1
|
Dai J, Jiang H, Cheng Z, Li Y, Yang Z, Cheng C, Tang X. Genetic polymorphism of WNT9A is functionally associated with thumb osteoarthritis in the Chinese population. Adv Rheumatol 2024; 64:12. [PMID: 38287451 DOI: 10.1186/s42358-023-00337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/04/2023] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND In a recent genome-wide association study, novel genetic variations of WNT9A were reported to be involved in the etiopathogenesis of thumb osteoarthritis (TOA) in Caucasians. Our purposes were to replicate the association of WNT9A with the development of TOA in the Chinese population and to further unveil the functional role of the risk variants. METHODS SNP rs11588850 of WNT9A were genotyped in 953 TOA patients and 1124 healthy controls. The differences of genotype and allele distributions between the patients and healthy controls were evaluated using the Chi-square test. Luciferase Reporter Assay was performed to investigate the influence of variant on the gene expression. RESULTS There was significantly lower frequency of genotype AA in TOA patients than in the controls 74.9% vs. 81.9%, p < 0.001). The frequency of allele A was remarkably lower in the patients than in the controls (86.3% vs. 90.5%, p < 0.001), with an odds ratio of 0.66 (95% CI = 0.54-0.80). Luciferase Reporter Assay showed that the construct containing mutant allele G of rs11588850 displayed 29.1% higher enhancer activity than the wild allele A construct (p < 0.05). CONCLUSIONS Allele G of rs11588850 was associated with the increased risk of TOA possibly via up-regulation of WNT9A expression. Further functional analysis into the regulatory role of rs11588850 in WNT9A expression can shed new light on the genetic architecture of TOA.
Collapse
Affiliation(s)
- Jian Dai
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Haitao Jiang
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Zhang Cheng
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Yao Li
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China
| | - Zhaoqi Yang
- Postgraduate in Orthopedics Surgery, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Chuan Cheng
- Department of Orthopedics Surgery, Third People's Hospital of Jiujiang City, Jiujiang, Jiangxi Province, China.
| | - Xiaoming Tang
- Department of Orthopedics Surgery, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu Province, China.
| |
Collapse
|
2
|
Steingrebe H, Spancken S, Sell S, Stein T. Effects of hip osteoarthritis on lower body joint kinematics during locomotion tasks: a systematic review and meta-analysis. Front Sports Act Living 2023; 5:1197883. [PMID: 38046934 PMCID: PMC10690786 DOI: 10.3389/fspor.2023.1197883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/09/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Motion analysis can be used to gain information needed for disease diagnosis as well as for the design and evaluation of intervention strategies in patients with hip osteoarthritis (HOA). Thereby, joint kinematics might be of great interest due to their discriminative capacity and accessibility, especially with regard to the growing usage of wearable sensors for motion analysis. So far, no comprehensive literature review on lower limb joint kinematics of patients with HOA exists. Thus, the aim of this systematic review and meta-analysis was to synthesise existing literature on lower body joint kinematics of persons with HOA compared to those of healthy controls during locomotion tasks. Methods Three databases were searched for studies on pelvis, hip, knee and ankle kinematics in subjects with HOA compared to healthy controls during locomotion tasks. Standardised mean differences were calculated and pooled using a random-effects model. Where possible, subgroup analyses were conducted. Risk of bias was assessed with the Downs and Black checklist. Results and Discussion A total of 47 reports from 35 individual studies were included in this review. Most studies analysed walking and only a few studies analysed stair walking or turning while walking. Most group differences were found in ipsi- and contralateral three-dimensional hip and sagittal knee angles with reduced ranges of motion in HOA subjects. Differences between subjects with mild to moderate and severe HOA were found, with larger effects in severe HOA subjects. Additionally, stair walking and turning while walking might be promising extensions in clinical gait analysis due to their elevated requirements for joint mobility. Large between-study heterogeneity was observed, and future studies have to clarify the effects of OA severity, laterality, age, gender, study design and movement execution on lower limb joint kinematics. Systematic Review Registration PROSPERO (CRD42021238237).
Collapse
Affiliation(s)
- Hannah Steingrebe
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Sina Spancken
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Stefan Sell
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Joint Center Black Forest, Hospital Neuenbürg, Neuenbürg, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| |
Collapse
|
3
|
Ibara T, Fujita K, Watanabe N, Takada R, Miyatake K, Nimura A, Akita K. Stabilization and compensation strategy of the hip angle during gait in hip-osteoarthritis patients from the perspective of whole-body movement synergy. Gait Posture 2023; 106:65-71. [PMID: 37660515 DOI: 10.1016/j.gaitpost.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/28/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The implementation of a strategy to control the hip angle during gait is important to avoid disease progression in patients with hip osteoarthritis (OA). RESEARCH QUESTION Do patients with hip OA tend to stabilize their hip angles by a combination of whole-body movements during gait in terms of variability? METHODS A public gait dataset comprising 80 asymptomatic participants and 106 patients with hip OA was used. Uncontrolled manifold analysis was performed using the joint angles as elemental variables and the hip joint angles as performance variables. The synergy index ΔV, variances of elemental variables that did not affect the performance variable (VUCM) and of those that affected the performance variable (VORT), and index of covariation strategy (COV) were calculated in sagittal and frontal plane. A one-sample t-test for statistical parametric mapping (SPM) analysis was used for ΔV and COV. Two-sample t-tests of SPM analyses were used for ΔV, VUCM, and VORT to compare the two groups. RESULTS In both planes, the ΔV and COV were significantly larger than zero in both groups (p < 0.001). In the sagittal plane, the VORT was higher in the hip OA group than in the control group after 77 % of stance phase. In the frontal plane, the hip OA group had larger ΔV and VUCM after last half and last quartile of stance phase compared to the control group, respectively. The VORT was smaller in the hip OA group than in the control group. SIGNIFICANCE The hip angle was stabilized in the hip OA group in the frontal plane but insufficiently stabilized in the sagittal plane; however, the patients changed their hip angle during the early phase of stance. The combination of whole-body movements contributed to the stabilization of hip angle.
Collapse
Affiliation(s)
- Takuya Ibara
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
| | - Koji Fujita
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Naoto Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Japan
| | - Ryohei Takada
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Japan
| | - Kazumasa Miyatake
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Japan
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Keiichi Akita
- Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| |
Collapse
|
4
|
Higgs JP, Diamond LE, Saxby DJ, Barrett RS, Graham DF. Individual muscle contributions to the acceleration of the centre of mass during gait in people with mild-to-moderate hip osteoarthritis. Gait Posture 2023; 104:151-158. [PMID: 37421811 DOI: 10.1016/j.gaitpost.2023.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/29/2023] [Accepted: 06/26/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND People with mild-to-moderate hip osteoarthritis (OA) exhibit hip muscle weakness, alterations in hip kinematics and kinetics and hip contact forces during gait compared to healthy controls. However, it is unclear if those with hip OA use different motor control strategies to coordinate the motion of the centre of mass (COM) during gait. Such information could provide further critical assessment of conservative management strategies implemented for people with hip OA. RESEARCH QUESTION Do muscle contributions to the acceleration of the COM during walking differ between individuals with mild-to-moderate hip OA and controls? METHODS Eleven individuals with mild-to-moderate hip OA and 10 healthy controls walked at a self-selected speed while whole-body motion and ground reaction forces were measured. Muscle forces during gait were obtained using static optimisation and an induced acceleration analysis was performed to determine individual muscle contributions to the acceleration of the COM during single-leg stance (SLS). Between-group comparisons were made using independent t-tests via Statistical Parametric Modelling. RESULTS There were no between-group differences in spatial-temporal gait parameters or three-dimensional whole-body COM acceleration. The rectus femoris, biceps femoris, iliopsoas and gastrocnemius muscles in the hip OA group contributed less to the fore-aft accelerations of the COM (p < 0.05), and more to the vertical COM acceleration with the gluteus maximus (p < 0.05), during SLS, compared to the control group. SIGNIFICANCE Subtle differences exist in the way people with mild-to-moderate hip OA use their muscles to accelerate the whole-body centre of mass during the SLS phase of walking relative to healthy controls. These findings improve understanding of the complex functional consequences of hip OA and enhance our understanding of how to monitor the effectiveness of an intervention on biomechanical changes in gait in people with hip OA.
Collapse
Affiliation(s)
- Jeremy P Higgs
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - Laura E Diamond
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - David J Saxby
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - Rod S Barrett
- Griffith University, Griffith Centre of Biomedical and Rehabilitation Engineering, Menzies Health Institute Queensland, Gold Coast, QLD 4222, Australia; Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia
| | - David F Graham
- Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD 4222, Australia; Montana State University, College of Education. Health & Human Development, Bozeman, MT 59717-2940, USA.
| |
Collapse
|
5
|
The biomechanical fingerprint of hip and knee osteoarthritis patients during activities of daily living. Clin Biomech (Bristol, Avon) 2023; 101:105858. [PMID: 36525720 DOI: 10.1016/j.clinbiomech.2022.105858] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Osteoarthritis is a highly prevalent disease affecting the hip and knee joint and is characterized by load-mediated pain and decreased quality of life. Dependent on involved joint, patients present antalgic movement compensations, aiming to decrease loading on the involved joint. However, the associated alterations in mechanical loading of the ipsi- and contra-lateral lower limb joints, are less documented. Here, we documented the biomechanical fingerprint of end-stage hip and knee osteoarthritis patients in terms of ipsilateral and contralateral hip and knee loading during walking and stair ambulation. METHODS Three-dimensional motion-analysis was performed in 20 hip, 18 knee osteoarthritis patients and 12 controls during level walking and stair ambulation. Joint contact forces were calculated using a standard musculoskeletal modelling workflow in Opensim. Involved and contralateral hip and knee joint loading was compared against healthy controls using independent t-tests (p < 0.05). FINDINGS Both hip and knee cohorts significantly decreased loading of the involved joint during gait and stair ambulation. Hip osteoarthritis patients presented no signs of ipsilateral knee nor contralateral leg overloading, during walking and stair ascending. However, knee osteoarthritis patients significantly increased loading at the ipsilateral hip, and contralateral hip and knee joints during stair ambulation compared to controls. INTERPRETATION The biomechanical fingerprint in knee and hip osteoarthritis patients confirmed antalgic movement strategies to unload the involved leg during gait. Only during stair ambulation in knee osteoarthritis patients, movement adaptations were confirmed that induced unbalanced intra- and inter-limb loading conditions, which are known risk factors for secondary osteoarthritis.
