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Published in: BMC Musculoskeletal Disorders 1/2021

01-12-2021 | Osteoarthritis of the Hip | Research article

Effects of unweighting on gait kinematics during walking on a lower-body positive-pressure treadmill in patients with hip osteoarthritis

Authors: Yoshiaki Kataoka, Tomohiro Shimizu, Ryo Takeda, Shigeru Tadano, Yuki Saito, Satoshi Osuka, Tomoya Ishida, Mina Samukawa, Tohru Irie, Daisuke Takahashi, Norimasa Iwasaki, Harukazu Tohyama

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

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Abstract

Background

Hip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities. Treadmills that support the body weight (BW) reduce the load on the lower limbs, and those equipped with a lower-body positive-pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. However, the effects of unweighting on gait kinematics remain unclear in patients with hip OA. Therefore, we investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device.

Methods

A total of 15 women with hip OA and 15 age-matched female controls wore a three-dimensional (3-D) motion analysis system and walked at a self-selected speed on the LBPP treadmill. Data regarding self-reported hip pain using a numeric rating scale (NRS) in which the scores 0 and 10 represented no pain and the worst pain, respectively, under three different BW conditions (100, 75, and 50%) were collected. Moreover, 3-D peak joint angles during gait under each condition were calculated and compared.

Results

In the hip OA group, the NRS pain scores at 50 and 75% BW conditions significantly decreased compared with that at 100% BW condition (50%, P = 0.002; 75%, P = 0.026), and the peak hip extension angle decreased compared with that in the healthy controls (P = 0.044). In both groups, unweighting significantly decreased the peak hip (P < 0.001) and knee (P < 0.001) flexion angles and increased the peak ankle plantar flexion angle (P < 0.001) during walking.

