Knee osteoarthritis and walking biomechanics
One page on PainSci cites Bechard 2012: Does Posture Matter?
PainSci notes on Bechard 2012:
This 2012 study of knee arthritis showed that people who already have arthritic knees are bigger leaners, and their gait is “consistently different” than people with healthy knees, and they probably weren’t walking different because of pain. (Causality is a major problem with studies like this: it lacks the scientific power to actually demonstrate causality. Neverthless, I like that the authors actually considered the problem, and I do agree with their conclusion: “over 30 minutes of walking, these gait characteristics remain quite stable, suggesting they are not acute compensatory mechanisms in response to repetitive loading with subtle increases in pain.” That’s good thinking, I think.)
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVE: To compare the time-varying behavior of maximum toe-out angle, lateral trunk lean (over the stance leg), and pelvic obliquity (rise and drop on the swing leg) during prolonged walking in participants with and without medial compartment knee osteoarthritis (OA), and to explore correlations between these gait characteristics and pain.
METHODS: Twenty patients with knee OA and 20 healthy controls completed 30 minutes of treadmill walking. Toe-out, trunk lean, pelvic obliquity, and pain were measured at 5-minute intervals.
RESULTS: The mean ± SD toe-out angle was significantly smaller (P = 0.04) in patients with knee OA (6.7 ± 2.5 degrees) than in controls (10.3 ± 2.2 degrees). Toe-out changed significantly over time (P = 0.002), but not in a systematic way, and there was no interaction between group and time. The mean ± SD trunk lean was higher (P = 0.03) in patients with knee OA (2.0 ± 1.0 degrees) than in controls (0.7 ± 0.5 degrees). Trunk lean did not change over time and there was no interaction between group and time. There were no differences for pelvic drop. The mean ± SD pelvic rise was higher (P = 0.01) in patients with knee OA (2.8 ± 0.9 degrees) than in controls (1.2 ± 0.8 degrees), but did not change over time and there was no interaction. Patients experienced a small increase in pain (P < 0.001). Trunk lean and pelvic drop were correlated with pain (r = 0.49, P = 0.03 and r = 0.47, P = 0.04, respectively).
CONCLUSION: Toe-out and trunk lean are consistently different between individuals with and without medial compartment knee OA during prolonged walking, and patients with greater pain have greater trunk lean. However, over 30 minutes of walking, these gait characteristics remain quite stable, suggesting they are not acute compensatory mechanisms in response to repetitive loading with subtle increases in pain.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
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- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.