Subjects with hip osteoarthritis show distinctive patterns of trunk movements during gait-a body-fixed-sensor based analysis

Abstract

BackgroundCompensatory trunk movements during gait, such as a Duchenne limp, are observed frequently in subjects with osteoarthritis of the hip, yet angular trunk movements are seldom included in clinical gait assessments. Hence, the objective of this study was to quantify compensatory trunk movements during gait in subjects with hip osteoarthritis, outside a gait laboratory, using a body-fixed-sensor based gait analysis. Frontal plane angular movements of the pelvis and thorax and spatiotemporal parameters of persons who showed a Duchenne limp during gait were compared to healthy subjects and persons without a Duchenne limp.MethodsA Body-fixed-sensor based gait analysis approach was used. Two body-fixed sensors were positioned at the dorsal side of the pelvis and on the upper thorax. Peak-to-peak frontal plane range of motion (ROM) and spatiotemporal parameters (walking speed, step length and cadence) of persons with a Duchenne limp during gait were compared to healthy subjects and persons without a Duchenne limp. Participants were instructed to walk at a self-selected low, preferred and high speed along a hospital corridor. Generalized estimating equations (GEE) analyses were used to assess group differences between persons with a Duchenne limp, without a Duchenne limp and healthy subjects.ResultsPersons with a Duchenne limp showed a significantly larger thoracic ROM during walking compared to healthy subjects and to persons without a Duchenne limp. In both groups of persons with hip osteoarthritis, pelvic ROM was lower than in healthy subjects. This difference however only reached significance in persons without a Duchenne limp. The ratio of thoracic ROM relative to pelvic ROM revealed distinct differences in trunk movement patterns. Persons with hip osteoarthritis walked at a significantly lower speed compared to healthy subjects. No differences in step length and cadence were found between patients and healthy subjects, after correction for differences in walking speed.ConclusionsDistinctive patterns of frontal plane angular trunk movements during gait could be objectively quantified in healthy subjects and in persons with hip osteoarthritis using a body-fixed-sensor based gait analysis approach. Therefore, frontal plane angular trunk movements should be included in clinical gait assessments of persons with hip osteoarthritis.

Early gait analysis after curved periacetabular osteotomy for acetabular dysplasia

“…30,31 The range of tilting movement of the trunk in the coronal plane during walking was increased before surgery (5.2°), although not significantly compared to the healthy group (3.7°), and it further increased after surgery (5.9°) and showed a significant difference from the healthy group. Reininga et al 43 obtained similar findings in a comparison of trunk movement during walking using a body sensor in patients with osteoarthritis of the hip and healthy subjects. Trunk sway during walking is caused by a compensatory action to reduce pain by increasing coverage of the femoral head and reducing weight bearing on the hip joint by tilting the trunk toward the affected side in the stance phase of the affected side.…”

Spatial-Temporal Gait Characteristics in Individuals With Hip Osteoarthritis: A Systematic Literature Review and Meta-analysis

“…In 1 study, 66 swing duration originally reported as percentage of gait cycle was calculated from given values of the contralateral single-limb support time in seconds. Stride length was calculated as a function of cadence and speed in the studies by Reininga et al 67 and Watanabe et al, 77,78 cadence was calculated as a function of speed and stride length in 3 studies, 2,45,61 and speed was calculated as a function of stride length and cadence in 1 study. 54 Where studies reported values for both limbs in individuals with hip OA and in controls, symmetry indices were calculated.…”

“…53 The pooled mean and standard deviation for spatial-temporal data across 2 groups of individuals with preoperative hip OA in 2 studies, 36,45 across test-retest of individuals with hip OA conditions in 2 studies, 32,76 and across 2 groups of individuals with hip OA in 1 study 67 were used in the meta-analysis. In the control groups, the within-study pooled mean and standard deviation for relevant gait measures across dominant and nondominant lower limbs were used in 8 studies.…”

Frontal plane kinematics in walking with moderate hip osteoarthritis: Stability and fall risk

“…In the patient group, the static margin of stability was largest at the affected side, which suggests that patients walked with more lateral trunk inclination toward unaffected than toward affected, as Thurston (1985) reported for patients with more serious pain. Note, however that Reininga et al (2012) observed more inclination toward affected; however, in that study inclination toward affected was used as a preselection criterion.…”

“…Still, these margins co-depend on amplitude and speed of frontal plane trunk movements. Some HOA patients walk with lateral trunk inclination toward the affected side (Reininga et al, 2012). However, patients with more severe pain tend to walk with lateral inclination toward their unaffected side (Thurston, 1985).…”