Criteria of gait asymmetry in patients with hip osteoarthritis

Abstract

Gait symmetry is often a goal for physiotherapy in patients with hip osteoarthritis and after total hip replacement. However, there is no agreement on criteria for pathological gait asymmetry. In this study we investigated discriminative abilities of trunk and footfall gait symmetry measures, and thereafter assessed whether a 10% cutoff value is valid as a general criterion of pathological gait asymmetry across measures. Anteroposterior, vertical, and mediolateral trunk symmetry, single support, and step length symmetry were obtained simultaneously by trunk accelerometry and an electronic walkway in 37 patients with end-stage hip osteoarthritis and 56 controls. Subjects walked six times along a 7-meter walkway at slow, preferred, and fast speed, before data were normalized for gait velocity. Anteroposterior, vertical, and single support symmetry measures showed best discriminating abilities. The general 10% criterion of gait asymmetry and optimal cutoff criteria calculated for each symmetry measure showed approximately equal total classification ability. However, the optimal cutoff criteria classified a high number of controls as having pathological gait asymmetry. The general criterion of 10% is valid with high total classification ability, does not classify asymmetry in able-bodied subjects as pathological, and is feasible for use on individual patients in the clinic as well as in research.

A Review of Selected Factors Affecting Gait Symmetry

“…Achieving full gait symmetry is often an important target for physiotherapy in people with various diseases and functional anomalies [5,8]. Examples of clinical trials include a comparison between dysfunctional gait and normal people with hypothetical gait symmetry [13].…”

“…In this case, gait asymmetry is considered an important factor to evaluate the functional inefficiency of the patients with the anomaly. Thereby, achieving gait symmetry or reducing gait asymmetry in people with any disorder before and after rehabilitation has been used to assess the effectiveness of the treatment model [2][3][4][5][6]. In this context, the results of several studies have also shown the effectiveness of rehabilitation exercises [3,30,39,47].…”

“…Ellis et al [7] reported that increased gait asymmetry would increase metabolic and mechanical costs, suggesting the gait symmetry as the best prescription for healthy people. Thus, achieving full gait symmetry in most cases is an important target for physiotherapy in people with various diseases and functional anomalies [5,8], although many other papers have not supported this claim [9,10]. However, many scholars have discussed the issue of gait symmetry in people with and without various diseases and anomalies.…”

Gait variability and symmetry assessment with inertial sensors for quantitative discrimination of Trendelenburg sign in total hip arthroplasty patients: a pilot study based on convenience sampling

“…In pathological gait, marked differences have been reported between the affected and unaffected limbs, as observed in amputee gait (Kaufman et al, 2012), in post-stroke patients (Lewek et al, 2014), in hemiplegic subjects, in hemiparetic patients, ageing and Parkinson's disease (Yogev et al, 2007), in patients with limb length inequality (Kaufman et al, 1996), or osteoarthritis and THA patients (Hodt-Billington et al, 2012). These examples illustrate how gait asymmetry can be a direct consequence of abnormality, and, furthermore, can reduce the performance of everyday tasks and the quality of life (Kaufman et al, 2012).…”

Validity and sensitivity of the longitudinal asymmetry index to detect gait asymmetry using Microsoft Kinect data

“…Lower-limb gait asymmetry (GA) is characteristic of a number of chronic neurological and mu culo kele al i ea e [1] inclu ing cerebral pal y [2] Parkin on' i ea e [3] an knee and hip osteoarthritis [4][5]. Onset of GA can also follow acute events such as stroke [6] and amputation [7].…”