Background

People with knee osteoarthritis are at higher risk of postural deficits and locomotor adaptations which could be manifested in transient tasks like gait initiation. To better understand the effect of early knee osteoarthritis on gait initiation, we measured the gait initiation in two groups of early knee osteoarthritis and healthy age-matched controls and assessed the effect of lateral wedge insole in knee osteoarthritis group.

Methods

Twenty-one individuals with early knee osteoarthritis, mean (SD) age = 53.1 (7.4, years), and 19 age- and sex-matched asymptomatic healthy individuals, mean (SD) age = 47.5 (11.2, years), participated. Centre of pressure trajectories were used to quantify the two phases of gait initiation in barefoot condition: anticipatory postural adjustment, and locomotor phase. The immediate and four-week effect of lateral wedge insole and shod condition were also compared for individuals in knee osteoarthritis group.

Findings

Longer duration of anticipatory postural adjustment phase (P = 0.046), locomotor phase (P = 0.049), and total duration of gait initiation (P = 0.035) with lower length and velocity of the center of pressure trajectories in anticipatory postural adjustment phase (P = 0.002, and 0.008, respectively) were observed in knee osteoarthritis group compared to controls. Lateral wedge insole could increase the length and velocity of the centre of pressure in locomotor phase compared to barefoot condition (P = 0.001, and 0.002, respectively).

Interpretation

Our study outlined that people with early knee osteoarthritis adopt different gait initiation strategies mainly in postural preparation phase. The potential effect of lateral wedge insole was shown with better performance of the locomotor phase.

Clinical trial registry number

IRCT2016060628310N1.

中文翻译：

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早期膝骨关节炎患者的步态起始和外侧楔形鞋垫

背景

膝骨关节炎患者的姿势缺陷和运动适应性风险较高，这可能在步态启动等短暂任务中表现出来。为了更好地了解早期膝关节骨关节炎对步态启动的影响，我们测量了两组早期膝关节骨关节炎和健康年龄匹配的对照组的步态启动，并评估了膝关节骨关节炎组中外侧楔形鞋垫的作用。

方法

参加了21例早期膝骨关节炎患者，平均（SD）年龄= 53.1（7.4岁），以及19例年龄和性别匹配的无症状健康个体，平均（SD）年龄= 47.5（11.2岁）。压力轨迹中心用于量化赤脚状态下步态起始的两个阶段：预期姿势调整和运动阶段。还比较了膝骨关节炎组个体的外侧楔形鞋垫和穿鞋情况的即时和四周效果。

发现

预期姿势调整阶段中较长的预期姿势调整阶段（P  = 0.046），运动阶段（P  = 0.049）和步态启动总持续时间（P  = 0.035）较长，而压力轨迹中心的长度和速度较低（P 与对照组相比，在膝骨关节炎组中分别观察到分别为0.002和0.008）。与赤脚状态相比，外侧楔形鞋垫可以在运动阶段增加压力中心的长度和速度（ 分别为P = 0.001和0.002）。

解释

我们的研究概述了早期膝骨关节炎患者主要在姿势准备阶段采用不同的步态起始策略。显示了侧向楔形鞋垫的潜在作用以及运动阶段的更好性能。

临床试验注册号

IRCT2016060628310N1。