Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2013

Open Access 01-12-2013 | Research article

Analysis of knee flexion characteristics and how they alter with the onset of knee osteoarthritis: a case control study

Authors: Ian McCarthy, Diana Hodgins, Amit Mor, Avi Elbaz, Ganit Segal

Published in: BMC Musculoskeletal Disorders | Issue 1/2013

Login to get access

Abstract

Background

The purpose of this study was to examine the differences in gait profile between patients with knee osteoarthritis (OA) and healthy control and to create motion characteristics that will differentiate between them.

Methods

Twenty three patients diagnosed with knee OA and 21 healthy matched controls underwent a gait test using a sensor system (gaitWALK). Gait parameters evaluated were: stride duration, knee flexion range of motion (ROM) in swing and stance. T-Test was used to evaluate significant differences between groups (P < 0.05).

Results

Patients with knee OA had significant lower knee flexion ROM (10.3° ± 4.0°) during stance than matched controls (18.0° ± 4.0°) (p < 0.001). Patients with knee OA had significant lower knee flexion ROM (54.8° ± 5.5°) during swing than matched controls (61.2° ± 6.1) (p = 0.003). Patients with knee OA also had longer stride duration (1.12 s ± 0.09 s) than matched controls (1.06 s ± 0.11 s), but this was not statistically significant (p = 0.073). Motion characteristics differentiate between a patient with knee OA and a healthy one with a sensitivity of 0.952 and a specificity of 0.783.