Collapse
|
6
|
Emmerzaal J, Van Rossom S, van der Straaten R, De Brabandere A, Corten K, De Baets L, Davis J, Jonkers I, Timmermans A, Vanwanseele B. Joint kinematics alone can distinguish hip or knee osteoarthritis patients from asymptomatic controls with high accuracy. J Orthop Res 2022; 40:2229-2239. [PMID: 35043466 DOI: 10.1002/jor.25269] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/17/2021] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is one of the leading musculoskeletal disabilities worldwide, and several interventions intend to change the gait pattern in OA patients to more healthy patterns. However, an accessible way to follow up the biomechanical changes in a clinical setting is still missing. Therefore, this study aims to evaluate whether we can use biomechanical data collected from a specific activity of daily living to help distinguish hip OA patients from controls and knee OA patients from controls using features that potentially could be measured in a clinical setting. To achieve this goal, we considered three different classes of statistical models with different levels of data complexity. Class 1 is kinematics based only (clinically applicable), class 2 includes joint kinetics (semi-applicable under the condition of access to a force plate or prediction models), and class 3 uses data from advanced musculoskeletal modeling (not clinically applicable). We used a machine learning pipeline to determine which classification model was best. We found 100% classification accuracy for KneeOA-vs-Asymptomatic and 93.9% for HipOA-vs-Asymptomatic using seven features derived from the lumbar spine and hip kinematics collected during ascending stairs. These results indicate that kinematical data alone can distinguish hip or knee OA patients from asymptomatic controls. However, to enable clinical use, we need to validate if the classifier also works with sensor-based kinematical data and whether the probabilistic outcome of the logistic regression model can be used in the follow-up of patients with OA.
Collapse
Affiliation(s)
- Jill Emmerzaal
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.,REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Sam Van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
| | - Rob van der Straaten
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Arne De Brabandere
- Declarative Languages and Artificial Intelligence Group, Department of Computer Science, KU Leuven, Belgium
| | - Kristoff Corten
- Department of Orthopaedics, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Ixelles, Belgium
| | - Jesse Davis
- Declarative Languages and Artificial Intelligence Group, Department of Computer Science, KU Leuven, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
| | - Annick Timmermans
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
| |
Collapse
|
7
|
Bertaux A, Gueugnon M, Moissenet F, Orliac B, Martz P, Maillefert JF, Ornetti P, Laroche D. Gait analysis dataset of healthy volunteers and patients before and 6 months after total hip arthroplasty. Sci Data 2022; 9:399. [PMID: 35821499 PMCID: PMC9276684 DOI: 10.1038/s41597-022-01483-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/16/2022] [Indexed: 11/09/2022] Open
Abstract
Clinical gait analysis is a promising approach for quantifying gait deviations and assessing the impairments altering gait in patients with osteoarthritis. There is a lack of consensus on the identification of kinematic outcomes that could be used for the diagnosis and follow up in patients. The proposed dataset has been established on 80 asymptomatic participants and 106 patients with unilateral hip osteoarthritis before and 6 months after arthroplasty. All volunteers walked along a 6 meters straight line at their self-selected speed. Three dimensional trajectories of 35 reflective markers were simultaneously recorded and Plugin Gait Bones, angles, Center of Mass trajectories and ground reaction forces were computed. Gait video recordings, when available, anthropometric and demographic descriptions are also available. A minimum of 10 trials have been made available in the weka file format and C3D file to enhance the use of machine learning algorithms. We aim to share this dataset to facilitate the identification of new movement-related kinematic outcomes for improving the diagnosis and follow up in patients with hip OA.
Collapse
Affiliation(s)
- Aurélie Bertaux
- CIAD UMR 7533, Univ. Bourgogne Franche-Comté, UB, F-21000, Dijon, France
| | - Mathieu Gueugnon
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France
| | | | - Baptiste Orliac
- INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France
| | - Pierre Martz
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,Orthopaedics department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Jean-Francis Maillefert
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,Rheumatology department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Paul Ornetti
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France.,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.,Rheumatology department, CHU Dijon-Bourgogne, 21000, Dijon, France
| | - Davy Laroche
- INSERM, UMR1093-CAPS, Univ. Bourgogne Franche-Comté, UB, 21000, Dijon, France. .,INSERM, CIC 1432, Module Plurithematique, Plateforme d'Investigation Technologique, 21000, Dijon, France. .,CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Plurithématique, Plateforme d'Investigation Technologique, 21000, Dijon, France.
| |
Collapse
|
8
|
Steingrebe H, Stetter BJ, Sell S, Stein T. Effects of Hip Bracing on Gait Biomechanics, Pain and Function in Subjects With Mild to Moderate Hip Osteoarthritis. Front Bioeng Biotechnol 2022; 10:888775. [PMID: 35898647 PMCID: PMC9309805 DOI: 10.3389/fbioe.2022.888775] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/13/2022] [Indexed: 12/02/2022] Open
Abstract
Hip Osteoarthritis (HOA) is a common joint disease with serious impact on the quality of life of the affected persons. Additionally, persons with HOA often show alterations in gait biomechanics. Developing effective conservative treatment strategies is of paramount importance, as joint replacement is only indicated for end-stage HOA. In contrast to knee osteoarthritis, little is known about the effectiveness of hip bracing for the management of HOA. Studies analysing mechanically unloading hip braces partly showed beneficial results. However, methodological limitations of these studies, such as small sample sizes or lack of control groups, limit the applicability of the results. Additionally, mechanically unloading braces might impose restrictions on motion and comfort and thus, might not be suitable for people with only mild or moderate symptoms. The aim of this study was to comprehensively quantify the effects of unilateral HOA as well as functional hip bracing on gait biomechanics, pain, proprioception and functional capacity in people with mild to moderate HOA. Hip and pelvis biomechanics during walking were analysed in 21 subjects with mild to moderate HOA under three bracing conditions: unbraced, immediately after brace application and after 1 week of brace usage. Additionally, pain, hip proprioception and functional capacity were assessed. A matched group of 21 healthy subjects was included as reference. Kinematic and kinetic data were collected using a 16-camera infrared motion capturing system and two force plates. Visual analogue scales, an angle reproduction test and a 6-min walking test were applied to measure pain, hip proprioception and functional capacity, respectively. Subjects with HOA walked slower, with reduced step length, sagittal hip range of motion and peak extension angle and had a reduced functional capacity. After 1 week of brace application step length, walking speed and functional capacity were significantly increased. Additionally, pain perception was significantly lower in the intervention period. These results encourage the application of functional hip braces in the management of mild to moderate HOA. However, as key parameters of HOA gait such as a reduced peak extension angle remained unchanged, the underlying mechanisms remain partly unclear and have to be considered in the future.
Collapse
Affiliation(s)
- Hannah Steingrebe
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- *Correspondence: Hannah Steingrebe,
| | - Bernd J. Stetter
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Stefan Sell
- Sports Orthopedics, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Joint Center Black Forest, Hospital Neuenbürg, Neuenbürg, Germany
| | - Thorsten Stein
- BioMotion Center, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| |
Collapse
|
9
|
Movement Quality Parameters during Gait Assessed by a Single Accelerometer in Subjects with Osteoarthritis and Following Total Joint Arthroplasty. SENSORS 2022; 22:s22082955. [PMID: 35458937 PMCID: PMC9029923 DOI: 10.3390/s22082955] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/04/2022] [Accepted: 04/07/2022] [Indexed: 01/13/2023]
Abstract
This study’s aim is threefold: (I) Evaluate movement quality parameters of gait in people with hip or knee osteoarthritis (OA) compared to asymptomatic controls from a single trunk-worn 3D accelerometer. (II) Evaluate the sensitivity of these parameters to capture changes at 6-weeks, 3-, 6-, and 12-months following total knee arthroplasty (TKA). (III) Investigate whether observed changes in movement quality from 6-weeks and 12-months post-TKA relates to changes in patient-reported outcome measures (PROMs). We invited 20 asymptomatic controls, 20 people with hip OA, 18 people pre- and post-TKA to our movement lap. They wore a single trunk-worn accelerometer and walked at a self-selected speed. Movement quality parameters (symmetry, complexity, smoothness, and dynamic stability) were calculated from the 3D acceleration signal. Between groups and between timepoints comparisons were made, and changes in movement quality were correlated with PROMs. We found significant differences in symmetry and stability in both OA groups. Post-TKA, most parameters reflected an initial decrease in movement quality at 6-weeks post-TKA, which mostly normalised 6-months post-TKA. Finally, improved movement quality relates to improvements in PROMs. Thus, a single accelerometer can characterise movement quality in both OA groups and post-TKA. The correlation shows the potential to monitor movement quality in a clinical setting to inform objective, data-driven personalised rehabilitation.
