Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Sagittal Plane Hip Motion During Gait and Function and Disability in Knee Osteoarthritis.
Moisio, Kirsten, Colbert, Carmelita J., Almagor, Orit, Chmiel, Joan S., Chang, Alison, Zhang, Yunhui, Cahue, September
Studies have established that sagittal plane range of knee motion during gait is associated with physical function in knee osteoarthritis (OA) (Maly 2006). The impact of knee OA on range of knee motion during gait may lead to a greater reliance on the hip. Even when knees are healthy, hips play a critical role in daily activities. With knee OA, the compensatory role of the hip may be considerable. In persons with knee OA, reduced range of hip motion during gait may be a result of shortness of two joint hip flexor muscles such as the rectus femoris or the tensor fascia lata-iliotibial band complex. We hypothesized that reduced sagittal plane range of hip motion during gait is associated with worse function and greater disability in persons with knee OA.
We studied 250 persons with knee OA (defined by osteophyte presence in at least one knee). Quantitative gait analysis was performed at the participant's self-selected normal walking speed to calculate kinematic and kinetic data for the hip and knee. Function was evaluated using: WOMAC function scale (higher score worse); Late Life Function Instrument (LL-FI), basic and advanced lower extremity function scales (lower score worse); and 20 m walk time. Disability was measured using: Late Life Disability Instrument (LL-DI), activity frequency and activity limitation scales (lower score worse). To evaluate the relationship between sagittal range of motion during gait (independent variable) and function or disability (dependent variables), linear regression models were used (analyzing the data from the limb with less sagittal motion). The results are reported as regression coefficients (slopes) and associated 95% confidence intervals (95% CIs), separately for each dynamic range of motion variable, adjusted for age, gender, and BMI.
250 persons had a mean age of 64.8 years (SD 10.2), BMI 28.6 kg/m2 (5.6), and 76% were women. Mean (SD) sagittal range of hip motion during gait was 43.1° (5.6), and mean (SD) sagittal range of knee motion was 60.9° (5.5). The table shows adjusted coefficients per 5° (95% CI); significant values are bolded. Range of hip motion during gait was significantly associated with function by self-report, performance function, and both measures of disability; range of knee motion during gait was associated with function measures but not these measures of disability.
Table. Dynamic Sagittal Plane Hip and Knee Motion and Measures of Function and Disability
|WOMAC function scale||20 meter walk time||LL-FI, basic LE function||LL-FI, advanced LE function||LL-DI, activity frequency||LL-DI, activity limitation|
|Sagittal hip motion (°)||-2.37 (-3.60, -1.15)||-1.53 (-1.77, -1.29)||3.04 (1.61, 4.47)||2.86 (1.54, 4.17)||1.37 (0.64, 2.11)||2.35 (0.95, 3.74)|
|Sagittal knee motion (°)||-1.75 (-3.06, -0.44)||-0.89 (-1.20, -0.58)||1.49 (-0.06, 3.05)||1.47 (0.02, 2.93)||-0.50 (-1.30, 0.31)||1.12 (-0.40, 2.63)|
Sagittal range of hip motion during gait was consistently associated with measures of function and disability, supporting a compensatory role played by the hip in the setting of knee OA. Longitudinal studies will help to elucidate whether range of hip motion during gait should be a rehabilitative target (e.g., stretching the hip flexors with concomitant strengthening of hip extensors, gait training) to potentially enhance outcome for persons with knee OA.
To cite this abstract, please use the following information:
Moisio, Kirsten, Colbert, Carmelita J., Almagor, Orit, Chmiel, Joan S., Chang, Alison, Zhang, Yunhui, et al; Sagittal Plane Hip Motion During Gait and Function and Disability in Knee Osteoarthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1087