Background

Kinematic changes in patients with knee osteoarthritis (OA) have been extensively studied. Concerns have been raised whether the measured spatiotemporal and kinematic alterations are associated with disease progression or merely a result of reduced walking speed.

Research question: The purpose of this study was to investigate the effect of walking speed on kinematic parameters in patients with knee OA using statistical parametric mapping (SPM).

Methods

Twenty-three patients with unilateral knee OA scheduled for a total knee replacement and 28 age matched control subjects were included in this study. Spatiotemporal parameters and sagittal plane kinematics were measured in the hip, knee, and ankle using the inertial sensors system RehaGait® while walking at a self-selected normal (patients and controls) and slow walking speed (controls) for a distance of 20 meters. Gait parameters were compared between groups for self-selected walking speed and for matched walking speed using SPM with independent sample t tests.

Results

At self-selected walking speed, patients had significantly lower knee flexion during stance (maximum difference, -6.8°) and during swing (-11.0°), as well as higher ankle dorsiflexion during stance phase (+12.5°) and lower peak hip extension at the end of stance compared to controls (+4.2°). At matched speed, there were no significant differences in joint kinematics between groups.

Significance

Differences in sagittal plane gait kinematics between patients with knee OA and asymptomatic controls appear to be mainly a result of reduced walking speed. These results emphasize the importance of considering walking speed in research on gait kinematics in patients with knee OA and in clinical trials using gait parameters as outcome measures.

中文翻译：

---

严重膝关节骨关节炎患者的运动学改变是步行速度降低而不是疾病严重程度的结果。

背景

膝骨关节炎（OA）患者的运动学变化已得到广泛研究。有人担心测量的时空和运动学变化是与疾病进展有关，还是仅仅是步行速度降低的结果。

研究问题：这项研究的目的是使用统计参数映射（SPM）研究步行速度对膝OA患者运动学参数的影响。

方法

这项研究包括了23例计划进行全膝关节置换的单侧膝OA患者和28个年龄相匹配的对照受试者。使用惯性传感器系统RehaGait®在自行选择的正常人群（患者和对照组）和慢速行走速度（对照组）步行20米时，测量髋，膝和踝的时空参数和矢状面运动学。使用独立样本t检验的SPM，比较了两组之间的步态参数，以进行自我选择的步行速度和匹配的步行速度。

结果

在自行选择的步行速度下，患者在站立期间（最大差，-6.8°）和挥杆期间（-11.0°）的膝盖屈曲明显降低，在站立阶段（+ 12.5°）和较低的峰值髋关节屈膝与对照相比（+ 4.2°），站立时的伸展距离更大。在匹配的速度下，各组之间的关节运动学没有显着差异。

意义

膝骨关节炎患者和无症状对照之间的矢状面步态运动学差异似乎主要是步行速度降低的结果。这些结果强调了在步行性膝关节炎患者的步态运动学研究以及使用步态参数作为结果指标的临床试验中考虑步行速度的重要性。