Influences of knee osteoarthritis and walking difficulty on knee kinematics and kinetics.
Annalisa Na, Sara R Piva, Thomas S Buchanan
PMID 29477961WHAT IT FOUND
At a controlled walking speed, knee OA patients who reported walking difficulty had lower peak knee extension moments and a higher first peak knee adduction moment than those without difficulty.
Those without difficulty did not differ from controls on moments.
Key findings
01The group with knee OA and self-reported walking difficulty had the smallest peak knee extension moment compared with both the no-difficulty OA group and the control group.
02The first peak knee adduction moment was significantly larger in the walking-difficulty group, while the no-difficulty OA group did not differ from controls on joint moments.
03Knee excursion differences were mainly between the OA groups and controls, and the walking-difficulty and no-difficulty OA groups did not differ significantly on flexion, extension, or frontal plane excursions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study compared groups at one time point, so it cannot show whether walking difficulty came before or after the gait differences. The sample was small, and the groups were matched and tested at a controlled speed, so the results may not apply to everyday walking. Walking was tested at a fixed speed, which may not reflect how people normally walk. The study did not measure foot and ankle mechanics, so explanations involving toe-out gait are speculative. The authors state that the design makes clinical recommendations difficult.
Declared interests
The study was funded by the Orthopaedic Section of the American Physical Therapy Association. The authors reported no conflict of interest.
The easy way to misread this
Do not read these gait differences as proof that walking difficulty causes abnormal knee mechanics or that a specific treatment will change them. The study is cross-sectional, small, and used a fixed walking speed, so it cannot show cause or test an intervention.