Trunk movement asymmetry associated with pain, disability, and quadriceps strength asymmetry in individuals with knee osteoarthritis: a cross-sectional study

Abstract

Improved harmonic ratio Knee pain Disability Quadriceps strength asymmetry s u m m a r yObjective: This study examined 1) the clinical relevance of trunk movement asymmetry, which was evaluated using a trunk-mounted inertial measurement unit (IMU), and 2) the relationship between trunk movement asymmetry and lower limb muscle strength asymmetry in individuals with knee osteoarthritis (OA). Design: One-hundred-thirty-one participants (mean age, 74.2 years; 71.8% female; Kellgren and Lawrence [K&L] grade !1) underwent gait analysis at their preferred pace for IMU-based measurement of trunk movement asymmetry (harmonic ratio [HR] and improved HR). The isometric strength of quadriceps and hip abductors was evaluated using a hand-held dynamometer. Pain and disability level were evaluated using a validated self-reported questionnaire. Multiple regression analyses with covariate adjustment were performed to examine the relationship between trunk movement asymmetry (independent variable) and pain, disability level, or muscle strength asymmetry (dependent variables). Results: Individuals with severe knee OA (K&L grade !3) had increased trunk movement asymmetry in the medio-lateral axis compared to those with a K&L grade of 1. Increased trunk movement asymmetry was associated with a greater knee pain and disability. The increased trunk movement asymmetry was significantly associated with an increase in the asymmetry of quadriceps strength, but not with asymmetry in the strength of hip abductor. Conclusion: Our findings indicate that increased medio-lateral trunk movement asymmetry may be an indicator of impairment, rather than adaptation, in individuals with knee OA. This preliminary finding warrants validation by future study. Paying close attention to medio-lateral trunk movement asymmetry may be key to our understanding of OA-related pain and disability.

Association between Foot Posture Asymmetry and Static Stability in Patients with Knee Osteoarthritis: A Case-Control Study

“…To the best of our knowledge, this is the first time to evaluate the foot posture asymmetry in KOA patients and compare their foot posture asymmetries to the healthy adults. It was reported that there were some asymmetries of two legs in KOA patients [17,18], and they were related to an increased risk of injury and exerted impacts on lower extremity function [18]. The results of this study revealed that individuals with KOA revealed a higher percentage of severe asymmetry.…”

“…In addition, asymmetries including quadriceps strength asymmetry and trunk movement asymmetry were considered to cause the development of KOA [17]. And there was some evidence that foot asymmetry was associated with lower extremity function [18].…”

Low Back Pain as a Risk Factor for Recurrent Falls in People With Knee Osteoarthritis

“…Gait velocity (in meters/ second) was evaluated using the 10-meter walking test with self-selected speed, and a trained examiner (KS) measured the time taken to walk 10 meters with a stopwatch in accordance with a previously suggested method (23). The maximum isometric quadriceps strength (in Nm/kg) in both legs was measured using a hand-held dynamometer (μTas F-1, Anima) in accordance with a previously described method (24). The minimum detectable change (MDC 95 ) was 0.227 Nm/kg, and the intrarater reliability was excellent (intraclass correlation coefficient [ICC 1,1 ] 0.939 [95% confidence interval (95% CI) 0.921-0.954]) (24).…”

“…The maximum isometric quadriceps strength (in Nm/kg) in both legs was measured using a hand-held dynamometer (μTas F-1, Anima) in accordance with a previously described method (24). The minimum detectable change (MDC 95 ) was 0.227 Nm/kg, and the intrarater reliability was excellent (intraclass correlation coefficient [ICC 1,1 ] 0.939 [95% confidence interval (95% CI) 0.921-0.954]) (24).…”

Identification of Body Behaviors and Facial Expressions Associated with Induced Orthopedic Pain in Four Equine Pain Scales

“…However, this is not the case in human studies, where more complex relationships between pain and movement asymmetry are demonstrated. Both linear and non-linear positive relationships between biomechanical parameters (trunk asymmetry, vertebral motion, and range of motion in different joints) and pain have been shown [ 15 , 16 , 17 ], but also no relationship [ 18 ] or a negative relationship [ 19 ] between knee biomechanics and pain. Hence, a positive linear relationship between the magnitude of movement asymmetry or lameness and pain intensity should not be assumed.…”