Coordination of lower limbs in patients with knee osteoarthritis during walking

Abstract

BackgroundThe movement coordination in patients with knee osteoarthritis may be impaired and the identification of the deficits in lower limb inter-segmental coordination is crucial to understand the effect of knee osteoarthritis on knee function. Research questionThis study utilizes continuous relative phase to investigate the pattern and variability of lower limb inter-segmental coordination in patients with knee osteoarthritis and in healthy subjects during walking, and to evaluate inter-segmental coordination alterations in patients. MethodsGait was measured by a three-dimensional motion capture system for 44 patients with late-stage knee osteoarthritis and 22 healthy subjects. Segmental kinematic parameters, continuous relative phase and its variability were calculated. Independent samples t-tests were used to detect differences between patients and healthy subjects. ResultsThigh-shank continuous relative phase of patients is significantly decreased by 16.04° and 16.18° during late stance and swing phase as compared with healthy subjects (P < 0.05). Shank-foot continuous relative phase of patients is significantly decreased by 6.89° during early stance and significantly increased by 5.49° and 6.39° during late stance and swing phase (P < 0.05). Patients also exhibit increased variability of thigh-shank continuous relative phase during late stance and swing phase by 1.90° and 1.65° respectively, and increased variability of shank-foot continuous relative phase during early stance and swing phase by 0.83° and 0.88° respectively as compared to healthy subjects (P < 0.05). SignificancePatients with knee osteoarthritis exhibit altered coordination patterns and increased coordination variability of thigh-shank and shank-foot. Knee dysfunction results in altered lower limbs coordination and unstable motor control during walking. Investigation of inter-segmental coordination could therefore provide insights into changes in neuromuscular control of gait in patients with knee osteoarthritis.