Comparison of gait, functional activities, and patient-reported outcome measures in patients with knee osteoarthritis and healthy adults using 3D motion analysis and activity monitoring: an exploratory case-control analysis

Abstract

Objective

To examine functional performance differences using kinematic and kinetic analysis between participants with and without knee osteoarthritis (OA) to determine which outcomes best characterize persons with and without knee OA.

Methods

Participants with unilateral moderate knee OA (Kellgren–Lawrence grades 2 or 3) and controls without knee pain were matched for age, gender, and body mass index. Primary outcomes included temporal parameters, joint rotations and moments, and ground reaction forces assessed via 3D motion capture during walking and ascending/descending stairs. Secondary outcomes included timed functional activities (sit to stand; tying shoelaces), 48 hrs lower limb activity monitoring, and patient-reported outcome measures (Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, European Quality of Life–5 Dimensions).

Results

Eight matched pairs were analyzed. Compared with controls, OA participants exhibited significant reductions in peak frontal hip and sagittal knee moments, and decreased peak anterior ground reaction force with the affected limb while walking. Ascending stairs, OA participants had slower speed, fewer strides per minute, longer cycle and stance times, and increased trunk range of motion (ROM) in assessments of both limbs; longer swing time and reduced ankle ROM in the affected limb; and increased knee frontal ROM in the unaffected limb. Descending stairs, OA participants had fewer strides per minute and decreased trunk transverse ROM in assessments of both limbs; increased knee frontal ROM in the affected limb; and longer strides, shorter stance and cycle times, increased trunk sagittal and decreased knee transverse ROMs in the unaffected limbs vs controls. Compared with controls, OA participants had slower walking cadence (120–130 vs 100–110 steps/min, respectively), took significantly longer on timed functional measures, and had significantly worse scores in patient-reported outcomes.

Conclusion

Several objectives and patient-reported measures examined in this study could potentially be considered as outcomes in pharmacologic or physical therapy OA trials.

Keywords:

• osteoarthritis
• knee
• 3D motion analysis
• biomechanics
• kinetics
• gait

Acknowledgments

Writing support was provided by Peloton Advantage, an OPEN Health company, Parsippany, NJ, USA and was funded by GlaxoSmithKline Consumer Healthcare Pte, 150 Beach Road, #22-00 Gateway West, Singapore, 189720. This study was funded by GlaxoSmithKline Consumer Healthcare, 23 Rochester Park, Singapore, 139234. GlaxoSmithKline Consumer Healthcare reviewed the data report and publication, and provided funding for writing support.

Ethics approval and consent to participate

This study was approved by the National Institute for Social Care and Health Research (Research Ethics Committee) and Cardiff and Vale University Health Board. It was conducted in accordance with ethical principles delineated in the Declaration of Helsinki. All participants provided written informed consent prior to performing any study procedures.

Availability of data and materials

The dataset supporting the conclusions of this article can be requested for further research from www.clinicalstudydatarequest.com.

Abbreviations

AE, adverse event; BMI, body mass index; %BW, percent body weight; EQ-5D, European Quality of Life–5 Dimensions; EULAR, European League Against Rheumatism; KOOS, Knee Injury and Osteoarthritis Outcome Score; OA, osteoarthritis; ROM, range of motion; SD, standard deviation; WOMAC, Western Ontario and McMaster Universities.

Author contributions

All authors contributed to the design, acquisition, or data analysis; drafting and revising the article; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

Dr Martina Hagen is an employee of GlaxoSmithKline Consumer Healthcare. Dr Gemma M Whatling reports grants from GlaxoSmithKline Consumer Healthcare during the conduct of the study. The authors report no other conflicts of interest in this work.