Collapse
|
10
|
Lewis CL, Halverstadt AL, Graber KA, Perkins Z, Keiser E, Belcher H, Khuu A, Loverro KL. Individuals With Pre-arthritic Hip Pain Walk With Hip Motion Alterations Common in Individuals With Hip OA. Front Sports Act Living 2021; 3:719097. [PMID: 34505057 PMCID: PMC8421535 DOI: 10.3389/fspor.2021.719097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Individuals with hip osteoarthritis (OA) commonly walk with less hip extension compared to individuals without hip OA. This alteration is often attributed to walking speed, structural limitation, and/or hip pain. It is unclear if individuals who are at increased risk for future OA (i.e., individuals with pre-arthritic hip disease [PAHD]) also walk with decreased hip extension. Objectives: (1) Determine if individuals with PAHD exhibit less hip extension compared to individuals without hip pain during walking, and (2) investigate potential reasons for these motion alterations. Methods: Adolescent and adult individuals with PAHD and healthy controls without hip pain were recruited for the study. Kinematic data were collected while walking on a treadmill at three walking speeds: preferred, fast (25% faster than preferred), and prescribed (1.25 m/s). Peak hip extension, peak hip flexion, and hip excursion were calculated for each speed. Linear regression analyses were used to examine the effects of group, sex, side, and their interactions. Results: Individuals with PAHD had 2.9° less peak hip extension compared to individuals in the Control group (p = 0.014) when walking at their preferred speed. At the prescribed speed, the PAHD group walked with 2.7° less hip extension than the Control group (p = 0.022). Given the persistence of the finding despite walking at the same speed, differences in preferred speed are unlikely the reason for the reduced hip extension. At the fast speed, both groups increased their hip extension, hip flexion, and hip excursion by similar amounts. Hip extension was less in the PAHD group compared to the Control group (p = 0.008) with no significant group-by-task interaction (p = 0.206). Within the PAHD group, hip angles and excursions were similar between individuals reporting pain and individuals reporting no pain. Conclusions: The results of this study indicate that kinematic alterations common in individuals with hip OA exist early in the continuum of hip disease and are present in individuals with PAHD. The reduced hip extension during walking is not explained by speed, structural limitation, or current pain.
Collapse
Affiliation(s)
- Cara L Lewis
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Anne L Halverstadt
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Kerri A Graber
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Zoe Perkins
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emily Keiser
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Hadwin Belcher
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Anne Khuu
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Kari L Loverro
- Human Adaptation Lab, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States.,U.S. Army Combat Capabilities Development Command Soldier Center, Natick, MA, United States
| |
Collapse
|
11
|
Buehler C, Koller W, De Comtes F, Kainz H. Quantifying Muscle Forces and Joint Loading During Hip Exercises Performed With and Without an Elastic Resistance Band. Front Sports Act Living 2021; 3:695383. [PMID: 34497999 PMCID: PMC8419330 DOI: 10.3389/fspor.2021.695383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/21/2021] [Indexed: 01/13/2023] Open
Abstract
An increase in hip joint contact forces (HJCFs) is one of the main contributing mechanical causes of hip joint pathologies, such as hip osteoarthritis, and its progression. The strengthening of the surrounding muscles of the joint is a way to increase joint stability, which results in the reduction of HJCF. Most of the exercise recommendations are based on expert opinions instead of evidence-based facts. This study aimed to quantify muscle forces and joint loading during rehabilitative exercises using an elastic resistance band (ERB). Hip exercise movements of 16 healthy volunteers were recorded using a three-dimensional motion capture system and two force plates. All exercises were performed without and with an ERB and two execution velocities. Hip joint kinematics, kinetics, muscle forces, and HJCF were calculated based on the musculoskeletal simulations in OpenSim. Time-normalized waveforms of the different exercise modalities were compared with each other and with reference values found during walking. The results showed that training with an ERB increases both target muscle forces and HJCF. Furthermore, the ERB reduced the hip joint range of motion during the exercises. The type of ERB used (soft vs. stiff ERB) and the execution velocity of the exercise had a minor impact on the peak muscle forces and HJCF. The velocity of exercise execution, however, had an influence on the total required muscle force. Performing hip exercises without an ERB resulted in similar or lower peak HJCF and lower muscle forces than those found during walking. Adding an ERB during hip exercises increased the peak muscle and HJCF but the values remained below those found during walking. Our workflow and findings can be used in conjunction with future studies to support exercise design.
Collapse
Affiliation(s)
- Callum Buehler
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Willi Koller
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Florentina De Comtes
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Hans Kainz
- Neuromechanics Research Group, Department of Biomechanics, Kinesiology and Computer Science in Sport, Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| |
Collapse
|
12
|
Stief F, Holder J, Feja Z, Lotfolahpour A, Meurer A, Wilke J. Impact of subject-specific step width modification on the knee and hip adduction moments during gait. Gait Posture 2021; 89:161-168. [PMID: 34303070 DOI: 10.1016/j.gaitpost.2021.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/17/2021] [Accepted: 07/17/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patients with hip osteoarthritis (OA) exhibit an increased step width (SW) during walking before and up to 2 years after total hip arthroplasty. Wider SW is associated with a reduction in the external knee adduction moment (KAM), but there is a lack of research regarding the effect of SW on the hip adduction moment (HAM). RESEARCH QUESTION Is a wider SW an effective compensatory mechanism to reduce the hip joint loading? We hypothesized that (1) an increased SW reduces, (2) a decreased SW increases the KAM/HAM, and (3) secondary kinematic gait changes have an effect on the KAM/HAM. METHODS Twenty healthy individuals (24.0 ± 2.5 years of age) underwent instrumented gait analyses with 4 different subject-specific SW modifications (habitual, halved, double, and triple SW). The resulting external KAMs and HAMs were compared using statistical parametric mapping (SPM). RESULTS Post hoc testing demonstrated significantly lower HAM for both the double (p < 0.001, 15-31 % and 61-98 % of the stance phase) and the triple SW (p < 0.001, 1-36 % and 58-98 %) compared to the habitual SW. The extent of the reduction at the first and second peak was comparable for HAM (15-25 % reduction) and less pronounced at the first peak of KAM (9-11 % reduction) compared to the second peak of KAM (19-28 % reduction). In contrast, halving the SW did not lead to a significant change in KAM or HAM compared to the habitual SW (p > 0.009). SIGNIFICANCE An increase in SW is an effective and simple gait mechanism to reduce the frontal plane knee and hip joint moments. However, hypothesis 2 could not be confirmed, as halving the SW did not cause a significant change in KAM or HAM. Given the results of the present study, gait retraining with regard to an increased SW may be an adequate, noninvasive option for the treatment of patients with hip OA.
Collapse
Affiliation(s)
- Felix Stief
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Marienburgstraße 2, 60528 Frankfurt/Main, Germany.
| | - Jana Holder
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Zoe Feja
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Arian Lotfolahpour
- Goethe University Frankfurt, Department of Sports Medicine, Ginnheimer Landstraße 32, 60487 Frankfurt/Main, Germany
| | - Andrea Meurer
- University Hospital Frankfurt, Department of Orthopedics (Friedrichsheim), Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Jan Wilke
- Goethe University Frankfurt, Department of Sports Medicine, Ginnheimer Landstraße 32, 60487 Frankfurt/Main, Germany
| |
Collapse
|
13
|
Roach KE, Pedoia V, Lee JJ, Popovic T, Link TM, Majumdar S, Souza RB. Multivariate functional principal component analysis identifies waveform features of gait biomechanics related to early-to-moderate hip osteoarthritis. J Orthop Res 2021; 39:1722-1731. [PMID: 33615524 PMCID: PMC8180534 DOI: 10.1002/jor.24901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 02/04/2023]
Abstract
Clinicians often examine movement patterns to design hip osteoarthritis (OA) interventions, yet traditional biomechanical analyses only report a single timepoint. Multivariate principal component analysis (MFPCA) analyzes the entire waveform (i.e., movement pattern), which clinicians observe to direct treatment. This study investigated hip OA indicators, by (1) employing MFPCA to characterize variance across the hip, knee, and ankle angles in healthy and early-to-moderate hip OA participants; and (2) investigating relationships between these waveform features and hip cartilage health. Bilateral hip magnetic resonance images from 72 participants with Kellgren-Lawrence grades ranging from 0 to 3 were used to calculate mean T 1ρ and T 2 relaxation times in the femoral and acetabular cartilage. MFPCA was performed on lower-limb gait biomechanics and used to identify primary modes of variation, which were related to T 1ρ and T 2 relaxation times. Here, a MFPC = mode of variation = waveform feature. In the femoral cartilage, transverse plane MFPCs 3 and 5 and body mass index (BMI) was related to T 1ρ , while MFPC 2 and BMI were related to T 2 relaxation times. In the acetabular cartilage, sagittal plane MFPC 1 and BMI were related to T 1ρ , while BMI was related to T 2 relaxation times. Greater internal rotation was related to increased T 1ρ and T 2 relaxation times in the femoral cartilage, while the greater extension was related to increased T 1ρ relaxation times in the acetabular cartilage. This study established a data-driven framework to assess relationships between multi-joint biomechanics and quantitative assessments of cartilage health and identified waveform features that could be evaluated in future hip OA intervention studies.
