Article

This study tested the hypothesis that the presence of isolated ankle (A-OA;
N=30), knee (K-OA; N=20), or hip (H-OA; N=30) osteoarthritis (OA) compared to
asymptomatic controls (N=15) would lead to mechanical changes in the affected
joint but also in all other lower limb joints and gait overall. Stride length,
stance and swing times, as well as joint angles and moments at the hip, knee, and
ankle were derived from 3-D kinematic and kinetic data collected from seven
self-selected speed walking trial. Values were compared across groups using a 1x4
ANCOVA, covarying for walking speed. With walking speed controlled, the results
indicated a reduction in hip and knee extension and ankle plantar flexion in
accordance with the joint affected. In addition, OA in one joint had strong
effects on other joints. In both H-OA and K-OA groups the hip never passed into
extension, and A-OA subjects significantly changed hip kinematics to compensate
for lack of plantar flexion. Finally, OA in any joint led to lower peak vertical
forces as well as extension and plantar flexion moments compared to controls. The
presence of end-stage OA at various lower extremity joints results in
compensatory gait mechanics that cause movement alterations throughout the lower
extremity. This work reinforces our understanding of the complex interaction of
joints of the lower limb and the importance of focusing on the mechanics of the
entire lower limb when considering gait disability and potential interventions in
patients with isolated OA.
CI - Copyright (c) 2015 Elsevier B.V. All rights reserved.

Langue : ANGLAIS