Association of Varus Knee Thrust During Walking With Worsening Western Ontario and McMaster Universities Osteoarthritis Index Knee Pain: A Prospective Cohort Study

Wink, Alexandra E.; Gross, K.D.; Brown, Carrie; Lewis, Cora E.; Torner, James C.; Nevitt, Michael C.; Tolstykh, Irina; Sharma, Leena; Felson, David T.

doi:10.1002/acr.23766

Cited by 12 publications

(10 citation statements)

References 24 publications

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“…In their 12-month prospective study, Tateuchi et al reported that limited hip extension and limited external rotation angles during gait were associated with worsening hip pain in patients with hip OA [ 24 ]. In a prospective study of patients with knee OA, a varus thrust of the knee during gait, which is associated with a knee adduction moment, was related to worsening knee pain [ 25 ]. The subjects in our study included older adults with musculoskeletal problems and most of these subjects with pain after walking were already experiencing some degree of pain before walking.…”

Section: Discussionmentioning

confidence: 99%

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study

Misu

Asai

Murata

et al. 2022

IJERPH

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This study aimed to investigate whether abnormal gait patterns are associated with experiencing an elevated degree of pain after daily walking. In this preliminary, cross-sectional study, 223 community-dwelling older adults were assessed for pain experienced after daily walking using a simple question that involved asking the subject about their past experiences of an elevated degree of pain after walking for 400 m or more. Gait patterns were assessed using the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score), derived from the data measured by Inertial sensors attached to the lower trunk and heel when subjects walked along a 15 m walkway at a self-selected preferred speed. The score was the sum of 10 gait parameter scores. The lower scores indicated more and worse abnormal gait patterns. In total, 24 older adults (10.8%) reported that they experienced pain after daily walking. According to the multiple logistic regression analyses, older adults with a lower total C-GAITS score had a significantly greater probability of having past experiences of pain after walking (odds ratio = 1.11, 95% confidence interval = 1.03–1.20). The findings of this study suggest that more and worse abnormal gait patterns among older adults in a clinical walking test are associated with an elevated degree of pain after daily walking.

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Section: Discussionmentioning

confidence: 99%

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study

Misu

Asai

Murata

et al. 2022

IJERPH

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“…Varus thrust frequently occurs in 16–31% of patients with knee OA , and these altered knee kinematics may explain the much higher prevalence of LBP in patients with knee OA than in older adults . Thrust contributes to aggravated knee pain and increased knee joint stress through increased external knee adduction moment . This may cause proximal gait adaptations, such as lateral trunk leaning , possibly to avoid pain and minimize knee stress through decrease in the external knee adduction moment .…”

Section: Discussionmentioning

confidence: 99%

“…We set the number of times that the physical therapists could observe the videos at up to a maximum of 5 times. The patients were categorized into the following 2 groups: those with varus thrust (including patients with varus thrust being definitely present during any [≥1] steps and those with varus thrust being possibly present during all steps ), and those without varus thrust (including those with varus thrust being definitely absent and those with varus thrust being possibly present but not during all steps). This categorization slightly differs from that in a previous study ; that is, patients with varus thrust being possibly present were categorized as with varus thrust to maximize statistical power.…”

Section: Methodsmentioning

confidence: 99%

“…Varus thrust during gait is an easily assessed measure of frontal plane dynamic knee motion that is defined as the dynamic worsening or abrupt onset of varus motion during weight acceptance . Varus thrust has been previously linked to the progression of knee OA , worsening cartilage and bone marrow lesions , worsening and incidence of knee pain , and severe knee pain . Although thrust influences the entire kinematic chain of the lower extremity and may cause altered lower back motions, its effects on LBP have yet to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Relationship Between Varus Thrust During Gait and Low Back Pain in Individuals With Knee Osteoarthritis

Iijima

Suzuki

Aoyama

et al. 2020

Arthritis Care & Research

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Objective To test the hypothesis that varus thrust visualized during gait is associated with a higher prevalence of low back pain (LBP) in individuals with knee osteoarthritis (OA). Methods Individuals with knee OA (Kellgren/Lawrence grade ≥1) underwent a gait observation to assess varus thrust. The participants identified LBP and its severity using questionnaires. Logistic regression analyses were performed to examine the association between varus thrust and LBP. Results We included 205 participants (mean age 68.19 years; 72.20% women). A total of 45 participants (22.0%) showed varus thrust in their painful knee, in whom 31 (68.89%) and 18 (40.00%) were identified as having any LBP and moderate‐to‐severe LBP (numerical rating scale ≥4 points), respectively. Patients with varus thrust demonstrated a 3.6‐fold higher risk of the presence of moderate‐to‐severe LBP (95% confidence interval [95% CI] 1.62–8.10). In patients with LBP, the presence of varus thrust was associated with more severe LBP intensity (proportional odds ratio 2.25 [95% CI 1.02–4.96]). Conclusion This study highlights the novel relationship between varus thrust and LBP, which supports the idea of a biomechanical link, the so‐called knee–spine syndrome. These findings provide new insight for clarifying the pathogenesis of LBP related to knee OA.

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“…WOMAC score is a recognized self-rating scale about knee osteoarthritis. The WOMAC score is made up of three parts (24 items), including the pain (5 items), stiffness (2 items), and joint function (17 items) [ 25 , 26 ]. The higher score means the more severe symptom of osteoarthritis.…”

Section: Methodsmentioning

confidence: 99%

Effects of Golden Plaster on Knee Osteoarthritis: A Multicenter Randomized, Double-Blind, Placebo-Controlled Trial

Chen

Liu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Golden plaster is the preferred and most commonly used in China for pain reduction in patients with knee osteoarthritis (OA). However, there was no evidence-based medical evidence about its effect in relieving pain of knee OA patients. Here, a multicenter randomized, double-blind, placebo-controlled trial was performed to evaluate the efficacy and safety of golden plaster for the improvement of pain relief and function’s obstacle in patients with knee OA. Methods. 320 patients with knee OA were enrolled at four hospitals and randomly divided into the treatment group and the control group with 160 subjects in each group. Patients in treatment group were treated with golden plaster, and those in control group with placebo plaster. The study cycle in both groups was 21 days. Patient visits were documented before treatment and 7-, 14-, and 21-day follow-ups after treatment. The outcomes included VAS score, WOMAC score, and adverse events. Results. Compared to the control group, the VAS score in the treatment group was significantly decreased after treatment with golden plaster for 7 days, 14 days, and 21 days. Compared to the control group, the WOMAC score in the treatment group was significantly decreased 14 days and 21 days. The incidence rate of adverse events had no statistical difference between both the groups. Conclusions. In conclusion, our study, for the first time by carrying on the double-blind and placebo-controlled randomized trial, showed that golden plaster can effectively alleviate the pain of knee and improve the physical function in the patients with knee OA. This trial is registered with ChiCTR-TRC-13003418.

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Association of Varus Knee Thrust During Walking With Worsening Western Ontario and McMaster Universities Osteoarthritis Index Knee Pain: A Prospective Cohort Study

Cited by 12 publications

References 24 publications

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study

Association between Abnormal Gait Patterns and an Elevated Degree of Pain after Daily Walking: A Preliminary Study

Relationship Between Varus Thrust During Gait and Low Back Pain in Individuals With Knee Osteoarthritis

Effects of Golden Plaster on Knee Osteoarthritis: A Multicenter Randomized, Double-Blind, Placebo-Controlled Trial

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