Collapse
Affiliation(s)
- Koren E. Roach
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Valentina Pedoia
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Jinhee J. Lee
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Tijana Popovic
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Thomas M. Link
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA
| | - Richard B. Souza
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA, USA,Department of Physical Therapy and Rehabilitation Science, University of California – San Francisco, San Francisco, CA, USA
| |
Collapse
|
14
|
Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading. Arthritis Res Ther 2021; 23:129. [PMID: 33910597 PMCID: PMC8080338 DOI: 10.1186/s13075-021-02514-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. Methods Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. Results The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. Conclusions Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02514-x.
Collapse
Affiliation(s)
- Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazutaka So
- Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|
15
|
Diamond LE, Hoang HX, Barrett RS, Loureiro A, Constantinou M, Lloyd DG, Pizzolato C. Individuals with mild-to-moderate hip osteoarthritis walk with lower hip joint contact forces despite higher levels of muscle co-contraction compared to healthy individuals. Osteoarthritis Cartilage 2020; 28:924-931. [PMID: 32360739 DOI: 10.1016/j.joca.2020.04.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare hip joint contact forces (HJCF), hip muscle forces, and hip muscle co-contraction levels between individuals with mild-to-moderate hip osteoarthritis (OA) and healthy controls during walking. DESIGN Eighteen participants with mild-to-moderate hip OA and 23 healthy controls walked at a self-selected speed while motion capture and electromyographic data were synchronously collected. HJCF were computed using a calibrated electromyography-informed neuromusculoskeletal model. Hip joint contact forces, muscle forces, and co-contraction indices for flexor/extensor and adductor/abductor muscle groups were compared between groups using independent sample t-tests (P < 0.05). RESULTS There was no between-group difference in self-selected walking speed. On average, participants with hip OA walked with 11% lower first peak (mean difference 235 [95% confidence interval (CI) 57-413] N) and 22% lower second peak (mean difference 574 [95%CI 304-844] N) HJCF compared to controls. Hip muscle forces were also significantly lower in the hip OA compared to control group at first (mean difference 224 [95%CI 66-382] N) and second (mean difference 782 [95%CI 399-1164] N) peak HJCF. Participants with hip OA exhibited higher levels of hip muscle co-contraction in both flexor/extensor and adductor/abductor muscle groups. Consistent with existing literature, hip joint angles (extension, adduction) and external moments (flexion, extension, adduction) were lower in hip OA compared to controls. CONCLUSION Lower HJCF were detected in mild-to-moderate hip OA, primarily due to lower hip muscle force production, and despite higher levels of hip muscle co-contraction. Findings suggest that lower loading of the hip joint during walking is a feature of mild-to-moderate hip OA, which could have implications for the pathogenesis of hip OA and/or disease progression.
Collapse
Affiliation(s)
- L E Diamond
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health & Rehabilitation Sciences, The University of Queensland, Queensland, Australia.
| | - H X Hoang
- Department of Movement Sciences, KU Leuven, Leuven, Belgium.
| | - R S Barrett
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - A Loureiro
- Faculty of Physical Education and Sports, UNISINOS, São Leopoldo, Brazil.
| | - M Constantinou
- School of Physiotherapy, Australian Catholic University, Brisbane, Australia.
| | - D G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| | - C Pizzolato
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
| |
Collapse
|
16
|
|
17
|
Olsen AL, Magnussen LH, Skjaerven LH, Assmus J, Sundal MA, Ostelo R, Strand LI. Movement quality evaluation and its correlation with recommended functional measures in hip osteoarthritis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1848. [PMID: 32449252 DOI: 10.1002/pri.1848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/07/2020] [Accepted: 04/29/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Hip osteoarthritis may cause compensational movement strategies that require extra physical and mental effort. Such aberrant functioning can be captured in movement quality evaluation. The objective of this study was to explore whether movement quality, evaluated as a multiperspective phenomenon, is reflected in commonly used and recommended functional measures in this group of patients. METHODS A cross-sectional study design was used. Baseline included 80 female and 21 male participants with hip osteoarthritis. Movement quality was evaluated by the Body Awareness Rating Scale-Movement Quality and Experience (BARS-MQE), part one, including 12 movement items. Correlation analyses (Pearson and Spearman) were performed to explore associations between BARS-MQE (sum score and single item scores), and scores on measures of physical capacity (Chair test, Stairs test, 6 minutes walking test; 6MWT), self-reported activity level (UCLA), function (HOOS subscales), pain during walking (NRS), self-efficacy (ASES) and health (EQ-5D-5L). Based on previous evidence, we hypothesized moderate associations between BARS-MQE and these measures. RESULTS BARS-MQE's sum score showed moderate associations with Stairs test, 6MWT and UCLA (r = -0.425 to 0.304) and weak associations (r = 0.29 to 0.12) with ASES Pain and Symptoms, HOOS ADL, Chair test, NRS, HOOS Pain and Sports, and EQ-5D-5L. No association was found between BARS-MQE and HOOS Symptoms and Quality of life. Movement quality in item 12, walking, demonstrated moderate or weak association with all included measures. CONCLUSION In this study of participants diagnosed with hip osteoarthritis, movement quality evaluated by BARS-MQE was moderately reflected in measures of physical capacity and activity, but weakly reflected in self-reported measures of health problems. With its particular dynamic procedure and inclusion of the whole moving person, movement quality evaluation by the BARS-MQE was shown to provide supplementary information on functioning, scarcely captured by the commonly used and recommended measures.
Collapse
Affiliation(s)
- Aarid Liland Olsen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Liv Heide Magnussen
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Helvik Skjaerven
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jörg Assmus
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Mary-Anne Sundal
- Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Raymond Ostelo
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands.,Department of Health Sciences, VU University and Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| |
Collapse
|
18
|
Steele A, Gonzalez R, Garbalosa JC, Steigbigel K, Grgurich T, Parisi EJ, Feinn RS, Tommasini SM, Macica CM. Osteoarthritis, Osteophytes, and Enthesophytes Affect Biomechanical Function in Adults With X-linked Hypophosphatemia. J Clin Endocrinol Metab 2020; 105:5734494. [PMID: 32047911 PMCID: PMC8416779 DOI: 10.1210/clinem/dgaa064] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 02/06/2020] [Indexed: 12/17/2022]
Abstract
CONTEXT X-Linked hypophosphatemia (XLH) is a lifelong metabolic disease with musculoskeletal comorbidities that dominate the adult clinical presentation. OBJECTIVE The adult XLH disorder has yet to be quantified on the basis of the physical and functional limitations that can affect activities of daily living. Our goal was to report the impact of the musculoskeletal manifestations on physical function. DESIGN AND SETTING Musculoskeletal function was evaluated by validated questionnaires and in an interdisciplinary clinical space where participants underwent full-body radiologic imaging, goniometric range of motion (ROM) measurements, general performance tests, and kinematic gait analysis. PATIENTS Nine adults younger than 60 years with a diagnosis of XLH and self-reported musculoskeletal disability, but able to independently ambulate, were selected to participate. Passive ROM and gait analysis were also performed on age-approximated controls to account for differences between individual laboratory instrumentation. RESULTS Enthesophytes, degenerative arthritis, and osteophytes were found to be consistently bilateral and diffusely present at the spine and synovial joints across participants, with predominance at weight-bearing joints. Passive ROM in adults with XLH was decreased at the cervical spine, hip, knee, and ankle compared to controls. Gait analysis relative to controls revealed increased step width, markedly increased lateral trunk sway, and physical restriction at the hip, knees, and ankle joints that translated into limitations through the gait cycle. CONCLUSIONS The functional impact of XLH musculoskeletal comorbidities supports the necessity for creating an interprofessional health-care team with the goal of establishing a longitudinal plan of care that considers the manifestations of XLH across the lifespan.
Collapse
Affiliation(s)
- Amy Steele
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut
| | - Ramon Gonzalez
- Department of Diagnostic Imaging, School of Health Sciences at Quinnipiac University, North Haven, Connecticut
| | - Juan C Garbalosa
- Department of Physical Therapy, School of Health Sciences at Quinnipiac University, North Haven, Connecticut
| | - Keith Steigbigel
- Department of Physical Therapy, School of Health Sciences at Quinnipiac University, North Haven, Connecticut
| | - Tania Grgurich
- Department of Diagnostic Imaging, School of Health Sciences at Quinnipiac University, North Haven, Connecticut
| | - Erika J Parisi
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Richard S Feinn
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut
| | - Steven M Tommasini
- Department of Orthopaedics, Yale University School of Medicine at Quinnipiac University, New Haven, Connecticut
| | - Carolyn M Macica
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut
- Correspondence and Reprint Requests: Carolyn M. Macica, PhD, Department of Medical Sciences, Frank H. Netter MD School of Medicine, Quinnipiac University, NH-MED, 275 Mt Carmel Avenue, Hamden, CT 06518. E-mail:
| |
Collapse
|
19
|
Hunt MA, Charlton JM, Esculier JF. Osteoarthritis year in review 2019: mechanics. Osteoarthritis Cartilage 2020; 28:267-274. [PMID: 31877382 DOI: 10.1016/j.joca.2019.12.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/25/2019] [Accepted: 12/09/2019] [Indexed: 02/02/2023]
Abstract
Mechanics play a critical - but not sole - role in the pathogenesis of osteoarthritis, and recent research has highlighted how mechanical constructs are relevant at the cellular, joint, and whole-body level related to osteoarthritis outcomes. This review examined papers from April 2018 to April 2019 that reported on the role of mechanics in osteoarthritis etiology, with a particular emphasis on studies that focused on the interaction between movement and tissue biomechanics with other clinical outcomes relevant to the pathophysiology of osteoarthritis. Studies were grouped by themes that were particularly prevalent from the past year. Results of the search highlighted the large exposure of knee-related research relative to other body areas, as well as studies utilizing laboratory-based motion capture technology. New research from this past year highlighted the important role that rate of exerted loads and rate of muscle force development - rather than simply force capacity (strength) - have in OA etiology and treatment. Further, the role of muscle activation patterns in functional and structural aspects of joint health has received much interest, though findings remain equivocal. Finally, new research has identified potential mechanical outcome measures that may be related to osteoarthritis disease progression. Future research should continue to combine knowledge of mechanics with other relevant research techniques, and to identify mechanical markers of joint health and structural and functional disease progression that are needed to best inform disease prevention, monitoring, and treatment.
