Abstract
BackgroundHip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities. Treadmills that support the body weight (BW) reduce the load on the lower limbs, and those equipped with a lower-body positive-pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. However, the effects of unweighting on gait kinematics remain unclear in patients with hip OA. Therefore, we investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device.MethodsA total of 15 women with hip OA and 15 age-matched female controls wore a three-dimensional (3-D) motion analysis system and walked at a self-selected speed on the LBPP treadmill. Data regarding self-reported hip pain using a numeric rating scale (NRS) in which the scores 0 and 10 represented no pain and the worst pain, respectively, under three different BW conditions (100, 75, and 50%) were collected. Moreover, 3-D peak joint angles during gait under each condition were calculated and compared.ResultsIn the hip OA group, the NRS pain scores at 50 and 75% BW conditions significantly decreased compared with that at 100% BW condition (50%, P = 0.002; 75%, P = 0.026), and the peak hip extension angle decreased compared with that in the healthy controls (P = 0.044). In both groups, unweighting significantly decreased the peak hip (P < 0.001) and knee (P < 0.001) flexion angles and increased the peak ankle plantar flexion angle (P < 0.001) during walking.ConclusionsUnweighting by the LBPP treadmill decreased pain in the hip OA group but did not drastically alter the gait kinematics compared with that in the control group. Therefore, regarding the use of the LBPP treadmill for patients with hip OA, clinicians should consider the benefits of pain reduction rather than the kinematic changes.
Highlights
Hip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities
In the hip OA group, the numeric rating scale (NRS) pain score was significantly lower at 50% body weight (BW) condition than at the 100% (P = 0.002) and 75% (P = 0.018) BW conditions
The NRS pain score was significantly lower at 75% BW condition than at 100% BW condition (P = 0.026) (Fig. 3)
Summary
Hip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities. Treadmills that support the body weight (BW) reduce the load on the lower limbs, and those equipped with a lower-body positive-pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. We investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device. Walking exercises are widely used in individuals with hip osteoarthritis (OA) for rehabilitation [1, 2] These individuals often have difficulty in walking due to pain and excessive force induced by weight-bearing activities. Because LBPP treadmills reduce the stress induced by ground reaction forces on the lower limbs, unweighting by the LBPP treadmill has shown to significantly reduce pain in patients with OA and, has the potential to maintain or enhance aerobic exercise capacity [5, 6]. We thought that we could calculate gait kinematics in participants with hip OA by this system while walking on an LBPP treadmill
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