics during walking. Am J Phys Med Rehabil. 1998, 77: 2-7. 10.1097/00002060-199801000-00002.CrossRefPubMed
15.
Al-Obaidi S, Wall JC, Al-Yaqoub A, Al-Ghanim M: Basic gait parameters: a comparison reference data for normal subjects 20-29 years of age from Kuwait and Scandinavia. J Rehabil Res Develop. 2003, 40: 361-366. 10.1682/JRRD.2003.07.0361.CrossRef
16.
Barrett R, Noordegraaf MV, Morrison S: Gender difference in the variability of lower extremity kinematics during treadmill locomotion. J Mot Behav. 2008, 40: 62-70. 10.3200/JMBR.40.1.62-70.CrossRefPubMed
17.
Cho SH, Park JM, Kwon OY: Gender differences in three dimensional gait analysis data from 98 healthy Korean adults. Clin Biomech. 2004, 19: 145-152. 10.1016/j.clinbiomech.2003.10.003.CrossRef
18.
Laufer Y: Age- and gender-related changes in the temporal-spatial characteristics of forwards and backwards gaits. Physiother Res Int. 2003, 8: 131-142. 10.1002/pri.281.CrossRefPubMed
19.
Oberg T, Karsznia A, Oberg T: Basic gait parameters: Reference data for normal subjects, 10-79 years of age. J Rehabil Res Develop. 1993, 30: 210-223.
20.
Samson MM, Crowe A, de Vreede PL, Dessens JA, Duursma SA, Verhaar HJ: Differences in gait parameters at a preferred waking speed in healthy subjects due to age, height and body weight. Aging. 2001, 13: 16-21.PubMed
21.
Keefe FJ, Lefebvre JC, Egert JR, Affelck G, Sullivan MJ, Caldwell DS: The relationship of gender to pain, pain behavior, and disability in osteoarthritis: the role of catastrophizing. J Pain. 2000, 87: 325-334. 10.1016/S0304-3959(00)00296-7.CrossRef
22.
Robinson ME, Gagnon CM, Riley JL, Price DD: Altering gender role expectations: effects of pain tolerance, pain threshold, and pain rating. J Pain. 2003, 4: 284-288. 10.1016/S1526-5900(03)00559-5.CrossRefPubMed
23.
Keefe FJ, Lefebvre JC, Eqert JR, Affleck G, Sullivan MJ, Caldwell DS: The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. J Pain. 2000, 87: 325-334. 10.1016/S0304-3959(00)00296-7.CrossRef
24.
Tsang A, Von Kroff M, Lee S, Alonso J, Karam E, Angermeyer MC, Borges GL, Bromet EJ, Demytteneare K, de Girolamo G, de Graaf R, Gureje O, Lepine JP, Haro JM, Levinson D, Oakley Browne MA, Posada-Villa J, Seedat S, Watanabe M: Common chronic pain conditions in developed and developing countries: gender and age differences and morbidity with depression-anxiety disorders. J Pain. 2008, 9: 883-891. 10.1016/j.jpain.2008.05.005.CrossRefPubMed
25.
Salaffi F, Carotti M, Stancati A, Grassi W: Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res. 2005, 17: 255-263.CrossRefPubMed
26.
Briggs A, Scott E, Steele K: Impact of osteoarthritis and analgetic treatment on quality of life of an elderly population. Ann Pharmacother. 1999, 33: 1154-1159. 10.1345/aph.18411.CrossRefPubMed
27.
Rollnik JD, Karst M, Piepenbrock S, Gehrke A, Dengler R, Fink M: Gender differences in coping with tension-type headaches. Eur Neurol. 2003, 50: 73-77. 10.1159/000072502.CrossRefPubMed
28.
Altman R, Asch E, Bloch D, Bole G, Bronstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, Howell D, Kaplan D, Koopman W, Longley S, Mankin H, McShane DJ, Medsger T, Meenan R, Mikkelsen W, Moskowitz R, Murphy W, Rothschild B, Segal M, Sokoloff L, Wolfe F: Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rehum. 1986, 29: 1039-1049. 10.1002/art.1780290816.CrossRef
29.
Kellgren JH, Lawrence JS: Atlas of Standard Radiographs, Department of Rheumatology and Medical Illustration. 1963, University of Manchester. Oxford: Blackwell press
30.
Rosenberg TD, Paulos LE, Parker RD, Coward DB, Scott SM: The forty-five-degree posteroanterior flexion weigh-bearing radiograph of the knee. J Bone Joint Surg. 1988, 70-a (10): 1479-1482.
31.
Sparrow WA: Energetics of human activity. 2000, Champaign: Human Kinetics
32.
Van Uden CJT, Besser M: Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system (GAITRite). BMC Musculoskelet Disord. 2004, 17: 5-13.
