INDIVIDUAL JOINT CONTRIBUTIONS TO FORWARD PROPULSION DURING TREADMILL WALKING IN WOMEN WITH HIP OSTEOARTHRITIS
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Abstract
Introduction: Hip osteoarthritis (OA) is a prevalent degenerative joint condition that significantly impacts mobility and quality of life, especially among women.
Objective: The main objective of the study is to find the individual joint contributions to forward propulsion during treadmill walking in women with hip osteoarthritis.
Methodology: This observational study was conducted at Department of Orthopaedic Surgery Jinnah Medical &Dental College Karachi during March 2022 to March 2023. A total of 25 women diagnosed with hip OA were recruited for this study. Inclusion criteria required participants to have a confirmed diagnosis of hip OA based on clinical and radiographic assessments, with symptoms including joint pain, stiffness, and reduced range of motion.
Results: The study included 25 women with a mean age of 58.4 years (±5.8), ranging from 55 to 70 years. Participants had a mean BMI of 27.6 kg/m² (±3.1), indicating a moderately overweight population, with a weight range of 60 to 85 kg. The average walking speed was 1.08 m/s (±0.15), slightly below the typical speed for healthy individuals. Clinical assessments revealed moderate pain and functional impairments, as reflected by a mean WOMAC pain score of 15.4 (±4.3) and a function score of 22.1 (±6.8). Participants reported an average VAS pain score of 6.2 (±1.5), indicating moderate discomfort during walking.The hip joint contributed 22% to forward propulsion, showing an 18% reduction compared to healthy controls, primarily due to decreased power generation during the late stance phase. In contrast, the knee joint's contribution increased by 22%, accounting for 34% of the propulsion, highlighting compensatory overloading to offset the reduced hip function.
Conclusion: It is concluded that women with hip osteoarthritis (OA) exhibit significant alterations in joint contributions to forward propulsion during treadmill walking. Specifically, the hip joint demonstrates reduced power generation, which is compensated by increased knee joint contributions, while the ankle joint maintains its typical role in propulsion.
References
2. Lawrence RC, Felson DT, Helmick CG, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: part II. Arthritis Rheumatol. 2008;58(1):26-35. DOI:10.1002/art.23176.
3. Constantinou M, Barrett R, Brown M, Mills P. Spatial-temporal gait characteristics in individuals with hip osteoarthritis: a systematic literature review and meta-analysis. J Orthop Sports Phys Ther. 2014;44(4):291-B7. DOI:10.2519/jospt.2014.5034.
4. Hall M, Chabra S, Shakoor N, Leurgans SE, Demirtas H, Foucher KC. Hip joint moments in symptomatic vs. asymptomatic people with mild radiographic hip osteoarthritis. J Biomech. 2019;96:109347. DOI:10.1016/j.jbiomech.2019.109347.
5. Middleton A, Fritz SL, Lusardi M. Walking speed: the functional vital sign. J Aging Phys Act. 2015;23(2):314-322. DOI:10.1123/japa.2013-0236.
6. Fielding RA, Guralnik JM, King AC, et al. Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: results from the LIFE study randomized trial. PLoS One. 2017;12(8):e0182155. DOI:10.1371/journal.pone.0182155.
7. Boyer KA, Andriacchi TP, Beaupre GS. The role of physical activity in changes in walking mechanics with age. Gait Posture. 2012;36(1):149-153. DOI:10.1016/j.gaitpost.2012.02.002.
8. Schmid A, Duncan PW, Studenski S, et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-2100. DOI:10.1161/STROKEAHA.106.475921.
9. Faria-Fortini I, Polese JC, Faria CDCM, Teixeira-Salmela LF. Associations between walking speed and participation, according to walking status in individuals with chronic stroke. Neurorehabilitation. 2019;45(3):341-348. DOI:10.3233/NRE-192756.
10. Foucher KC, Aydemir B, Huang CH. Walking energetics and fatigue are associated with physical activity in people with knee osteoarthritis. Clin Biomech. 2021;88:105427. DOI:10.1016/j.clinbiomech.2021.105427.
11. Wallis JA, Webster KE, Levinger P, Taylor NF. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthritis Cartilage. 2013;21(11):1648-1659. DOI:10.1016/j.joca.2013.08.003.
12. Hall M, Allison K, Hinman RS, et al. Effects of adding aerobic physical activity to strengthening exercise on hip osteoarthritis symptoms: protocol for the PHOENIX randomised controlled trial. BMC MusculoskeletDisord. 2022;23(1):361. DOI:10.1186/s12891-022-05370-7.
13. Skou ST, Pedersen BK, Abbott JH, Patterson B, Barton C. Physical activity and exercise therapy benefit more than just symptoms and impairments in people with hip and knee osteoarthritis. J Orthop Sports Phys Ther. 2018;48(6):439-447. DOI:10.2519/jospt.2018.7877.
14. Browne MG, Franz JR. The independent effects of speed and propulsive force on joint power generation in walking. J Biomech. 2017;55:48-55. DOI:10.1016/j.jbiomech.2017.02.001.
15. Nilsson J, Thorstensson A. Ground reaction forces at different speeds of human walking and running. Acta Physiol Scand. 1989;136(2):217-227. DOI:10.1111/j.1748-1716.1989.tb08655.x.
16. Peterson CL, Kautz SA, Neptune RR. Braking and propulsive impulses increase with speed during accelerated and decelerated walking. Gait Posture. 2011;33(4):562-567. DOI:10.1016/j.gaitpost.2011.01.010.
17. Costello KE, Felson DT, Neogi T, et al. Ground reaction force patterns in knees with and without radiographic osteoarthritis and pain: descriptive analyses of a large cohort (the Multicenter Osteoarthritis Study). Osteoarthritis Cartilage. 2021;29(8):1138-1146. DOI:10.1016/j.joca.2021. v04.011.
18. DeVita P, Hortobagyi T. Age causes a redistribution of joint torques and powers during gait. J Appl Physiol. 2000;88(5):1804-1811. DOI:10.1152/jappl.2000.88.5.1804.
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Syed Abdur Rub Abidi
Associate Professor, Department of Orthopaedic Surgery Jinnah Medical &Dental College Karachi
Kashif Anwar
Senior Registrar, Department of Orthopedics, Jinnah Postgraduate Medical Center (Jpmc), Karachi
Zia Ullah
Assistant Professor, Department of Orthopaedics, Khalifa Gul Nawaz Hospital Bannu / Bannu Medical College
Abdul Rahman Shaikh
Resident Medical Officer, Department of Orthopedics, Lyari General Hospital , Karachi
Aman Ullah Khan Kakar
Associate Professor, Department of Orthopedic Surgery, Bolan Medical College, Quetta
Saeed Ahmad
Assistant Professor, Department of Orthopedic, Peshawar Medical College and Affiliated hospitals, Peshawar
Asnaf Siddique
Consultant Surgeon, Department of Orthopeadic, Latamber Type D Hospital Karak