Modificações biomecânicas na marcha de indivíduos com osteoartrite medial do joelho

Abstract

ObjectiveDemonstrate the presence and magnitude of biomechanical variables during gait in patients with medial knee osteoarthritis (OA) and the relationship with the knee loading.MethodsGait of 21 subjects diagnosed with medial knee OA was evaluated and compared to the control group.ResultsThe group with OA showed: Lower gait speed (0.8 ± 0.1 vs. 1.1 ± 0.1m/s), higher peak early (2.6 ± 1.2 vs. 0.3 ± 1.4 Nm/Kg) and late peak of the adduction moment (1.8 ± 0.7 vs. 0.9 ± 0.2 Nm/Kg), higher peak flexor moment (1.6 ± 0.9 vs. 0.6 ± 0.4 Nm/Kg), high dynamic peak varus (11.5º ± 8.3 vs. 3º ± 3.9), higher peak flexion (15.6º ± 8 vs. 9.3º to ± 4.1), with a flexion tendency (5.5º ± 8.5) in the stance phase, smaller peak of flexion (58.7º ± 13.3 vs. 67.5º ± 4.8) in the balance phase and higher peaks of external rotation (25.5º ± 12.7 vs. 0.5º ± 22.4).ConclusionPatients with medial knee OA show changes in gait with increased external rotation, speed reduction, increased flexor moment and flexion in the stance phase, insufficient for reduction of the load. Level of Evidence III, Case Control Study.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study

“…Earlier studies of movement alterations have demonstrated that patients walk with reduced speed [7,12], reduced knee flexion of the affected leg and trunk lean towards the more painful knee [8,9]. Pelvic movement strategies during walking have only been sparsely investigated [9,13], and we found no studies evaluating pelvic movement strategies for patients with medial compartment knee OA during more advanced tasks such as stair climbing and stepping onto a step.…”

“…Since knee OA causes pain, reduced range of motion, and instability of the joint [3][4][5][6], patients alter their movement pattern to unload the knee [7][8][9]. Altering a movement pattern might increase the load on the hip and contralateral knee joint, and alter the pelvic movements [10].…”

Effect of Peat Intervention on Pain and Gait in Patients with Knee Osteoarthritis: A Prospective, Double-Blind, Randomized, Controlled Study

“…In a previous study, two weeks of spa therapy increased gait velocity, cadence, and stride length and decreased pain; however, neither mud nor peat therapy was assessed, and data regarding angular analysis of the lower extremities were not collected [38]. e adduction angle of the knee joint is generally known to be increased in knee OA patients relative to the general population [9]. Previous studies of patients with knee OA have found that the larger is the varus/valgus range of motion of the knee, the lower is the functional ability and that this relationship is stronger in patients with severe varus deformity [39].…”

“…Knee joint misalignment and biomechanical modification also affect the evolution of OA. Kinematic gait analyses of OA patients have shown that the knee joint varus angle during the stance phase of gait is greater than in healthy control subjects [9,10].…”

Biomechanical Changes in Gait Patterns of Patients with Grade II Medial Gonarthritis

“…Typical biomechanical gait modifications associated with medial knee OA are characterized by a lower gait speed, which reduces the load on the affected limb, as well as smaller flexion–extension amplitudes in the affected knee [ 14 ]. The load on the medial knee compartment is usually estimated indirectly, using biomechanical methods, since its direct measurement is invasive.…”