Conclusions

Unweighting by the LBPP treadmill decreased pain in the hip OA group but did not drastically alter the gait kinematics compared with that in the control group. Therefore, regarding the use of the LBPP treadmill for patients with hip OA, clinicians should consider the benefits of pain reduction rather than the kinematic changes.
Literature
1.
go back to reference Bieler T, Siersma V, Magnusson SP, Kjaer M, Christensen HE, Beyer N. In hip osteoarthritis, Nordic walking is superior to strength training and home-based exercise for improving function. Scand J Med Sci Sports. 2017;27(8):873–86.PubMedCrossRef Bieler T, Siersma V, Magnusson SP, Kjaer M, Christensen HE, Beyer N. In hip osteoarthritis, Nordic walking is superior to strength training and home-based exercise for improving function. Scand J Med Sci Sports. 2017;27(8):873–86.PubMedCrossRef
2.
go back to reference Solomonow-Avnon D, Herman A, Levin D, Rozen N, Peled E, Wolf A. Positive outcomes following gait therapy intervention for hip osteoarthritis: a longitudinal study. J Orthop Res. 2017;35(10):2222–32.PubMedCrossRef Solomonow-Avnon D, Herman A, Levin D, Rozen N, Peled E, Wolf A. Positive outcomes following gait therapy intervention for hip osteoarthritis: a longitudinal study. J Orthop Res. 2017;35(10):2222–32.PubMedCrossRef
3.
go back to reference Cutuk A, Groppo ER, Quigley EJ, White KW, Pedowitz RA, Hargens AR. Ambulation in simulated fractional gravity using lower body positive pressure: cardiovascular safety and gait analyses. J Appl Physiol (1985). 2006;101(3):771–7.CrossRef Cutuk A, Groppo ER, Quigley EJ, White KW, Pedowitz RA, Hargens AR. Ambulation in simulated fractional gravity using lower body positive pressure: cardiovascular safety and gait analyses. J Appl Physiol (1985). 2006;101(3):771–7.CrossRef
4.
go back to reference Patil S, Steklov N, Bugbee WD, Goldberg T, Colwell CW Jr, D'Lima DD. Anti-gravity treadmills are effective in reducing knee forces. J Orthop Res. 2013;31(5):672–9.PubMedCrossRef Patil S, Steklov N, Bugbee WD, Goldberg T, Colwell CW Jr, D'Lima DD. Anti-gravity treadmills are effective in reducing knee forces. J Orthop Res. 2013;31(5):672–9.PubMedCrossRef
5.
go back to reference Takacs J, Anderson JE, Leiter JR, MacDonald PB, Peeler JD. Lower body positive pressure: an emerging technology in the battle against knee osteoarthritis? Clin Interv Aging. 2013;8:983–91.PubMedPubMedCentral Takacs J, Anderson JE, Leiter JR, MacDonald PB, Peeler JD. Lower body positive pressure: an emerging technology in the battle against knee osteoarthritis? Clin Interv Aging. 2013;8:983–91.PubMedPubMedCentral
6.
go back to reference Peeler J, Christian M, Cooper J, Leiter J, MacDonald P. Managing knee osteoarthritis: the effects of body weight supported physical activity on joint pain, function, and thigh muscle strength. Clin J Sport Med. 2015;25(6):518–23.PubMed Peeler J, Christian M, Cooper J, Leiter J, MacDonald P. Managing knee osteoarthritis: the effects of body weight supported physical activity on joint pain, function, and thigh muscle strength. Clin J Sport Med. 2015;25(6):518–23.PubMed
7.
go back to reference Ruckstuhl H, Kho J, Weed M, Wilkinson MW, Hargens AR. Comparing two devices of suspended treadmill walking by varying body unloading and Froude number. Gait Posture. 2009;30(4):446–51.PubMedCrossRef Ruckstuhl H, Kho J, Weed M, Wilkinson MW, Hargens AR. Comparing two devices of suspended treadmill walking by varying body unloading and Froude number. Gait Posture. 2009;30(4):446–51.PubMedCrossRef
8.
go back to reference Tadano S, Takeda R, Sasaki K, Fujisawa T, Tohyama H. Gait characterization for osteoarthritis patients using wearable gait sensors (H-gait systems). J Biomech. 2016;49(5):684–90.PubMedCrossRef Tadano S, Takeda R, Sasaki K, Fujisawa T, Tohyama H. Gait characterization for osteoarthritis patients using wearable gait sensors (H-gait systems). J Biomech. 2016;49(5):684–90.PubMedCrossRef
10.
go back to reference Sainton P, Nicol C, Cabri J, Barthelemy-Montfort J, Chavet P. Kinetics and muscle activity patterns during unweighting and reloading transition phases in running. PLoS One. 2016;11(12):e0168545.PubMedPubMedCentralCrossRef Sainton P, Nicol C, Cabri J, Barthelemy-Montfort J, Chavet P. Kinetics and muscle activity patterns during unweighting and reloading transition phases in running. PLoS One. 2016;11(12):e0168545.PubMedPubMedCentralCrossRef
11.