Conclusions

Significant differences were found in the gait profile of patients with knee OA compared to matched control and motion characteristics were identified. This test might help clinicians identify and evaluate a knee problem in a simple gait test.
Appendix
Available only for authorised users
Literature
1.
go back to reference Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF: The prevalence of knee osteoarthritis in the elderly: the Framingham osteoarthritis study. Arthritis Rheum. 1987, 38 (8): 914-918.CrossRef Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF: The prevalence of knee osteoarthritis in the elderly: the Framingham osteoarthritis study. Arthritis Rheum. 1987, 38 (8): 914-918.CrossRef
2.
go back to reference Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN: Gait characteristics of patients with knee osteoarthritis. J Biomech. 2001, 34 (7): 907-915. 10.1016/S0021-9290(01)00036-7.CrossRefPubMed Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN: Gait characteristics of patients with knee osteoarthritis. J Biomech. 2001, 34 (7): 907-915. 10.1016/S0021-9290(01)00036-7.CrossRefPubMed
3.
go back to reference Kellgren JH, Lawrence JA: Radiological assessment of osteo-arthrosis. Annals Rheumatic Dis. 1957, 16 (4): 494-502. 10.1136/ard.16.4.494.CrossRef Kellgren JH, Lawrence JA: Radiological assessment of osteo-arthrosis. Annals Rheumatic Dis. 1957, 16 (4): 494-502. 10.1136/ard.16.4.494.CrossRef
4.
go back to reference Stolz M, Gottardi R, Raiteri R, Miot S, Martin I, Imer R, Staufer U, Raducanu A, Duggelin M, Baschong W, Daniels AU, Friederich NF, Aszodi A, Aebi U: Early detection of aging cartilage and osteoarthritis in mice and patient samples using atomic force microscopy. Nat Nanotechnol. 2009, 4: 186-192. 10.1038/nnano.2008.410.CrossRefPubMed Stolz M, Gottardi R, Raiteri R, Miot S, Martin I, Imer R, Staufer U, Raducanu A, Duggelin M, Baschong W, Daniels AU, Friederich NF, Aszodi A, Aebi U: Early detection of aging cartilage and osteoarthritis in mice and patient samples using atomic force microscopy. Nat Nanotechnol. 2009, 4: 186-192. 10.1038/nnano.2008.410.CrossRefPubMed
5.
go back to reference Qazi AA, Folkesson J, Pettersen PC, Karsdal MA, Christiansen C, Dam EB: Separation of healthy and early osteoarthritis by automatic quantification of cartilage homogeneity. Osteoarthritis Cartilage. 2007, 15 (10): 1199-1206. 10.1016/j.joca.2007.03.016.CrossRefPubMed Qazi AA, Folkesson J, Pettersen PC, Karsdal MA, Christiansen C, Dam EB: Separation of healthy and early osteoarthritis by automatic quantification of cartilage homogeneity. Osteoarthritis Cartilage. 2007, 15 (10): 1199-1206. 10.1016/j.joca.2007.03.016.CrossRefPubMed
6.
go back to reference Shakoor N, Hurwitz DE, Block JA, Shott S, Case JP: Asymmetric knee loading in advanced unilateral hip osteoarthritis. Arthritis and Rheumarism. 2003, 48: 1556-1561. 10.1002/art.11034.CrossRef Shakoor N, Hurwitz DE, Block JA, Shott S, Case JP: Asymmetric knee loading in advanced unilateral hip osteoarthritis. Arthritis and Rheumarism. 2003, 48: 1556-1561. 10.1002/art.11034.CrossRef
7.
go back to reference Dieppe PA, Cushnaghan J, Shepstone L: The Bristol ‘OA500’ study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthritis Cartilage. 1997, 5 (2): 87-97. 10.1016/S1063-4584(97)80002-7.CrossRefPubMed Dieppe PA, Cushnaghan J, Shepstone L: The Bristol ‘OA500’ study: progression of osteoarthritis (OA) over 3 years and the relationship between clinical and radiographic changes at the knee joint. Osteoarthritis Cartilage. 1997, 5 (2): 87-97. 10.1016/S1063-4584(97)80002-7.CrossRefPubMed
8.
go back to reference Debi R, Mor A, Segal G, Segal O, Agar G, Debbi E, Halperin N, Haim A, Elbaz A: Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations. Disabil Rehabil. 2011, 33: 1103-1109. 10.3109/09638288.2010.520805.CrossRefPubMedPubMedCentral Debi R, Mor A, Segal G, Segal O, Agar G, Debbi E, Halperin N, Haim A, Elbaz A: Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations. Disabil Rehabil. 2011, 33: 1103-1109. 10.3109/09638288.2010.520805.CrossRefPubMedPubMedCentral
9.
