Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics

Schmitt, Daniel; Vap, Alexander R.; Queen, Robin M.

doi:10.1016/j.gaitpost.2015.07.005

Cited by 60 publications

(67 citation statements)

References 31 publications

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“…Individuals with ankle OA walked the slowest of all the cohorts, reflecting the deep disability associated with end-stage ankle OA [25,26]. The walking speed in our cohort with ankle OA is similar to those reported for patients with end-stage hip [22,25], knee [25,27], and ankle OA [17,20,21,23,25].…”

Section: Discussionsupporting

confidence: 80%

“…Although the presence of knee OA disrupts energy exchange, its effect was mild relative to the effect of hip and ankle OA, reflecting high levels of disability [25,26]. It has been shown that the presence of hip or ankle OA has a strong effect on the pattern of the vertical force during walking that is in turn reflected in the center of mass motion [25].…”

Section: Discussionmentioning

confidence: 99%

“…We hypothesized that individuals with lower extremity OA would exhibit a decrease in velocity compared with an asymptomatic cohort and that walking speed would be different between the OA cohorts based on the joint affected. In addition, we hypothesized that the OA cohorts would have decreased energy recovery during walking compared with an asymptomatic cohort and that individuals with hip and ankle OA would have a greater reduction in recovery compared with individuals with knee OA owing to restrictions in hip and ankle motion previously reported in these populations [25]. Finally, we hypothesized that congruity in the movement of the center of mass would explain the differences in energy recovery when comparing these study cohorts.…”

Section: Introductionmentioning

confidence: 96%

“…People affected by OA report general pain and fatigue after daily activities and walk at reduced speeds relative to asymptomatic adults [3,[24][25][26][27]29], Fatigue related to hip and knee OA also is associated with higher cardiac and ventilatory costs of gait [3,29]. In addition, the exchange of potential energy and kinetic energy which is associated with changes in the timing and magnitude of center of mass energy fluctuations, and which in turn can be influenced by walking speed, joint motion, and footfall timing [4-7, 14, 15], appears to be reduced in patients with mild to moderate knee OA perhaps leading to higher levels of muscular work [9,27].…”

Section: Introductionmentioning

confidence: 99%

“…1) [1, 4-7, 14, 15, 27]. Magnitude and congruity of potential energy and kinetic energy fluctuations can be influenced by mechanical factors such as changes in stride length and restrictions in hip, knee, and ankle motion, which are common to individuals with lower extremity OA [25].…”

Section: Introductionmentioning

confidence: 99%

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Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Queen

Sparling

Schmitt

2016

Clinical Orthopaedics &Amp; Related Research

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Background Individuals with osteoarthritis (OA) of the lower limb find normal locomotion tiring compared with individuals without OA, possibly because OA of any lower limb joint changes limb mechanics and may disrupt transfer of potential and kinetic energy of the center of mass during walking, resulting in increased locomotor costs. Although recovery has been explored in asymptomatic individuals and in some patient populations, the effect of changes in these gait parameters on center of mass movements and mechanical work in patients with OA in specific joints has not been well examined. The results can be used to inform clinical interventions and rehabilitation that focus on improving energy recovery. Questions/purposes We hypothesized that (1) individuals with end-stage lower extremity OA would exhibit a decrease in walking velocity compared with asymptomatic individuals and that the joint affected with OA would differntially influence walking velocity, (2) individuals with end-stage lower extremity OA would show decreased energy recovery compared with asymptomatic individuals and that individuals with end-stage hip and ankle OA would have greater reductions in recovery than would individuals with end-stage knee OA owing to restrictions in hip and ankle motion, and (3) that differences in the amplitude and congruity of the center of mass would explain the differences in energy recovery that are observed in each population. Methods Ground reaction forces at a range of self-selected walking speeds were collected from individuals with end-stage radiographic hip OA (n = 27; 14 males, 13 females; average age, 55.6 years; range, 41-70 years), knee OA (n = 20; seven males, 13 females; average age, 61.7 years; range, 49-74 years), ankle OA (n = 30; 14 males, 16 females; average age, 57 years; range, 45-70 years), and asymptomatic individuals (n = 13; eight males, five females; average age, 49.8 years; range, 41-67 years). Participants were all patients with end-stage OA who were scheduled to have joint replacement surgery within 4 weeks of testing. All patients were identified by the orthopaedic surgeon as having end-stage radiographic disease and to be a candidate for joint replacement surgery. Patients were excluded if they had pain at any other lower Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Queen

Sparling

Schmitt

2016

Clinical Orthopaedics &Amp; Related Research

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Validating Fitbit for Evaluation of Physical Activity in Patients with Knee Osteoarthritis: Do Thresholds Matter?

