Pre-operative self-efficacy and pain catastrophizing are associated with knee biomechanics during gait post-meniscectomy

Abstract

s / Osteoarthritis and Cartilage 21 (2013) S63–S312 S99 in IE rotation (r21⁄40.33) and total reaction moments (r21⁄40.66). There were no differences in walking speed or step-length for any treatment. Conclusion: The shift towards greater tibia internal rotation and the association with external joint moments suggests that with treatment of Celecoxib there may be a lessening of bracing or co-contraction around the joint that results from pain and inflammation. A rotational shift in joint kinematics has previously been linked with patterns of cartilage thinning. The different kinematic response between the two treatment arms suggest potential differences in the impact of these drugs on ambulation and may have implications for different rates of disease progression that require further study. 171 PRE-OPERATIVE SELF-EFFICACY AND PAIN CATASTROPHIZING ARE ASSOCIATED WITH KNEE BIOMECHANICS DURING GAIT POSTMENISCECTOMY C.-J. Hsieh, S.Z. George, J.A. Dominguez, M.W. Moser, T.L. Chmielewski. Univ. of Florida, Gainesville, FL, USA Purpose: Meniscectomy is a risk factor for developing knee osteoarthritis (OA) and potentially leads to altered gait. Altered gait (e.g. reduced knee angle excursion and knee extensor moment and lower peak vertical ground reaction force) can change articular cartilage loading and contribute to the onset of OA. A variety of impairments could lead to altered gait, including abnormal psychosocial factors. Few studies have investigated the effect of psychosocial factors on gait, particularly in people with meniscectomy. From a clinical perspective, such research could help identify rehabilitation targets for the recovery of normal gait to possibly minimize the risk of knee OA. Therefore, the purpose of this study was to 1) examine gait biomechanics after meniscectomy, and 2) determine if pre-operative psychosocial factors are associated with post-meniscectomy knee biomechanics during gait. Methods: Fifteen subjects with traumatic meniscal tear and meniscectomy were recruited (14 males; mean age: 20.1 2.9yrs; 10 lateral/5 medial meniscectomy). Questionnaires for psychosocial constructs were administered pre-operatively and included pain catastrophizing [Pain Catastrophizing Scale, PCS; range1⁄40-52 points], fear of movement/re-injury [Tampa Scale for Kinesiophobia, TSK-11; range1⁄411-44 points], and self-efficacy for knee activity [Knee Activity Self-Efficacy Scale, KASES; range1⁄40-100 points]. Higher scores indicate higher levels of the given construct. Gait analysis was conducted after rehabilitation was complete (mean 1⁄4 7.5 weeks post-operative). Retro-reflective markers were placed prior to five walking trials at a self-selected speed. Marker position was recorded with a motion capture system (Motion Analysis Corp), and ground reaction forces were recorded with two force platforms (Advanced Mechanical Technology Inc). Sagittal plane knee angle excursion, knee extensor moment and peak vertical ground reaction force (PVGRF) were analyzed bilaterally during weight acceptance. Gait biomechanical variables were compared between sides with paired t-tests. Pearson's Product Moment correlation determined the association between pre-operative questionnaire scores and postoperative gait biomechanical variables on the surgical side. Results: Compared to the non-surgical side, the surgical side showed reduced sagittal plane knee angle excursion and knee extensor moment during weight acceptance (p1⁄4.001 and p1⁄4.002, respectively, Table). Gait biomechanical variables and questionnaire scores Variable Surgical side Non-surgical side Points Knee angle excursion ( ) 13.05 (4.51) 16.48(4.37) Knee extensor moment (N-m/kg) 0.07(0.17) 0.18(0.18) Peak vertical ground reaction force (N) 996.51(316.28) 1005.53(283.43) Pain Catastrophizing Scale (PCS) 10.93(8.32)