33.
Webster KE, Wittwer JE, Feller JA: Validity of the GAITRite walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture. 2005, 22: 317-321. 10.1016/j.gaitpost.2004.10.005.CrossRefPubMed
34.
Messier SP: Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management. Rheum Dis Clin North Am. 2008, 34: 713-729. 10.1016/j.rdc.2008.04.007.CrossRefPubMedPubMedCentral
35.
Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M: Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001, 161: 2309-2316. 10.1001/archinte.161.19.2309.CrossRefPubMed
36.
Frederick EC, Hagy JL: Factors affecting peak vertical ground reaction forces in running. Int J Sport Biomech. 1986, 2: 41-49.
37.
Perry J: Gait analysis: normal and pathological function. 1992, Thorofare: SLACK Incorporated
38.
Magee DJ: Orthopedic physical assessment. 2007, St. Louis: Saunders, Fifth
39.
Brandes MB, Schomaker R, Mollenhoff G, Rosenbaum D: Quantity versus quality of gait and quality of life in patients with osteoarthritis. Gait Posture. 2008, 28: 74-79. 10.1016/j.gaitpost.2007.10.004.CrossRefPubMed
40.
Andrews M, Noyes FR, Hewett TE, Andriacchi TP: Lower limb alignment and foot angle are related to stance phase knee adduction in normal subjects: a critical analysis of the reliability of gain analysis data. J Orthop Res. 1996, 14: 289-295. 10.1002/jor.1100140218.CrossRefPubMed
41.
Hurwitz DE, Ryals AB, Case JP, Block JA, Andriacchi TP: The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain. J Orthop Res. 2002, 20: 101-107. 10.1016/S0736-0266(01)00081-X.CrossRefPubMed
42.
Hunt MA, Birmingham TB, Giffin JR, Jenkyn TR: Associations among knee adduction moment, frontal plane ground reaction force, and lever arm during walking in patients with knee osteoarthritis. J Biomech. 2006, 39: 2213-2220. 10.1016/j.jbiomech.2005.07.002.CrossRefPubMed
43.
Chang A, Hurwitz D, Dunlop D, Song J, Cahue S, Hayes K, Sharma L: The relationship between toe-out angle during gait and progression of medial tibiofemoral osteoarthritis. Ann Rheum Dis. 2007, 66: 1271-1275. 10.1136/ard.2006.062927.CrossRefPubMedPubMedCentral
44.
Tsai YF: Gender differences in pain and depressive tendency among Chinese elders with knee osteoarthritis. Pain. 2007, 130: 188-194. 10.1016/j.pain.2007.03.014.CrossRefPubMed
45.
Weidow J, Cederlund CG, Runstam J, Karrholm J: Ahlback grading of osteoarthritis of the knee: poor reproducibility and validity based on visual inspection of the joint. Acta Orthopaedica. 2006, 77 (2): 262-266. 10.1080/17453670610046000.CrossRefPubMed
46.
Kijowski R, Blankenbaker D, Stanton P, Fine J, De Smet A: Arthroscopic validation of radiographic grading scale of osteoarthritis of the tibiofemoral joint. Am J of Roentgent. 2006, 187: 794-799. 10.2214/AJR.05.1123.CrossRef
Metadata
Title
Differences in gait patterns, pain, function and quality of life between males and females with knee osteoarthritis: a clinical trial
Authors
Ronen Debi
Amit Mor
Ofer Segal
Ganit Segal
Eytan Debbi
Gabriel Agar
Nahum Halperin
Amir Haim
Avi Elbaz
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2009
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-10-127

Other articles of this Issue 1/2009

BMC Musculoskeletal Disorders 1/2009 Go to the issue

Research article

Principles of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: A double-blind randomized exploratory trial

Research article

Reducing work disability in Ankylosing Spondylitis – development of a work instability scale for AS

Research article

The relationship between quality of life and compliance to a brace protocol in adolescents with idiopathic scoliosis: a comparative study

Research article

Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study

Research article

Prevalence of fibromyalgia in a low socioeconomic status population

Research article

Biomechanical optimization of different fixation modes for a proximal femoral L-osteotomy