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Gait characteristics and lower limb muscle strength in women with early and established knee osteoarthritis
Authors:Isabel A.C. Baert  Ilse Jonkers  Filip Staes  Frank P. Luyten  Steven Truijen  Sabine M.P. Verschueren
Affiliation:1. Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Heverlee, Belgium;2. Department of Kinesiology, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Heverlee, Belgium;3. Division of Rheumatology, UZ - KU Leuven, O&N II Herestraat 49, Leuven, Belgium;4. Department of Health Care, Artesis University College of Antwerp, Van Aertselaerstraat 31, Merksem, Belgium;5. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Wilrijk, Belgium
Abstract:

Background

Based on novel classification criteria using magnetic resonance imaging, a subpopulation of “early knee osteoarthritis patients” was clearly defined recently. This study assessed whether these early osteoarthritis patients already exhibit gait adaptations (knee joint loading in particular) and changes in muscle strength compared to control subjects and established knee osteoarthritis patients.

Methods

Fourteen female patients with early knee joint degeneration, defined by magnetic resonance imaging (early osteoarthritis), 12 female patients with established osteoarthritis and 14 female control subjects participated. Specific gait parameters and lower limb muscle strength were analyzed and compared between groups. Within the osteoarthritis groups, association between muscle strength and dynamic knee joint loading was also evaluated.

Findings

Early osteoarthritis patients presented no altered gait pattern, no significant increase in knee joint loading and no significant decrease in hamstring muscle strength compared to controls, while established osteoarthritis patients did. In contrast, early osteoarthritis patients experienced significant quadriceps weakness, comparable to established osteoarthritis patients. Within the osteoarthritis groups, muscle strength was not correlated with knee joint loading during gait.

Interpretation

The results suggest that gait changes reflect mechanical overload and are most likely the consequence of structural degeneration in knee osteoarthritis. Quadriceps weakness might however contribute to the onset and progression of the disease. This study supports the relevance of classification of early osteoarthritis patients and assists in identifying their functional characteristics. This helps to understand the trajectory of disease onset and progression and further develop more targeted strategies for prevention and treatment of knee osteoarthritis.
Keywords:Early osteoarthritis   Knee   Gait   Knee adduction moment   Muscle strength
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