The purpose of this study was to clarify the pattern of coordination between the thigh and shank during gait in patients with knee OA.The purpose of this study was to clarify the pattern of coordination between the thigh and shank during gait in patients with knee OA.
This present study included 18 patients with knee osteoarthritis (knee OA group) (age: 59.9 ± 5.8 years, less than or equal to 3 at the Kellgren Lawrence grading system) and 10 age- and gender-matched community-dwelling control volunteers (control group) (age: 57.1 ± 4.5 years) . The task motion was gait at a comfortable gait speed, and the stance phase of the gait was analyzed. The measurement was made using a three-dimensional motion analysis system, and angular velocities in the three axial directions of the thigh and shank were calculated. MVCT was used to quantify the coordination between the thigh and shank, and the movement coordination pattern between the thigh and shank was classified into the following four phases: Proximal-phase (relatively large proximal segment angular velocity), Distal-phase (relatively large distal segment angular velocity), In-phase (the same directional movement with similar angular velocity), Anti-phase (opposite directional movement with similar angular velocity). The stance phase of gait was divided into the first half of stance phase and the second half of stance phase, and the percentage of the occurrence of the movement coordination pattern in each phase was calculated. All participants provided written informed consent prior to participating in this study.
Statistical analysis was performed by testing for two-sample differences in accordance with the normality (Shapiro–Wilk test). Statistical analysis software was R4.3.3, and the significance level was set at 5%.
The Proximal-phase appearance rate on the sagittal plane was significantly lower in the knee OA group compared with control group during the first half of the stance phase (p = 0.013). There was no significant difference in appearance rate of In-phase on the frontal plane between both groups, although it tended to be high in knee OA group compared with control group (p = 0.098).
The results of the knee OA group with lower rate of dominance of thigh movement on the sagittal plane suggest that it may be difficult to control the thigh by the hip joint. In addition, in the knee OA group tended to have a high rate of movement of the thigh and shank on frontal plane in the same direction. Further research may reveal the presence of knee varus/valgus stiffness.
Identification of the decreased intersegmental coordination in the lower limb is critical to understanding the effects on knee joint function and providing considered physical therapy for improved gait.
coordination pattern
Modified vector coding technique
