Frontal Plane Pelvic Motion during Gait Captures Hip Osteoarthritis Related Disability

Abstract

Gait analysis has widely been accepted as an objective measure of function and clinical outcome. Ambulatory accelerometer-based gait analysis has emerged as a clinically more feasible alternative to optical motion capture systems but does not provide kinematic characterization to identify disease dependent mechanisms causing walking disability. This study investigated the potential of a single inertial sensor to derive frontal plane motion of the pelvis (i.e. pelvic obliquity) and help identify hip osteoarthritis (OA) related gait alterations. Patients with advanced unilateral hip OA (n=20) were compared to patients with advanced unilateral knee OA (n=20) and to a healthy control group (n=20). Kinematic characterization of frontal plane pelvic motion during gait demonstrated decreased range of motion and increased asymmetry for hip OA patients specifically.

In Vivo Pelvic and Hip Joint Kinematics in Patients With Cam Femoroacetabular Impingement Syndrome: A Dual Fluoroscopy Study

“…Previous reports of patients with FAIS, hip OA, and lower back pain have reported a reduced range of pelvic motion . While we did not explicitly identify any reductions in the range of pelvic motion, we did find that when compared to control participants, patients with cam FAIS had reduced pelvic tilt during level gait relative to their standing position and an altered relationship between the hip joint and pelvic motion relative to the control participants.…”

“…Previous reports of patients with FAIS, hip OA, and lower back pain have reported a reduced range of pelvic motion. 10,14,31,32 While we did not explicitly identify any reductions in the range of pelvic motion, we did find that when compared to control participants, patients with cam FAIS had reduced pelvic tilt during level gait relative to their standing position and an altered relationship between the hip joint and pelvic motion relative to the control participants. Interestingly, the differences between pelvic motion in control participants and patients with cam FAIS were inconsistent between level and incline gait, which may indicate that patients with FAIS move with altered pelvic motion as a result of altered stability strategies during more challenging or irregular tasks.…”

Assessment of physical function following total hip arthroplasty: Inertial sensor based gait analysis is supplementary to patient-reported outcome measures

“…More recently, inertial sensors (i.e. accelerometer combined with a gyroscope) have been validated for kinematic measurements of gait (Bugane et al, 2014;Seel et al, 2014), such as joint range of motion (RoM), and could provide more detailed information on gait disturbances in hip OA patients outside the gait laboratory (Bolink et al, 2015a). Given the differences in self-reported functional outcomes between patients with low and high pre-operative function, it is important to establish if these patterns of recovery are also observed with objective measures of physical function (Kennedy et al, 2006;Roder et al, 2007).…”

Altered erector spinae activity and trunk motion occurs with moderate and severe unilateral hip OA

“…Hip joint osteoarthritis (OA) leads to musculoskeletal disability in many older adults, but the effects are not isolated to the hip region. During walking, altered gait patterns have been found at the ankle, knee, pelvis,and lumbar spine, as well as a general ipsilateral shift of the body's center of mass over the affected leg . While as many as one in two people with hip or knee OA also report low back pain (LBP), little is known about the mechanics and muscle activation patterns of the trunk in this population.…”

“…In order to maintain efficient gait patterns, despite decreased hip mobility, joints proximal, and distal to the symptomatic hip may exhibit compensatory patterns. People with unilateral hip OA frequently demonstrate an ipsilateral displacement of their upper body over the affected hip during stance, have greater amounts of pelvic anterior pelvic tilt as well as increased total pelvis motion in the sagittal and frontal planes, regardless of disease severity . These kinematic changes have implications for understanding the mechanisms of LBP in this population.…”