What is the influence of severity levels of knee osteoarthritis on gait initiation?. (April 2020)

• Record Type: Journal Article
• Authors: da Silva Soares, Fabiana; Moreira, Vanessa Martins Pereira Silva; Alves, Luiza Vinhal; Dionisio, Valdeci Carlos
• Is Part Of: Clinical biomechanics. Volume 74(2020)
• Page Start: 51
• Page End: 57
• Publication Date: 2020-04
• Subjects: Anticipatory postural adjustments -- Gait initiation -- Knee osteoarthritis -- Severity; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2020.02.007
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: The anticipatory postural adjustments required for gait initiation have not yet been investigated in older adults with different levels of severity of knee osteoarthritis. This study aimed to evaluate the anticipatory postural adjustments adopted by older adults with different severity levels of knee osteoarthritis during gait initiation. Methods: Sixty-seven older adults with knee osteoarthritis (mild, moderate, and severe levels) and 11 healthy older adults control were evaluated bilaterally with a force plate to analyze gait initiation. The center of pressure trajectory during gait initiation was divided into four phases: three anticipatory postural adjustments, and a locomotor phase. The length, duration, and velocity of each phase were calculated. Findings: The results showed that during the right and left limbs swing forward, the severe and moderate knee osteoarthritis groups presented a significant reduction in the length of anticipatory postural adjustment phases, locomotion, duration, and velocity ( P < 0.05). The severe knee osteoarthritis group presented a significantly higher body mass index ( P < 0.003) than the other groups. However, just the healthy group presented a correlation between body mass index and anticipatory postural adjustments. Interpretation: Our results demonstrated that older adults with severe and moderate levels of knee osteoarthritis adopt longer lasting and slower anticipatory postural adjustment phases, lower locomotion, and lower center of pressure displacement during gait initiation, suggesting that this population has adaptive strategy in performing gait initiation, which is significantly changed by the knee osteoarthritis severity level. Highlights: Severe and moderate knee osteoarthritis affects the gait initiation. Knee osteoarthritis is associated with a reduced center of pressure displacement. The slower anticipatory postural adjustment was observed for knee osteoarthritis. Knee osteoarthritis leads to the high duration of anticipatory postural adjustments. Knee osteoarthritis causes an adaptive strategy to perform the postural transition.