EFFECTS OF KNEE OSTEOARTHRITIS ON BODY'S CENTER OF MASS MOTION IN OLDER ADULTS DURING LEVEL WALKING

Abstract

Knowledge of the control of the body's dynamic stability in patients with knee osteoarthritis (OA) is helpful for the management of these patients and for the evaluation of treatment outcomes. The purpose of the current study was to investigate the dynamic stability of patients with knee OA during level walking using variables describing the motion of the body's center of mass (COM) and its relationship to the center of pressure (COP). Kinematic and kinetic data during level walking were obtained from 10 patients with bilateral knee OA and 10 normal controls using a motion analysis system and two forceplates. Compared to the normal controls, patients with knee OA exhibited normal COM positions and velocities at key instances of gait but with significant changes in COM accelerations. In the sagittal plane, adjustments to the anterioposterior acceleration of the COM throughout the complete gait cycle were needed for better control of the COM during the more challenging latter half of single leg stance. Diminished A/P COM–COP separation was also used to maintain body stability with reduced joint loadings. In the frontal plane, this was achieved by increasing the acceleration of the body's COM towards the stance leg. The more jerky motion of the body's COM observed may be a result of reduced ability associated with knee OA in the control of the motion of the COM. Strengthening of the muscles of the lower extremities, as well as training of the control of the COM through a dynamic balance training program, are equally important for the dynamic stability of patients with knee OA.