Collapse
Affiliation(s)
- M A Hunt
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
| | - J M Charlton
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
| | - J-F Esculier
- Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, BC, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
20
|
Effect of total joint replacement in hip osteoarthritis on serum COMP and its correlation with mechanical-functional parameters of gait analysis. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100034. [DOI: 10.1016/j.ocarto.2020.100034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/28/2020] [Indexed: 12/13/2022] Open
|
21
|
King MG, Semciw AI, Schache AG, Middleton KJ, Heerey JJ, Sritharan P, Scholes MJ, Mentiplay BF, Crossley KM. Lower-Limb Biomechanics in Football Players with and without Hip-related Pain. Med Sci Sports Exerc 2020; 52:1776-1784. [PMID: 32079924 DOI: 10.1249/mss.0000000000002297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to evaluate the differences in lower-limb biomechanics between adult subelite competitive football players with and without hip-related pain during two contrasting tasks-walking and single-leg drop jump (SLDJ)-and to determine whether potential differences, if present, are sex dependent. METHODS Eighty-eight football players with hip-related pain (23 women, 65 men) and 30 asymptomatic control football players (13 women, 17 men) who were currently participating in competitive sport were recruited. Biomechanical data were collected for the stance phase of walking and SLDJ. Pelvis, hip, knee, and ankle angles, as well as the impulse of the external joint moments, were calculated. Differences between groups and sex-specific effects were calculated using linear regression models. RESULTS Compared with their asymptomatic counterparts, football players with hip-related pain displayed a lower average pelvic drop angle during walking (P = 0.03) and a greater average pelvic hike angle during SLDJ (P < 0.05). Men with hip-related pain displayed a smaller total range of motion (excursion) for the transverse plane pelvis angle (P = 0.03) and a smaller impulse of the hip external rotation moment (P < 0.01) during walking compared with asymptomatic men. Women with hip-related pain displayed a greater total range of motion (excursion) for the sagittal plane knee angle (P = 0.01) during walking compared with asymptomatic women. CONCLUSION Overall, few differences were observed in lower-limb biomechanics between football players with and without hip-related pain, irrespective of the task. This outcome suggests that, despite the presence of symptoms, impairments in lower-limb biomechanics during function do not appear to be a prominent feature of people with hip-related pain who are still participating in sport.
Collapse
Affiliation(s)
- Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, AUSTRALIA
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Gait kinematics of the hip, pelvis, and trunk associated with external hip adduction moment in patients with secondary hip osteoarthritis: toward determination of the key point in gait modification. BMC Musculoskelet Disord 2020; 21:8. [PMID: 31906926 PMCID: PMC6945754 DOI: 10.1186/s12891-019-3022-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/24/2019] [Indexed: 01/12/2023] Open
Abstract
Background A larger daily cumulative hip loading, which is the product of the external hip adduction moment (HAM) impulse during gait and the number of steps per day has been identified as a factor associated with the progression of secondary hip osteoarthritis (OA). The cause of the increased HAM impulse in patients with hip OA has not been identified. The purpose of this study was to identify the gait parameters associated with HAM impulse during gait in patients with secondary hip OA. Methods Fifty-five patients (age 22–65 years) with mild-to-moderate secondary hip OA participated in this cross-sectional study. The HAM impulse during gait was measured using a three-dimensional gait analysis system. To identify the gait parameters associated with HAM impulse, hierarchical multiple regression analysis was performed. The first model (basic model) included body weight and stance phase duration. The second models included gait parameters (gait speed; ground reaction force [GRF] in frontal plane; and hip, pelvic, and trunk angle in frontal plane) and hip pain in addition to the basic model. Results Body weight and stance phase duration explained 61% of the variance in HAM impulse. In the second model, which took into account body weight and stance phase duration, hip adduction angle (9.4%), pelvic tilt (6.5%), and trunk lean (3.2%) in addition to GRF explained the variance in the HAM impulse. Whereas larger hip adduction angle and pelvic tilt toward the swing limb were associated with a larger HAM impulse, larger trunk lean toward the stance limb was associated with smaller HAM impulse. Conclusion In patients with excessive hip adduction and pelvic tilt toward the swing limb during gait, gait modification may contribute to the reduction of hip joint loading.
Collapse
Affiliation(s)
- Hiroshige Tateuchi
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazutaka So
- Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
23
|
Tateuchi H. Gait- and postural-alignment-related prognostic factors for hip and knee osteoarthritis: Toward the prevention of osteoarthritis progression. Phys Ther Res 2019; 22:31-37. [PMID: 31289710 DOI: 10.1298/ptr.r0003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/08/2019] [Indexed: 12/19/2022]
Abstract
Osteoarthritis (OA) is a chronic progressive disease, and thus, prevention of this progression is an important issue. Currently, there is little evidence of the effect of exercise therapy for the prevention of hip and knee OA progression. An understanding of prognostic factors is the basis for the prevention of progression. Previous research indicates that in case of knee OA, abnormalities in knee alignment (varus or valgus) while standing, varus thrust during walking, increased knee flexion in the early stance phase, abnormal displacement of the femur in relation to the tibia, and an increase in knee adduction and flexion moment are risk factors for disease progression. At the same time, the prognostic factors in hip OA are anterior spinal inclination while standing, decreased mobility of the thoracolumbar spine, and increased cumulative hip loading during daily walking. Further research is required to investigate these prognostic factors, particularly the modifiable factors, to analyze the relationships between these factors, and to verify the structural and clinical efficacy of modifying these factors through interventions.
Collapse
Affiliation(s)
- Hiroshige Tateuchi
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University
| |
Collapse
|
24
|
Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study. Arch Phys Med Rehabil 2019; 100:2053-2062. [PMID: 31054296 DOI: 10.1016/j.apmr.2019.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/13/2019] [Accepted: 04/01/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). DESIGN Prospective cohort study. SETTING Clinical biomechanics laboratory of a university. PARTICIPANTS Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). MAIN OUTCOME MEASURES Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. RESULTS Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: -0.52 [-0.88 to -0.17]) and limited external rotation angles (-0.51 [-0.85 to -0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (-0.54 [-0.99 to -0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. CONCLUSIONS Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
Collapse
Affiliation(s)
- Hiroshige Tateuchi
- Department of Preventive Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazutaka So
- Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
25
|
Lewis R, Gómez Álvarez CB, Rayman M, Lanham-New S, Woolf A, Mobasheri A. Strategies for optimising musculoskeletal health in the 21 st century. BMC Musculoskelet Disord 2019; 20:164. [PMID: 30971232 PMCID: PMC6458786 DOI: 10.1186/s12891-019-2510-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 03/17/2019] [Indexed: 12/19/2022] Open
Abstract
We live in a world with an ever-increasing ageing population. Studying healthy ageing and reducing the socioeconomic impact of age-related diseases is a key research priority for the industrialised and developing countries, along with a better mechanistic understanding of the physiology and pathophysiology of ageing that occurs in a number of age-related musculoskeletal disorders. Arthritis and musculoskeletal disorders constitute a major cause of disability and morbidity globally and result in enormous costs for our health and social-care systems.By gaining a better understanding of healthy musculoskeletal ageing and the risk factors associated with premature ageing and senescence, we can provide better care and develop new and better-targeted therapies for common musculoskeletal disorders. This review is the outcome of a two-day multidisciplinary, international workshop sponsored by the Institute of Advanced Studies entitled "Musculoskeletal Health in the 21st Century" and held at the University of Surrey from 30th June-1st July 2015.The aim of this narrative review is to summarise current knowledge of musculoskeletal health, ageing and disease and highlight strategies for prevention and reducing the impact of common musculoskeletal diseases.