Silva

Yang

Collins

et al. 2019

ACR Open Rheumatology

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Objective. We sought to evaluate the performance of Fitbit in estimating ActiGraph-derived moderate-to-vigorous physical activity (MVPA) and sedentary time in the knee osteoarthritis (OA) population.Methods. We used data from two weeks of Fitbit and ActiGraph wear among knee OA subjects. In primary analyses, we used literature-based ActiGraph thresholds of 200 and 1924 counts/min (triaxial vector magnitude) for sedentary and MVPA time as the gold standard to which we compared three sets of Fitbit thresholds informed by literature and data (Youden index). We also considered personalized, stride length-based Fitbit thresholds. In sensitivity analyses, we used uniaxial, vertical axis-based as well as personalized, BMI-based ActiGraph thresholds. We calculated agreement, sensitivity, and specificity of Fitbit in classifying sedentary and MVPA time.Results. In the primary analysis (vector magnitude thresholds), maximum agreement for sedentary and MVPA time was 67.0% from the Youden index-based and 91.1% from the stride length-based Fitbit thresholds. For sedentary time, the 20 strides/min threshold had the highest sensitivity (97.6%), and Youden-derived 1 stride/ min had the highest specificity (51.6%). For MVPA, Youden-derived 14 strides/min yielded 72.8% sensitivity, and using stride length yielded 98.6% specificity. MVPA time ranged from 49-323 min/d, depending on threshold used, with literature-based and personalized thresholds leading to more conservative estimates of MVPA than Youden-derived thresholds.Conclusion. Using Fitbit for MVPA and sedentary time assessment may lead to inaccurate estimates of both. Fitbit MVPA estimates were generally more conservative than ActiGraph estimates. Incorporating individuals' characteristics did not meaningfully improve Fitbit performance. Caution should be exercised when measuring activity using Fitbit.

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Unilateral hip osteoarthritis: The effect of compensation strategies and anatomic measurements on frontal plane joint loading

et al. 2016

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In order to reduce pain caused by the affected hip joint, unilateral hip osteoarthritis patients (HOAP) adopt characteristic gait patterns. However, it is unknown if the knee and hip joint loading in the non-affected (limb ) and the affected (limb ) limb differ from healthy controls (HC) and which gait parameters correlate with potential abnormal joint loading. Instrumented 3D-gait analysis was performed on 18 HOAP and 18 sex, age, and height matched HC. The limb showed greater first and second peak external hip adduction moments (first HAM: +15%, p = 0.014; second HAM: +15%, p = 0.021, respectively), than seen in HC. In contrast, the second peak external knee adduction moment (KAM) in the limb is reduced by about 23% and 30% compared to the limb and HC, respectively. Furthermore, our patients showed characteristic gait compensation strategies including reduced peak vertical forces (pvF), a greater foot progression angle (FPA), and reduced knee range of motion (ROM) in the limb . The limb was 5.6 ± 3.8 mm shorter than the limb . Results of stepwise regression analyses showed that increased first pvF explain 16% of first HAM alterations, whereas knee ROM and FPA explain 39% of second KAM alterations. We therefore expect an increased rate of progression of OA in the hip joint of the limb and suggest that the shift in the medial-to-lateral knee joint load distribution may impact the rate of progression of OA in the limb . The level of evidence is III. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1764-1773, 2017.

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Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics

Cited by 60 publications

References 31 publications

Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Validating Fitbit for Evaluation of Physical Activity in Patients with Knee Osteoarthritis: Do Thresholds Matter?

Unilateral hip osteoarthritis: The effect of compensation strategies and anatomic measurements on frontal plane joint loading

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