Mark Degenhardt (Basel / CH; Köln), Matthias Wittauer (Basel / CH), Dr. Corina Nüesch (Basel / CH), Ives Acklin (Basel / CH), PD Dr. Christian Egloff (Basel / CH), Prof. Annegret Mündermann (Basel / CH)
Abstract-Text (inkl. Referenzen und Bildunterschriften)
Introduction: Joint coordination may provide important information on fundamental aspects of pathological gait and the effect of treatment.
Purpose: The primary aim of this study was to investigate differences in inter-joint coordination in patients with knee osteoarthritis (OA) between the affected leg (AL) and unaffected leg (UL) and compared with healthy controls (HC), before and 6 months after knee arthroplasty during the gait phases of walking.
Methods: We included 23 patients with knee OA (age: 72 ± 9 years) and 20 healthy controls (HC) (age: 33 ± 10 years). The groups matched in walking speed (0.88 m/s). Sagittal joint angles of the hip, knee and ankle during walking were obtained via IMUs. Coupling angles (CA) were calculated via vector coding technique1 (Fig.1). Circular statistics (circular t-test and Waston‑Williams test) was used to detect within subject and between group differences. The gait cycle was divided into five phases2.
Results: The hip-knee CA in the AL differed from the UL and the HC during loading response pre-surgery (P<0.001; P=0.016) and post-surgery (P<0.001; P=0.030) with smaller differences post‑surgery (Fig.2). During terminal stance, the hip-knee CA in the UL differed from the HC post-surgery (P=0.023), but not pre-surgery.
Conclusion: Observed differences were gait phase specific. Some differences in inter-joint coordination in the UL emerged only after surgery and may be linked to simultaneous abnormal CA in the AL. Therefore, the rehabilitation process and follow-up in these patients should also focus on the specific biomechanical properties of the different gait phases to regain coordination in the AL closer to healthy and pay attention to the UL to prevent the manifestation of abnormal coordination and the development of secondary diseases.
1Needham, 2014, J Biomech
2Perry, 1992, Gait Analysis
Funding: Deutsche Arthrose-Hilfe e.V.; University of Basel