Collapse
Affiliation(s)
- Rebecca Lewis
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Constanza B. Gómez Álvarez
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Margaret Rayman
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Susan Lanham-New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anthony Woolf
- Department of Rheumatology, Royal Cornwall Hospital, Truro, UK
| | - Ali Mobasheri
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Queen’s Medical Centre, Nottingham, UK
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- The D-BOARD FP7 Consortium, http://www.d-board.eu
- The APPROACH IMI Consortium, https://www.approachproject.eu
| |
Collapse
|
26
|
Lawrenson PR, Crossley KM, Vicenzino BT, Hodges PW, James G, Croft KJ, King MG, Semciw AI. Muscle size and composition in people with articular hip pathology: a systematic review with meta-analysis. Osteoarthritis Cartilage 2019; 27:181-195. [PMID: 30389399 DOI: 10.1016/j.joca.2018.10.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/17/2018] [Accepted: 10/19/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To synthesise and evaluate the current evidence investigating muscle size and composition in non-inflammatory articular hip pathology. METHODS A systematic review of five electronic databases, using three concepts; articular hip pathology (e.g., osteoarthritis (OA)); hip muscles; and outcomes (e.g., muscle size and adiposity) was undertaken. Studies addressing non-inflammatory or non-traumatic articular hip pain, using measures of muscle size and adiposity were included and appraised for risk of bias. Data was extracted to calculate standardised mean differences (SMD) and pooled where possible for meta-analysis. RESULTS Thirteen cross-sectional studies were included; all studies measured muscle size and 5/13 measured adiposity. In OA, there was low to very low quality evidence of no difference in hip muscle size, compared with matched controls. In unilateral OA, there was low to very low quality evidence of smaller size in gluteus minimus (SMD -0.38; 95% confidence interval (CI) -0.74, -0.01), gluteus medius (-0.44; 95% CI: -0.83, -0.05) and gluteus maximus (-0.39; 95% CI: -0.75, -0.02) muscles in the symptomatic limb. Individual studies demonstrated non-uniform changes in muscle size in OA. No significant difference was observed in muscle size in other pathologies or in adiposity for any group. CONCLUSION There is some low quality evidence that specific hip muscles are smaller in unilateral hip OA. Variation in the magnitude of differences indicate changes in size are not uniform across all muscles or stage of pathology. Studies in larger cohorts investigating muscle size and composition across the spectrum of articular pathologies are required to clarify these findings.
Collapse
Affiliation(s)
- P R Lawrenson
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - K M Crossley
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
| | - B T Vicenzino
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - P W Hodges
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - G James
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - K J Croft
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia.
| | - M G King
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
| | - A I Semciw
- School of Health & Rehabilitation Sciences, University of Queensland, Brisbane, QLD, 4072, Australia; La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, VIC, 3086, Australia.
| |
Collapse
|
27
|
Diamond LE, Allison K, Dobson F, Hall M. Hip joint moments during walking in people with hip osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage 2018; 26:1415-1424. [PMID: 29621605 DOI: 10.1016/j.joca.2018.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis investigated surrogate measures of hip joint loading during walking in people with hip osteoarthritis (OA). METHODS Five databases were searched up to January 14th, 2018. Studies that measured hip joint moments in the frontal or sagittal plane during walking in people with hip OA and used either a healthy control group or the unaffected leg to compare hip joint moments were included. Standardised mean differences (SMD) in sagittal and frontal plane moments were pooled as appropriate, using a random effect approach. Methodological quality was assessed using the Downs and Black checklist. RESULTS Thirteen studies with 1,141 participants were eligible and suitable for meta-analyses. Overall, people with hip OA had lower sagittal (SMD -0.55 (95% confidence interval (CI) -1.00 to -0.10) and frontal plane moments (SMD -0.63 (95% CI -0.92, -0.34) compared to controls. However, substantial heterogeneity was observed (I2 ≤ 89%). Results by disease stage suggest that people with end-stage hip OA have lower sagittal (SMD -0.96; -1.30, -0.61; I2 = 69%) and frontal (SMD -1.17; 95% CI -1.71, -0.64; I2 = 85%) plane moments compared to controls. People with less severe hip OA than end-stage disease have comparable sagittal (SMD 0.37; 95% CI -0.17, 0.90; I2 = 69%) and frontal (SMD -0.24; 95% CI -0.76, 0.27; I2 = 51%) plane moments compared to controls. CONCLUSION Hip joint loading may be dependent on disease stage. People with end-stage hip OA under-loaded compared to controls, while those who were not awaiting hip joint replacement had comparable hip joint loads to controls.
Collapse
Affiliation(s)
- L E Diamond
- Griffith University, Menzies Health Institute Queensland, School of Allied Health Sciences, Gold Coast, QLD 4222, Australia
| | - K Allison
- The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia; The University of Melbourne, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia
| | - F Dobson
- The University of Melbourne, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia
| | - M Hall
- The University of Melbourne, Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Parkville, VIC 3010, Australia.
| |
Collapse
|
28
|
Halilaj E, Rajagopal A, Fiterau M, Hicks JL, Hastie TJ, Delp SL. Machine learning in human movement biomechanics: Best practices, common pitfalls, and new opportunities. J Biomech 2018; 81:1-11. [PMID: 30279002 DOI: 10.1016/j.jbiomech.2018.09.009] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 09/08/2018] [Indexed: 12/11/2022]
Abstract
Traditional laboratory experiments, rehabilitation clinics, and wearable sensors offer biomechanists a wealth of data on healthy and pathological movement. To harness the power of these data and make research more efficient, modern machine learning techniques are starting to complement traditional statistical tools. This survey summarizes the current usage of machine learning methods in human movement biomechanics and highlights best practices that will enable critical evaluation of the literature. We carried out a PubMed/Medline database search for original research articles that used machine learning to study movement biomechanics in patients with musculoskeletal and neuromuscular diseases. Most studies that met our inclusion criteria focused on classifying pathological movement, predicting risk of developing a disease, estimating the effect of an intervention, or automatically recognizing activities to facilitate out-of-clinic patient monitoring. We found that research studies build and evaluate models inconsistently, which motivated our discussion of best practices. We provide recommendations for training and evaluating machine learning models and discuss the potential of several underutilized approaches, such as deep learning, to generate new knowledge about human movement. We believe that cross-training biomechanists in data science and a cultural shift toward sharing of data and tools are essential to maximize the impact of biomechanics research.
Collapse
Affiliation(s)
- Eni Halilaj
- Department of Mechanical Engineering, Carnegie Mellon University, United States.
| | - Apoorva Rajagopal
- Department of Mechanical Engineering, Stanford University, United States
| | - Madalina Fiterau
- Department of Computer Science, Stanford University, United States
| | - Jennifer L Hicks
- Department of Bioengineering, Stanford University, United States
| | - Trevor J Hastie
- Department of Statistics, Stanford University, United States; Department of Health Research and Policy, Stanford University, United States
| | - Scott L Delp
- Department of Mechanical Engineering, Stanford University, United States; Department of Bioengineering, Stanford University, United States; Department of Orthopaedic Surgery, Stanford University, United States
| |
Collapse
|
29
|
Moreside J, Wong I, Rutherford D. Altered erector spinae activity and trunk motion occurs with moderate and severe unilateral hip OA. J Orthop Res 2018; 36:1826-1832. [PMID: 29251373 DOI: 10.1002/jor.23841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 12/14/2017] [Indexed: 02/04/2023]
Abstract
People with hip osteoarthritis (OA) demonstrate altered movement patterns in the hip joint, as well as the pelvis and spine. While kinematic changes have been described in the literature, little is known about the associated erector spinae (ES) activity. Increased or prolonged ES activity may contribute to the low back pain often associated with hip OA. Using a cross-sectional cohort study, 3D trunk motions and ES surface electromyography were recorded on 19 individuals with severe OA (SOA), 20 with moderate hip OA (MOA), and 19 asymptomatic (ASYM) individuals during treadmill walking, using standardized collection and processing procedures. Principal component analysis was used to derive electromyographic amplitude and temporal waveform features. Three-dimensional thoracic motion in a global system, and thoraco-lumbar motion was calculated. Various statistical analyses determined between group differences (α = 0.05). In the sagittal plane, thoracic motion was greater in the SOA group (p < 0.001), whereas the ASYM group used less thoraco-lumbar motion than either OA group (p ≤ 0.002). Greater frontal plane angular excursion during early stance was found in the thoracic region in the SOA group (p ≤ 0.001) . With increasing OA severity, bilateral ES activity increased during the swing phase of gait (p < 0.001), whereas during stance, the SOA ipsilateral ES activity was higher than other groups (p < 0.001). Statement of clinical significance: with moderate and severe OA, sagittal, and frontal trunk motion increases during gait. ES activity during the entire gait cycle is more sustained with increased disease severity, which may aide our understanding of low back pain associated with hip OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1826-1832, 2018.
Collapse
Affiliation(s)
- Janice Moreside
- Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Janice Moreside, 6230 South St., Halifax, Nova Scotia, B3H 4R2, Canada
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ivan Wong
- Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Janice Moreside, 6230 South St., Halifax, Nova Scotia, B3H 4R2, Canada
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
- Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Derek Rutherford
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
- Faculty of Engineering, School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
30
|
Steppacher R, North D, Künzle C, Lengnick H, Klima H, Mündermann A, Wegener R. Retrospective Evaluation of Changes in Gait Patterns in Children and Adolescents With Cerebral Palsy After Multilevel Surgery. J Child Neurol 2018; 33:453-462. [PMID: 29683017 DOI: 10.1177/0883073818766681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to retrospectively investigate changes in gait patterns after single-event multilevel surgery in children and adolescents with bilateral cerebral palsy. Three-dimensional instrumented pre- and postoperative gait data of 12 patients were compared to data of 12 healthy control subjects using principal component analysis to reduce the dimensionality of kinematic and kinetic gait data and detect gait differences. The differences between pre- and postoperative data and between postoperative data and data of control subjects were calculated using a linear mixed model. The results revealed 14 significant effects for pre- and postoperative waveforms and 11 significant effects for postoperative and control waveforms. Patients after single-event multilevel surgery walked with smaller internal foot progression angle throughout the gait cycle, lower knee flexion at initial swing, and earlier knee extension during terminal swing. Retained gait deviations included excessive pelvic tilt and internally rotated and flexed hips over the entire gait cycle. Contrary to our hypothesis, postoperative waveforms in the sagittal plane differed more from control waveforms than from preoperative waveforms. These results emphasize the importance of carefully planning further conservative therapy 2 years after single-event multilevel surgery.
