Article

OBJECTIVE: To compare lower-limb kinematic asymmetries during gait in individuals
with unilateral and bilateral symptomatic osteoarthritis and controls. DESIGN:
Cross-sectional. SETTING: Laboratory. PARTICIPANTS: Participants (N=54) had
symptomatic unilateral (n=18) or bilateral (n=18) knee osteoarthritis. Healthy
controls were sex- and age-matched and similar in height and weight to
osteoarthritis groups (n=18). INTERVENTION: Three-dimensional motion analysis was
conducted while participants walked on a treadmill at 1.1m/s. MAIN OUTCOME
MEASURES: Maximum joint angles and velocities of the knee and hip during stance,
knee flexion, knee adduction, and hip adduction at initial contact, pelvic drop,
stride length, and average toe out. RESULTS: There was a significant limb effect
for knee flexion at initial contact (P=.01). The bilateral osteoarthritis group
demonstrated the largest between-limb asymmetry (2.83 degrees ; 95% confidence
interval, .88-4.78; effect size [ES]=.67). The bilateral osteoarthritis group
also displayed tendencies toward between-limb asymmetry in hip adduction at
initial contact and peak knee adduction during stance; ESs were small (ES=.33 and
.48). Lower-limb kinematics was symmetrical in the control and unilateral knee
osteoarthritis groups. CONCLUSIONS: Between-limb asymmetries are present even at
mild to moderate stages of knee osteoarthritis. During this stage, between-limb
asymmetry appears to be more prevalent in patients with bilateral symptomatic
disease, suggesting that patients with unilateral disease maintain kinematic
symmetry for longer in the knee osteoarthritis process. Further, early treatment
strategies should target the restoration of gait symmetry and involve kinematics
changes in both lower limbs. Future research is needed to determine the efficacy
of such strategies with respect to kinematic asymmetry, pain, and disease
progression.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS