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Compensatory Gait Mechanics in Patients with Unilateral Knee Arthritis CHRIS A. McGIBBON and DAVID E. KREBS
ABSTRACT.
Methods. Thirteen elderly patients with unilateral knee OA and 10 matched healthy elderly controls were studied during preferred and paced speed gait. Gait speed, step length, and lower extremity and low back joint MEE and MEC were compared between groups. Results. Patients with knee OA had lower, but not significantly different, walking speed and step length compared to the controls, and had significantly different joint kinetic profiles. Patients had reduced ankle power at terminal stance, lacked a second positive peak in knee power, and had increased power absorption at the hip. Abnormal knee kinematics were exaggerated when walking at a paced speed, but hip kinetics normalized among patients with OA. Conclusion. Reduced ankle plantar-flexion power in patients with knee OA was probably due to disrupted transfer of energy through the knee. Lack of concentric knee power supports prior studies' conclusions that patients with knee OA avoid using their quadriceps to stabilize the knee, probably to reduce articular loads. Patients with knee OA increase eccentric hip power due to increased hip extension caused by abnormal knee kinematics, potentially increasing hip articular forces. This passive mechanism, however, may assist in the advancement of the leg into swing phase. (J Rheumatol 2002;29:2410-9) Key Indexing Terms:
GAIT
From the Biomotion Laboratory, Massachusetts General Hospital, Boston, and Harvard Medical School, Cambridge, Massachusetts, USA. Supported in part by grants from the National Institutes of Health: NIA (R01 AG12561) and NIAMS (R01 AR45278). C.A. McGibbon, PhD, Associate Professor, Graduate Programs in Physical Therapy, MGH Institute of Health Professions, Lecturer in Orthopaedic Surgery, Harvard Medical School; D.E. Krebs, PhD, PT, Professor, Graduate Programs in Physical Therapy and Clinical Investigation, MGH Institute of Health Professions, Lecturer in Orthopaedic Surgery, Harvard Medical School. Address reprint requests to Dr. C.A. McGibbon, Biomotion Laboratory, RSL 010, Massachusetts General Hospital, 40 Parkman St., Boston, MA 02114. E-mail: cmcgibbon@partners.org Submitted November 2, 2001; revision accepted May 9, 2002.
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