go back to reference Elbaz A, Mor A, Segal O, Agar G, Halperin N, Haim A, Debbi EM, Segal G, Debi R: Can single limb support objectively assess the functional severity of knee osteoarthritis?. Knee. 2012, 12 (1): 32-35.CrossRef Elbaz A, Mor A, Segal O, Agar G, Halperin N, Haim A, Debbi EM, Segal G, Debi R: Can single limb support objectively assess the functional severity of knee osteoarthritis?. Knee. 2012, 12 (1): 32-35.CrossRef
10.
go back to reference Mündermann A, Dyrby CA, Andriacchi TP: Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum. 2005, 52 (9): 2585-2954. 10.1002/art.21363.CrossRef Mündermann A, Dyrby CA, Andriacchi TP: Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum. 2005, 52 (9): 2585-2954. 10.1002/art.21363.CrossRef
11.
go back to reference Brinkmann JR, Perry J: Rate and range of knee motion during ambulation in healthy and arthritic subjects. Phys Ther. 1985, 65: 1055-1060.PubMed Brinkmann JR, Perry J: Rate and range of knee motion during ambulation in healthy and arthritic subjects. Phys Ther. 1985, 65: 1055-1060.PubMed
12.
go back to reference Bejek Z, Paroczai R, Illyes A, Kiis RM: The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2006, 14: 612-622. 10.1007/s00167-005-0005-6.CrossRefPubMed Bejek Z, Paroczai R, Illyes A, Kiis RM: The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2006, 14: 612-622. 10.1007/s00167-005-0005-6.CrossRefPubMed
13.
go back to reference Tolea M, Costa PT, Terracciano A, Griswold M, Simonsick EM, Najjar SS, Scuteri A, Deiana B, Orrù M, Masala M, Uda M, Schlessinger D, Ferrucci L: Sex-specific correlates of walking speed in a wide age-ranged population. J Gerontology Psychological Sci. 2010, 65B: 174-184. 10.1093/geronb/gbp130.CrossRef Tolea M, Costa PT, Terracciano A, Griswold M, Simonsick EM, Najjar SS, Scuteri A, Deiana B, Orrù M, Masala M, Uda M, Schlessinger D, Ferrucci L: Sex-specific correlates of walking speed in a wide age-ranged population. J Gerontology Psychological Sci. 2010, 65B: 174-184. 10.1093/geronb/gbp130.CrossRef
14.
go back to reference 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 osteoarthritis. Knee. 2011, 10.1016/j.knee.2011.11.02. 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 osteoarthritis. Knee. 2011, 10.1016/j.knee.2011.11.02.
15.
go back to reference Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ: Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. 2008, 26: 332-341. 10.1002/jor.20496.CrossRefPubMed Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ: Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. 2008, 26: 332-341. 10.1002/jor.20496.CrossRefPubMed
16.
go back to reference Zeni JA, Higginson JS: Differences in gait parameters between healthy subjects and persons with moderate and severe osteoarthritis: a result of altered walking speed?. Clin Biomechanics. 2009, 24: 372-378. 10.1016/j.clinbiomech.2009.02.001.CrossRef Zeni JA, Higginson JS: Differences in gait parameters between healthy subjects and persons with moderate and severe osteoarthritis: a result of altered walking speed?. Clin Biomechanics. 2009, 24: 372-378. 10.1016/j.clinbiomech.2009.02.001.CrossRef
17.
go back to reference Sheldon RS: Quantification of human motion: gait analysis – benefits and limitations to its application to clinical problems. J Biomech. 2004, 37 (12): 1869-1880. 10.1016/j.jbiomech.2004.02.047.CrossRef Sheldon RS: Quantification of human motion: gait analysis – benefits and limitations to its application to clinical problems. J Biomech. 2004, 37 (12): 1869-1880. 10.1016/j.jbiomech.2004.02.047.CrossRef
18.
go back to reference Bilney B: Concurrent related validity of the GAITRite® walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture. 2003, 17: 68-74. 10.1016/S0966-6362(02)00053-X.CrossRefPubMed Bilney B: Concurrent related validity of the GAITRite® walkway system for quantification of the spatial and temporal parameters of gait. Gait Posture. 2003, 17: 68-74. 10.1016/S0966-6362(02)00053-X.CrossRefPubMed
19.
go back to reference Barker S, Craik R, Freedman W, Herrmann N, Hillstrom H: Accuracy, reliability, and validity of a spatiotemporal gait analysis system. Medical Engineering and Physics. 2006, 28 (5): 460-467. 10.1016/j.medengphy.2005.07.017.CrossRefPubMed Barker S, Craik R, Freedman W, Herrmann N, Hillstrom H: Accuracy, reliability, and validity of a spatiotemporal gait analysis system. Medical Engineering and Physics. 2006, 28 (5): 460-467. 10.1016/j.medengphy.2005.07.017.CrossRefPubMed
