Neuromechanical assessment of knee joint instability during perturbed gait in patients with knee osteoarthritis

Schrijvers, J.; Noort, Josien C. van den; Esch, M. van der; Harlaar, Jaap

doi:10.1016/j.jbiomech.2021.110325

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…Moreover, it is yet unclear if deviations in these type of balance metrics translate to problems with recovery from external perturbations. So far, studies investigating responses to perturbations in individuals with knee OA have shown mixed results (24)(25)(26)(27)(28)(29). For example, Schrijvers et al found larger knee flexion angles and increased co-contraction after AP perturbations in individuals with knee OA with self-reported instability (25).…”

Section: Discussionmentioning

confidence: 99%

“…So far, studies investigating responses to perturbations in individuals with knee OA have shown mixed results (24)(25)(26)(27)(28)(29). For example, Schrijvers et al found larger knee flexion angles and increased co-contraction after AP perturbations in individuals with knee OA with self-reported instability (25). Pater et al found a less optimal recovery strategy from trips over an obstacle during overground walking in individuals with mild to moderate knee OA compared to their healthy peers (27), although the number of fallers after perturbation was similar between groups.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…To study the effects of knee OA on gait stability, responses to AP (24)(25)(26)(27) and ML (25,28,29) gait perturbations have previously been compared between individuals with knee OA and healthy participants. Overall these studies showed mixed results, with some showing effects of knee OA on perturbation responses (24)(25)(26)(27) and others finding no such effects (28,29). Outcomes of these studies included muscle activation (including quadriceps, hamstrings, calf muscles) (25,28,29), lower-extremity kinematics (24)(25)(26)(27)(28)(29), lower-extremity kinetics (24), and step characteristics (24,26,27).…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, because stability measures vary with differences in gait speed (30,31), and gait speed of individuals with knee OA is lower compared to healthy individuals (32), gait speed should be considered as a confounder in these comparisons. Unfortunately, none of the previous studies (24)(25)(26)(27)(28)(29) controlled for gait speed in their experiments.…”

Section: Introductionmentioning

confidence: 99%

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Individuals with knee osteoarthritis show few limitations in reactive stepping responses after gait perturbations

Boekesteijn,

Keijsers,

Defoort

et al. 2023

Preprint

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BackgroundKnee osteoarthritis (OA) causes structural joint damage. The resultant symptoms can impair the ability to recover from unexpected gait perturbations, contributing to an increased fall risk. This study compared reactive stepping responses to gait perturbations between individuals with knee OA and healthy individuals.MethodsKinematic data of 35 individuals with end-stage knee OA, and 32 healthy individuals in the same age range were obtained during perturbed walking on a treadmill at 1.0 m/s. Participants received anteroposterior (trip or slip) or mediolateral perturbations during the stance phase. Changes from baseline in margin of stability (MoS), step length, step time, and step width during the first two steps after perturbation were compared between groups using a linear regression model. Extrapolated center of mass (XCoM) excursion was descriptively analyzed.FindingsAfter all perturbation modes, XCoM trajectories overlapped between individuals with knee OA and healthy individuals. Participants predominantly responded to mediolateral perturbations by adjusting their step width, and to anteroposterior perturbations by adjusting step length and step time. None of the perturbation modes yielded between-group differences in changes in MoS and step width during the first two steps after perturbation. Small between-group differences were observed for step length (i.e. 2 cm) of the second step after trip and slip perturbation, and for step time (i.e. 0.02 s) of the second step after slip perturbations.InterpretationDespite considerable pain and damage to the knee joint, individuals with knee OA showed comparable reactive stepping responses after gait perturbations to healthy participants.

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