Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease

Iijima, Hirotaka; Eguchi, Ryo; Shimoura, Kanako; Aoyama, Tomoki; Takahashi, Masaki

doi:10.1016/j.gaitpost.2019.06.004

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…One of the strategies which may have helped reduced TFJ loading during early stance is reducing the speed of performing stair ascent. Those with both mild 6,21,22 and severe 23 OA have reportedly performed stair ascent slower than their aged‐matched controls. Indeed, slowing down stair ambulation would allow more time during the stance phase, where the initial loading during early stance can be done more gradually.…”

Section: Discussionmentioning

confidence: 99%

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

Price

Gissane

Cleather

2020

Engineering Reports

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This study investigated the tibiofemoral joint (TFJ) forces and supporting muscle forces displayed by knee osteoarthritis (OA) patients during stair ascent, and if these forces were influenced by the presence of pain. Fifteen knee OA patients partitioned into two groups based on pain experienced during stair ascent trails using a Visual Analogue Scale (VAS) (OA-pain = 10; OA-no pain = 5) and 14 healthy aged-matched controls took part in this study. Kinematic and kinetic data were collected during three stair ascent trials, which provided the inputs for the musculoskeletal model FreeBody. TFJ contact forces and muscles forces were predicted by the model at early, mid-and late stance. These variables were compared between groups using a one-way analysis of variance. The results show the OA-pain (P < .05; d = 2.4) and OA-no pain (P < .05; d = 1.1) groups displayed reduced medial TFJ contact forces and altered muscle forces in comparison to healthy controls during early stance. This suggests pain and the anticipation of pain results in knee OA patients deliberately offloading the front limb during stair ascent, which alters supporting muscle forces. This study provides valuable information on knee OA mechanics during stair ascent for clinicians developing rehabilitation programs. K E Y W O R D S muscle forces, musculoskeletal model, osteoarthritis, stair ascent, tibiofemoral joint forces 1 INTRODUCTION Stair ascent is a challenging everyday activity for those who suffer with knee osteoarthritis (OA). Many studies have reported stair ascent being one of the main activities which elicits knee pain for those with knee OA, 1,2 greatly affecting quality of life. 3 The increased susceptibility of knee pain during stair ascent likely comes from weight-bearing at higher knee flexion angles. 4 Because of this, knee OA patients have been reported to compensate while walking upstairs to offload the OA knee as a strategy to avoid pain. 5 Asay et al 4 reported that during stair ascent those with knee OA increased trunk flexion angle during the weight-acceptance phase of stance to reduce the quadriceps moment in comparison to healthy controls. Further, Meireles et al 6 found that, in comparison to healthy controls, knee OA patients altered their stair ascent This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

Price

Gissane

Cleather

2020

Engineering Reports

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“…Since there was no significant difference in the time of the 11-SCT between ascending and descending in both KOA and the control group [ 11 ], we focused on stair ascent in this paper. As an example, as shown in Figure 2 , an arbitrary step knee joint trajectory in the sagittal plane was extracted for analysis.…”

Section: Methodsmentioning

confidence: 99%

“…For example, the knee joint load during stair walking is greater than that during level walking [ 8 , 9 , 10 ]. Our previous study showed that patients with early KOA take longer to climb stairs [ 11 ]. This evidence suggests that stair climbing performance time may identify early KOA, but the prediction accuracy is inadequate [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Identification of Early Knee Osteoarthritis Based on Knee Joint Trajectory during Stair Climbing

Ogawa

Iijima²,

Takahashi³

2022

IJERPH

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Patients with knee osteoarthritis show low stair climbing ability, but a diagnosis of stair performance time is not enough to identify the early stages of knee osteoarthritis. Therefore, we developed an indicator named range of the knee joint trajectory (RKJT) as a kinematic parameter to express more detailed characteristics than stair performance time. To achieve this, we used our developed “IR-Locomotion”, a markerless measurement system that can track the knee joint trajectory when climbing stairs. This study aimed to test whether the RKJT effectively identifies patients with early knee osteoarthritis even after controlling stair performance time. Forty-seven adults with moderate to severe knee pain (mean age 59.2 years; 68.1% women) underwent the radiographic examination (Kellgren and Lawrence grade) of both knees and a stair climbing test on 11 stairs. The RKJT during the stair climbing test was calculated by “IR-Locomotion”. A generalized linear mixed model was used to evaluate the discriminative capability of RKJT on early knee osteoarthritis (i.e., Kellgren and Lawrence grade of 1). As expected, patients with early knee osteoarthritis showed larger RKJT than non-radiographic controls (95% confidence interval: 1.007, 1.076). Notably, this finding was consistent even after adjusting stair performance time.

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“…Protocols for measuring stair climbing vary greatly and have been applied in a range of populations (ie, OA, rheumatoid arthritis [RA], joint replacement, elderly or frail, cardiopulmonary, cerebrovascular accident, and children). Test variations include nine‐step ascend/descend (9,35,73‐77), 10‐step stair climb (6), “long stair climb” or climbing 50 standard‐sized steps with three landings (78,79), four‐step ascend/descend (69,78,80), 11‐step ascend/descend (81,82), three‐step ascent cycle duration (83), 20‐second SCT (2), and six‐step fast‐paced and self‐paced tests (84).…”

Section: Stair Climb Testmentioning

confidence: 99%

Measures of Physical Performance

Coleman

Dobson

Hinman

et al. 2020

Arthritis Care & Research

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Stair climbing ability in patients with early knee osteoarthritis: Defining the clinical hallmarks of early disease

Cited by 8 publications

References 27 publications

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

The influence of pain on tibiofemoral joint contact force and muscle forces in knee osteoarthritis patients during stair ascent

Identification of Early Knee Osteoarthritis Based on Knee Joint Trajectory during Stair Climbing

Measures of Physical Performance

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