Collapse
Affiliation(s)
- Ramona Steppacher
- 1 Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland.,2 Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - David North
- 2 Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Christoph Künzle
- 3 Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Harald Lengnick
- 3 Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Harry Klima
- 3 Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Annegret Mündermann
- 4 Clinic of Traumatology and Orthopaedics, University Hospital Basel, Basel, Switzerland.,5 Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Regina Wegener
- 2 Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| |
Collapse
|
31
|
Stief F, Schmidt A, van Drongelen S, Lenarz K, Froemel D, Tarhan T, Lutz F, Meurer A. Abnormal loading of the hip and knee joints in unilateral hip osteoarthritis persists two years after total hip replacement. J Orthop Res 2018; 36:2167-2177. [PMID: 29536559 DOI: 10.1002/jor.23886] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 02/22/2018] [Indexed: 02/04/2023]
Abstract
A total hip replacement (THR) is a common and routine procedure to reduce pain and restore normal activity. Gait analysis can provide insights into functional characteristics and dynamic joint loading situation not identifiable by clinical examination or static radiographic measures. The present prospective longitudinal study tested whether 2 years after surgery a THR would restore dynamic loading of the knee and hip joints in the frontal plane to normal. Instrumented gait analysis was performed shortly before surgery and approximately 2 years after THR on 15 unilateral hip osteoarthritis (OA) patients. 15 asymptomatic matched individuals were recruited as healthy controls. Results showed that abnormal joint loading persisted 2 years after THR. The 2nd external knee adduction moment in terminal stance in the affected (-34%, p = 0.002, d = 1.22) and non-affected limb (-25%, p = 0.035, d = 0.81) was lower compared to controls and thus indicated a shift in the knee joint load distribution from medial to lateral. A correlation analysis revealed that a smaller hip range of motion explained 46% of 2nd knee adduction moment alterations. In contrast, the 2nd external hip adduction moment in terminal stance was postoperatively higher in the affected (+22%, p = 0.007, d = 1.04) and non-affected limb (+22%, p = 0.005, d = 1.05). Here, 51% of 2nd hip adduction moment alterations can be explained with a greater hip adduction angle. Patients with a THR may therefore be at higher risk for abnormal joint loading and thus for the development of OA in other joints of the lower extremities. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Collapse
Affiliation(s)
- Felix Stief
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - André Schmidt
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Stefan van Drongelen
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Katharina Lenarz
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Dara Froemel
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Timur Tarhan
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Frederick Lutz
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| | - Andrea Meurer
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528 Frankfurt/Main, Germany
| |
Collapse
|
32
|
Wesseling M, Meyer C, Corten K, Desloovere K, Jonkers I. Longitudinal joint loading in patients before and up to one year after unilateral total hip arthroplasty. Gait Posture 2018; 61:117-124. [PMID: 29324297 DOI: 10.1016/j.gaitpost.2018.01.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 12/22/2017] [Accepted: 01/04/2018] [Indexed: 02/02/2023]
Abstract
Abnormal kinematics and kinetics have been reported in hip osteoarthritis (OA) patients before and after total hip arthroplasty (THA). These changes can affect the loading of the ipsilateral hip, as well as the contralateral hip and knee joint. As it is not clear how hip and knee loading evolves in THA patients during the first year after surgery, the goal of this study is to define how joint loading changes in patients before and at three evaluation times after THA surgery. Musculoskeletal modelling in combination with gait analysis data was used to calculate hip and knee contact forces in 14 patients before and 3-, 6- and 12-months after unilateral THA, as well as in 18 healthy controls. Results showed that bilateral hip and knee loading were decreased compared to controls, both before and after THA surgery. Loading symmetry was altered compared to controls at 3-months post-surgery for the hip and at all evaluation times, except for 6-months post-surgery, for the knee, with ipsilateral joint loading decreased compared to the contralateral side. To conclude, 12-months after THA joint loading was not normalized, with both hip and knee loading in patients decreased compared to controls. Therefore, no overloading of the ipsi- or contralateral hip and knee joint was found before and up to one year after unilateral THA.
Collapse
Affiliation(s)
- Mariska Wesseling
- KU Leuven, Department of Kinesiology, Human Movement Biomechanics, Tervuursevest 101, Heverlee, Belgium.
| | - Christophe Meyer
- KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, Leuven, Belgium.
| | - Kristoff Corten
- Hip Unit, Orthopaedic Department, Ziekenhuis Oost-Limburg, Schiepse Bos 6, Genk, Belgium.
| | - Kaat Desloovere
- KU Leuven, Department of Rehabilitation Sciences, Tervuursevest 101, Leuven, Belgium; Clinical Motion Analysis Laboratory, University Hospitals Leuven, Weligerveld 1, Pellenberg, Belgium.
| | - Ilse Jonkers
- KU Leuven, Department of Kinesiology, Human Movement Biomechanics, Tervuursevest 101, Heverlee, Belgium.
| |
Collapse
|
33
|
Santilli V, Alviti F, Paoloni M, Mangone M, Bernetti A. Comment on "Efficacy of a single intra-articular injection of ultra-high molecular weight hyaluronic acid for hip osteoarthritis: a randomized controlled study". EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2018; 28:755. [PMID: 29387945 DOI: 10.1007/s00590-018-2132-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/03/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Valter Santilli
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy
| | - Federica Alviti
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Mangone
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy
| | - Andrea Bernetti
- Department of Physical Medicine and Rehabilitation, Sapienza University of Rome, Rome, Italy.
| |
Collapse
|
34
|
Hip movement pathomechanics of patients with hip osteoarthritis aim at reducing hip joint loading on the osteoarthritic side. Gait Posture 2018; 59:11-17. [PMID: 28968547 DOI: 10.1016/j.gaitpost.2017.09.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/11/2017] [Accepted: 09/19/2017] [Indexed: 02/02/2023]
Abstract
This study aims at defining gait pathomechanics in patients with hip osteoarthritis (OA) and their effect on hip joint loading by combining analyses of hip kinematics, kinetics and contact forces during gait. Twenty patients with hip OA and 17 healthy volunteers matched for age and BMI performed three-dimensional gait analysis. Hip OA level was evaluated based on plane radiographs using the Tönnis classification. Hip joint kinematics, kinetics as well as hip contact forces were calculated. Waveforms were time normalized and compared between groups using statistical parametric mapping analysis. Patients walked with reduced hip adduction angle and reduced hip abduction and external rotation moments. The work generated by the hip abductors during the stance phase of gait was largely decreased. These changes resulted in a decrease and a more vertical and anterior orientation of the hip contact forces compared to healthy controls. This study documents alterations in hip kinematics and kinetics resulting in decreased hip loading in patients with hip OA. The results suggested that patients altered their gait to increase medio-lateral stability, thereby decreasing demand on the hip abductors. These findings support discharge of abductor muscles that may bear clinical relevance of tailored rehabilitation targeting hip abductor muscles strengthening and gait retraining.
Collapse
|
35
|
Schmidt A, Meurer A, Lenarz K, Vogt L, Froemel D, Lutz F, Barker J, Stief F. Unilateral hip osteoarthritis: The effect of compensation strategies and anatomic measurements on frontal plane joint loading. J Orthop Res 2017; 35:1764-1773. [PMID: 27664397 DOI: 10.1002/jor.23444] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/15/2016] [Indexed: 02/04/2023]
Abstract
In order to reduce pain caused by the affected hip joint, unilateral hip osteoarthritis patients (HOAP) adopt characteristic gait patterns. However, it is unknown if the knee and hip joint loading in the non-affected (limbnon-affected ) and the affected (limbaffected ) limb differ from healthy controls (HC) and which gait parameters correlate with potential abnormal joint loading. Instrumented 3D-gait analysis was performed on 18 HOAP and 18 sex, age, and height matched HC. The limbnon-affected showed greater first and second peak external hip adduction moments (first HAM: +15%, p = 0.014; second HAM: +15%, p = 0.021, respectively), than seen in HC. In contrast, the second peak external knee adduction moment (KAM) in the limbaffected is reduced by about 23% and 30% compared to the limbnon-affected and HC, respectively. Furthermore, our patients showed characteristic gait compensation strategies including reduced peak vertical forces (pvF), a greater foot progression angle (FPA), and reduced knee range of motion (ROM) in the limbaffected . The limbaffected was 5.6 ± 3.8 mm shorter than the limbnon-affected . Results of stepwise regression analyses showed that increased first pvF explain 16% of first HAM alterations, whereas knee ROM and FPA explain 39% of second KAM alterations. We therefore expect an increased rate of progression of OA in the hip joint of the limbnon-affected and suggest that the shift in the medial-to-lateral knee joint load distribution may impact the rate of progression of OA in the limbaffected . The level of evidence is III. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1764-1773, 2017.
