The responsiveness of three-dimensional knee accelerations used as an estimation of knee instability and loading transmission during gait in osteoarthritis patient's follow-up

Abstract

Knee instability and joint loading transmission are two important biomechanical factors in subjects with knee osteoarthritis (OA). However, the relationship between these factors in a rehabilitation treatment remains unclear. The purpose of this study is to determine the responsiveness of a new three-dimensional (3D) acceleration method used as an estimation of knee instability and joint loading transmission during gait in OA subjects after a rehabilitation treatment. Twenty-four subjects with medial knee OA were included in this study. They had clinical and gait evaluations before and after 12 weeks of treatment. 3D linear knee accelerations, quadriceps and hamstring isometric strength and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) pain were quantified, and compared between both evaluations. Nine asymptomatic subjects participated in this study for gait comparison. A significant reduction of the anterior posterior (AP) knee acceleration peak (P=0.02) had been detected after the treatment. No difference for both distal and lateral knee accelerations peak was found. A significant increase in quadriceps (P<0.001) and hamstring (P=0.006) strength was seen after treatment. The WOMAC of pain had shown significant reduction after the treatment (P<0.001). The present study demonstrates that the estimation of knee acceleration parameters is sensitive to changes in knee OA gait after a rehabilitation treatment. This study also indicates that a treatment of 3 months which combines therapeutic and exercises program could have benefits on knee OA by increasing AP knee stability and stabilize joint loading transmission during gait.