go back to reference Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S, European Palliative Care Research C. studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manag. 2011;41(6):1073–93.CrossRef Hjermstad MJ, Fayers PM, Haugen DF, Caraceni A, Hanks GW, Loge JH, Fainsinger R, Aass N, Kaasa S, European Palliative Care Research C. studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manag. 2011;41(6):1073–93.CrossRef
12.
go back to reference Tadano S, Takeda R, Miyagawa H. Three-dimensional gait analysis using wearable acceleration and gyro sensors based on quaternion calculations. Sensors (Basel). 2013;13(7):9321–43.CrossRef Tadano S, Takeda R, Miyagawa H. Three-dimensional gait analysis using wearable acceleration and gyro sensors based on quaternion calculations. Sensors (Basel). 2013;13(7):9321–43.CrossRef
13.
go back to reference Takeda R, Lisco G, Fujisawa T, Gastaldi L, Tohyama H, Tadano S. Drift removal for improving the accuracy of gait parameters using wearable sensor systems. Sensors (Basel). 2014;14(12):23230–47.CrossRef Takeda R, Lisco G, Fujisawa T, Gastaldi L, Tohyama H, Tadano S. Drift removal for improving the accuracy of gait parameters using wearable sensor systems. Sensors (Basel). 2014;14(12):23230–47.CrossRef
14.
go back to reference Aminian K, Najafi B, Bula C, Leyvraz PF, Robert P. Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. J Biomech. 2002;35(5):689–99.PubMedCrossRef Aminian K, Najafi B, Bula C, Leyvraz PF, Robert P. Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. J Biomech. 2002;35(5):689–99.PubMedCrossRef
15.
go back to reference Finch L, Barbeau H, Arsenault B. Influence of body weight support on normal human gait: development of a gait retraining strategy. Phys Ther. 1991;71(11):842–55 discussion 855-846.PubMedCrossRef Finch L, Barbeau H, Arsenault B. Influence of body weight support on normal human gait: development of a gait retraining strategy. Phys Ther. 1991;71(11):842–55 discussion 855-846.PubMedCrossRef
16.
go back to reference Threlkeld AJ, Cooper LD, Monger BP, Craven AN, Haupt HG. Temporospatial and kinematic gait alterations during treadmill walking with body weight suspension. Gait Posture. 2003;17(3):235–45.PubMedCrossRef Threlkeld AJ, Cooper LD, Monger BP, Craven AN, Haupt HG. Temporospatial and kinematic gait alterations during treadmill walking with body weight suspension. Gait Posture. 2003;17(3):235–45.PubMedCrossRef
17.
go back to reference Watelain E, Dujardin F, Babier F, Dubois D, Allard P. Pelvic and lower limb compensatory actions of subjects in an early stage of hip osteoarthritis. Arch Phys Med Rehabil. 2001;82(12):1705–11.PubMedCrossRef Watelain E, Dujardin F, Babier F, Dubois D, Allard P. Pelvic and lower limb compensatory actions of subjects in an early stage of hip osteoarthritis. Arch Phys Med Rehabil. 2001;82(12):1705–11.PubMedCrossRef
18.
go back to reference Constantinou M, Loureiro A, Carty C, Mills P, Barrett R. Hip joint mechanics during walking in individuals with mild-to-moderate hip osteoarthritis. Gait Posture. 2017;53:162–7.PubMedCrossRef Constantinou M, Loureiro A, Carty C, Mills P, Barrett R. Hip joint mechanics during walking in individuals with mild-to-moderate hip osteoarthritis. Gait Posture. 2017;53:162–7.PubMedCrossRef
19.
go back to reference Eitzen I, Fernandes L, Nordsletten L, Risberg MA. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study. BMC Musculoskelet Disord. 2012;13:258.PubMedPubMedCentralCrossRef Eitzen I, Fernandes L, Nordsletten L, Risberg MA. Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study. BMC Musculoskelet Disord. 2012;13:258.PubMedPubMedCentralCrossRef
20.
go back to reference Rutherford D, Moreside J, Wong I. Knee joint motion and muscle activation patterns are altered during gait in individuals with moderate hip osteoarthritis compared to asymptomatic cohort. Clin Biomech (Bristol, Avon). 2015;30(6):578–84.CrossRef Rutherford D, Moreside J, Wong I. Knee joint motion and muscle activation patterns are altered during gait in individuals with moderate hip osteoarthritis compared to asymptomatic cohort. Clin Biomech (Bristol, Avon). 2015;30(6):578–84.CrossRef
Metadata
Title
Effects of unweighting on gait kinematics during walking on a lower-body positive-pressure treadmill in patients with hip osteoarthritis
Authors
Yoshiaki Kataoka
Tomohiro Shimizu
Ryo Takeda
Shigeru Tadano
Yuki Saito
Satoshi Osuka
Tomoya Ishida
Mina Samukawa
Tohru Irie
Daisuke Takahashi
Norimasa Iwasaki
Harukazu Tohyama
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-03909-8

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