Collapse
Affiliation(s)
- André Schmidt
- Experimental Orthopedics and Trauma Surgery, Frankfurt Initiative for Regenerative Medicine, Johann Wolfgang Goethe University Frankfurt, Marienburgstraße 2, 60528, Frankfurt/Main, Germany.,Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt/Main, Germany
| | - Andrea Meurer
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt/Main, Germany
| | - Katharina Lenarz
- Department of Sports Medicine, Johann Wolfgang Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt/Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine, Johann Wolfgang Goethe University Frankfurt, Ginnheimer Landstraße 39, 60487, Frankfurt/Main, Germany
| | - Dara Froemel
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt/Main, Germany
| | - Frederick Lutz
- Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt/Main, Germany
| | - John Barker
- Experimental Orthopedics and Trauma Surgery, Frankfurt Initiative for Regenerative Medicine, Johann Wolfgang Goethe University Frankfurt, Marienburgstraße 2, 60528, Frankfurt/Main, Germany
| | - Felix Stief
- Orthopedic University Hospital Friedrichsheim gGmbH, Marienburgstraße 2, 60528, Frankfurt/Main, Germany
| |
Collapse
|
36
|
Baker M, Moreside J, Wong I, Rutherford DJ. Passive hip movement measurements related to dynamic motion during gait in hip osteoarthritis. J Orthop Res 2016; 34:1790-1797. [PMID: 26895694 DOI: 10.1002/jor.23198] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 02/15/2016] [Indexed: 02/04/2023]
Abstract
Reduced sagittal plane range of motion (ROM) has been reported in individuals with hip osteoarthritis (OA) both during walking and passive testing. The purpose of this study was to determine if a relationship exists between hip extension ROM recorded during gait and passive hip extension ROM in individuals with moderate and severe hip OA, in comparison to an asymptomatic group. Sagittal plane hip ROM was calculated using skin surface marker trajectories captured during treadmill walking at self-selected speed. Passive hip ROM was measured using standardized position and recording procedures with a goniometer. Sagittal plane extension, flexion, and overall ROM were measured dynamically and passively. A two-way mixed model analysis of variance determined significant differences between groups and between passive and dynamic ROM (α = 0.05). Pearson correlations determined relationships between passive and dynamic ROM. Significant group by ROM interactions were found for flexion and extension ROM (p < 0.05). For extension, the severe OA group had less dynamic and passive ROM compared to the other groups and greater passive than dynamic ROM (p < 0.05). For flexion, significant differences in passive ROM existed between all three groups (p < 0.05) whereas no differences were found for dynamic flexion (p < 0.05). Significant correlations between dynamic and passive hip extension were found in the moderate (r = 0.596) and severe OA (r = 0.586) groups, and no correlation was found in the asymptomatic group (r = 0.139). Passive ROM explains variance in dynamic ROM measurements obtained during gait in individuals with moderate and severe hip OA which have implications for the design of treatment strategies targeting walking pathomechanics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1790-1797, 2016.
Collapse
Affiliation(s)
- Matt Baker
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, 4th Floor Forrest Building, 5869 University Ave, 15000, Halifax, Nova Scotia, Canada
| | - Janice Moreside
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, 4th Floor Forrest Building, 5869 University Ave, 15000, Halifax, Nova Scotia, Canada.,Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ivan Wong
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, 4th Floor Forrest Building, 5869 University Ave, 15000, Halifax, Nova Scotia, Canada.,Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada.,Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Derek J Rutherford
- Faculty of Health Professions, School of Physiotherapy, Dalhousie University, 4th Floor Forrest Building, 5869 University Ave, 15000, Halifax, Nova Scotia, Canada. .,Faculty of Health Professions, School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada. .,Faculty of Engineering, School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.
| |
Collapse
|
37
|
Ardestani MM, Wimmer MA. Can a linear combination of gait principal component vectors identify hip OA stages? J Biomech 2016; 49:2023-2030. [PMID: 27255606 DOI: 10.1016/j.jbiomech.2016.04.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/28/2016] [Accepted: 04/30/2016] [Indexed: 11/30/2022]
Abstract
Hip osteoarthritis (OA) has been shown to affect gait patterns of lower extremities. However, until now, no specific identifying gait characteristics for the various disease stages of hip OA have emerged. The present study addresses the following questions: (1) does a vector-based principal component analysis (PCA) discriminate between various disease stages? And, is this analysis more robust than using discrete gait variables? (2) Does the elimination of differences in walking speed affect the discriminatory robustness of a vector-based PCA? De-identified data sets of forty-five unilateral hip OA patients with varying disease stages and twenty-three age-matched, healthy control subjects were obtained from an available repository. PCA was performed on trial matrices consisting of all external joint moments and sagittal joint angles of one full gait cycle. Group differences in sagittal angles, external moments and the linear combination of PC vectors were investigated using spatial parameter mapping (SPM), a statistical vector field test. Several individual gait variables (i.e. joint moments or angles) demonstrated differences between healthy and moderately and/or severely affected subjects. Only the hip adduction moment could discriminate between the healthy and the early-stage OA group. There was no variable that could distinguish between all OA disease stages. In contrast, the linear combination of PC vectors demonstrated significant group differences between all stages of osteoarthritis; furthermore, these group differences stayed significant when matched speeds were input to the model.
Collapse
Affiliation(s)
- Marzieh M Ardestani
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Markus A Wimmer
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| |
Collapse
|
38
|
Leigh RJ, Osis ST, Ferber R. Kinematic gait patterns and their relationship to pain in mild-to-moderate hip osteoarthritis. Clin Biomech (Bristol, Avon) 2016; 34:12-7. [PMID: 27031047 DOI: 10.1016/j.clinbiomech.2015.12.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Mild-to-moderate hip osteoarthritis is often managed clinically in a non-surgical manner. Effective non-surgical management of this population requires characterizing the specific impairments within this group. To date, a complete description of all lower extremity kinematics in mild-to-moderate hip osteoarthritis patients has not been presented. The aim of the present study is to describe the lower extremity gait kinematics in mild-to-moderate hip osteoarthritis patients and explore the relationship between kinematics and pain. METHODS 22 subjects with mild-to-moderate radiographic hip osteoarthritis (Kellgren-Lawrence grade 2-3) and 22 healthy age and BMI matched control subjects participated. Kinematic treadmill walking data were collected across all lower extremity joints. A two-way repeated measures analysis of variance estimated mean differences in gait kinematics between groups. Correlations between gait kinematics and pain were assessed using a Spearman correlation coefficient. FINDINGS Hip osteoarthritis subjects hiked their unsupported hemi-pelvis 1.40° (P<0.001) more than controls and tilted their pelvis 4.65° more anteriorly (P=0.01). Osteoarthritis subjects walked with 4.30° more peak hip abduction (P<0.001), 8.57° less peak hip extension (P<0.001), and 10.54° more peak hip external rotation (P<0.001). Kinematics were related to pain in the ankle frontal plane only (r=-0.43, P<0.05). INTERPRETATION Individuals with mild-to-moderate hip osteoarthritis demonstrate altered gait biomechanics not related to pain. These altered biomechanics may represent effective therapeutic targets by clinicians working with this population. Understanding the underlying patho-anatomic changes that lead to these biomechanical changes requires further investigation.
Collapse
Affiliation(s)
- Ryan J Leigh
- Faculty of Kinesiology, Running Injury Clinic, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Sean T Osis
- Faculty of Kinesiology, Running Injury Clinic, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| | - Reed Ferber
- Faculty of Kinesiology, Running Injury Clinic, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada; Faculty of Nursing, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada.
| |
Collapse
|
39
|
Meyer CAG, Corten K, Fieuws S, Deschamps K, Monari D, Wesseling M, Simon JP, Desloovere K. Evaluation of stair motion contributes to new insights into hip osteoarthritis-related motion pathomechanics. J Orthop Res 2016. [PMID: 26212929 DOI: 10.1002/jor.22990] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Stair motion in the presence of hip osteoarthritis (OA) has received less attention than level walking. Its more strenuous aspect may shed the light on different locomotor strategies when compared to walking. We, therefore, aimed to define stair motion features associated to hip OA and to evaluate whether these specific features would differ from level walking and better characterize the hip pathological condition. Principal component and linear discriminant analyses were, respectively, used as data reduction and classification techniques. Our study highlighted that most of stair motion features associated to hip OA were similar to the ones of walking. Stair descent presented with the lowest misclassification error rate, ranging from 12% to 19% (estimated by cross-validation). But, features that may be considered as a mechanism to reduce demand on the hip abductors were found to be more important in the stair ascent condition. This was reflected by both, greater importance in the classification rule and variance compared with walking, that is, decreased hip internal rotation moment at mid-stance (72.50% vs. 57.63%) and increased trunk lateroflexion toward affected side (56.43% vs. 29.37%). This study emphasized the importance of investigating stair motion in hip osteoarthritic population by highlighting specific locomotor strategies.
Collapse
Affiliation(s)
- Christophe A G Meyer
- KU Leuven Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium.,UZ Pellenberg Orthopedic Department, University Hospitals Leuven, Pellenberg, Belgium.,Laboratory for Clinical Motion Analysis (C-MAL), University Hospital Pellenberg, KU Leuven, Belgium
| | - Kristoff Corten
- Orthopedic Association Genk, Ziekenhuis Oost-Limburg Genk, Belgium
| | - Steffen Fieuws
- I-Biostat, KU Leuven University and Universiteit Hasselt, Leuven, Belgium
| | - Kevin Deschamps
- KU Leuven Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium.,Laboratory for Clinical Motion Analysis (C-MAL), University Hospital Pellenberg, KU Leuven, Belgium
| | - Davide Monari
- KU Leuven Department of Mechanical Engineering, Faculty of Engineering, Leuven, Belgium
| | - Mariska Wesseling
- KU Leuven Human, Movement Biomechanics Research Group, Leuven, Belgium
| | - Jean-Pierre Simon
- UZ Pellenberg Orthopedic Department, University Hospitals Leuven, Pellenberg, Belgium.,KU Leuven Department of Development and Regeneration, Faculty of Medicine, Leuven, Belgium
| | - Kaat Desloovere
- KU Leuven Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium.,Laboratory for Clinical Motion Analysis (C-MAL), University Hospital Pellenberg, KU Leuven, Belgium
| |
Collapse
|