20.
go back to reference Rueterbories J, Spaich EG, Larsen B, Andersen OK: Methods for gait event detection and analysis in ambulatory systems. Medical Engineering and Physics. 2010, 32: 545-552. 10.1016/j.medengphy.2010.03.007.CrossRefPubMed Rueterbories J, Spaich EG, Larsen B, Andersen OK: Methods for gait event detection and analysis in ambulatory systems. Medical Engineering and Physics. 2010, 32: 545-552. 10.1016/j.medengphy.2010.03.007.CrossRefPubMed
21.
go back to reference Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M: Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum. 1986, 29: 1039-1049. 10.1002/art.1780290816.CrossRefPubMed Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M: Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum. 1986, 29: 1039-1049. 10.1002/art.1780290816.CrossRefPubMed
23.
go back to reference Cooper G, Sheret I, McMillan L, Siliverdis K, Sha N, Hodgins D, Kenney L, Howard D: Inertial sensor-based knee flexion/extension angle estimation. J Biomech. 2009, 42: 2678-2685. 10.1016/j.jbiomech.2009.08.004.CrossRefPubMed Cooper G, Sheret I, McMillan L, Siliverdis K, Sha N, Hodgins D, Kenney L, Howard D: Inertial sensor-based knee flexion/extension angle estimation. J Biomech. 2009, 42: 2678-2685. 10.1016/j.jbiomech.2009.08.004.CrossRefPubMed
24.
go back to reference Lewek MD, Scholz J, Dudolph KS, Snyder Mackler L: Stride-to-stride variability of knee motion in patients with knee osteoarthritis. Gait Posture. 2006, 23 (4): 505-511. 10.1016/j.gaitpost.2005.06.003.CrossRefPubMed Lewek MD, Scholz J, Dudolph KS, Snyder Mackler L: Stride-to-stride variability of knee motion in patients with knee osteoarthritis. Gait Posture. 2006, 23 (4): 505-511. 10.1016/j.gaitpost.2005.06.003.CrossRefPubMed
25.
go back to reference Hatfield GL, Hubley-Kozey CL, Astephen Wilson JL, Dunbar MJ: The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait. J Arthroplasty. 2011, 26: 309-318. 10.1016/j.arth.2010.03.021.CrossRefPubMed Hatfield GL, Hubley-Kozey CL, Astephen Wilson JL, Dunbar MJ: The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait. J Arthroplasty. 2011, 26: 309-318. 10.1016/j.arth.2010.03.021.CrossRefPubMed
26.
go back to reference Landry SC, McKean KA, Hubley-Kozey CL, Stanish WD, Deluzio KL: Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. J Biomech. 2007, 40: 1754-1761. 10.1016/j.jbiomech.2006.08.010.CrossRefPubMed Landry SC, McKean KA, Hubley-Kozey CL, Stanish WD, Deluzio KL: Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. J Biomech. 2007, 40: 1754-1761. 10.1016/j.jbiomech.2006.08.010.CrossRefPubMed
27.
go back to reference Lewek MD, Rudolph KS, Snyder-Mackler L: Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. J Orthop Res. 2004, 22 (1): 110-115. 10.1016/S0736-0266(03)00154-2.CrossRefPubMedPubMedCentral Lewek MD, Rudolph KS, Snyder-Mackler L: Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. J Orthop Res. 2004, 22 (1): 110-115. 10.1016/S0736-0266(03)00154-2.CrossRefPubMedPubMedCentral
28.
go back to reference Piazza S, Delp S: The influence of muscles on knee flexion during the swing phase of gait. J Biomech. 1996, 29: 723-733. 10.1016/0021-9290(95)00144-1.CrossRefPubMed Piazza S, Delp S: The influence of muscles on knee flexion during the swing phase of gait. J Biomech. 1996, 29: 723-733. 10.1016/0021-9290(95)00144-1.CrossRefPubMed
29.
go back to reference Hubley-Cozey CL, Hatfield GL, Wilson JL, Dunbar MJ: Alterations in neuromuscular patterns between pre- and one-year post-total knee arthroplasty. Clinical Biomechanics. 2010, 25: 995-1002. 10.1016/j.clinbiomech.2010.07.008.CrossRef Hubley-Cozey CL, Hatfield GL, Wilson JL, Dunbar MJ: Alterations in neuromuscular patterns between pre- and one-year post-total knee arthroplasty. Clinical Biomechanics. 2010, 25: 995-1002. 10.1016/j.clinbiomech.2010.07.008.CrossRef
Metadata
Title
Analysis of knee flexion characteristics and how they alter with the onset of knee osteoarthritis: a case control study
Authors
Ian McCarthy
Diana Hodgins
Amit Mor
Avi Elbaz
Ganit Segal
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2013
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-14-169

Other articles of this Issue 1/2013

BMC Musculoskeletal Disorders 1/2013 Go to the issue