Effects of unweighting on gait kinematics during walking on a lower-body positive-pressure treadmill in patients with hip osteoarthritis

Abstract

Background Hip osteoarthritis (OA) is a musculoskeletal condition that makes walking difficult due to pain induced by weight-bearing activities. Treadmills that support the body weight (BW) reduce the load on the lower limbs, and those equipped with a lower-body positive-pressure (LBPP) device, developed as a new method for unweighting, significantly reduce pain in patients with knee OA. However, the effects of unweighting on gait kinematics remain unclear in patients with hip OA. Therefore, we investigated the effects of unweighting on kinematics in patients with hip OA during walking on a treadmill equipped with an LBPP device. Methods A total of 15 women with hip OA and 15 age-matched female controls wore a three-dimensional (3-D) motion analysis system and walked at a self-selected speed on the LBPP treadmill. Data regarding self-reported hip pain using a numeric rating scale (NRS) in which the scores 0 and 10 represented no pain and the worst pain, respectively, under three different BW conditions (100, 75, and 50%) were collected. Moreover, 3-D peak joint angles during gait under each condition were calculated and compared. Results In the hip OA group, the NRS pain scores at 50 and 75% BW conditions significantly decreased compared with that at 100% BW condition (50%, P = 0.002; 75%, P = 0.026), and the peak hip extension angle decreased compared with that in the healthy controls (P = 0.044). In both groups, unweighting significantly decreased the peak hip (P < 0.001) and knee (P < 0.001) flexion angles and increased the peak ankle plantar flexion angle (P < 0.001) during walking. Conclusions Unweighting by the LBPP treadmill decreased pain in the hip OA group but did not drastically alter the gait kinematics compared with that in the control group. Therefore, regarding the use of the LBPP treadmill for patients with hip OA, clinicians should consider the benefits of pain reduction rather than the kinematic changes.

Evaluation of gait characteristics in subjects with locomotive syndrome using wearable gait sensors

“…The LS-stage 2 and LS-stage 1 groups had significantly smaller peak hip abduction angles during the swing phase compared with the non-LS group. However, these differences between groups were within the measurement error range [ 16 ]. Therefore, there was no clinically significant difference in the gait kinematics of the hip joint in the frontal plane, and the focus should be on the gait kinematics in the sagittal plane to detect the differences between individuals with versus without LS.…”

“…The H-Gait system analyzes the motion characteristics of the lower limbs outside the laboratory using seven wearable sensors that detect movements along three axes [ 14 ]. Although previous studies have suggested that the H-Gait system is applicable for people with knee osteoarthritis (OA) [ 15 ] and people with hip OA [ 16 ], this system may also be applied to community-dwelling older adults with LS. To help prevent the progression of LS, it is important to understand the differences in gait kinematics and parameters between individuals with and without LS.…”

Evaluation of Lower-Limb Kinematics during Timed Up and Go (TUG) Test in Subjects with Locomotive Syndrome (LS) Using Wearable Gait Sensors (H-Gait System)

“…Recently, we have developed a wearable sensor-based system (H-Gait) that utilizes seven wearable sensors consisting of tri-axial acceleration sensors and tri-axial gyro sensors to analyze the lower-limb kinematics during walking without optical tracking [ 6 ]. This system can calculate lower-limb kinematics while walking easily and quickly without the restriction of the location [ 7 , 8 ]. Moreover, we revealed the characteristics of lower-limb kinematics during the 10 m walking test using the H-Gait system in subjects with LS [ 9 ].…”

Evaluation of Gait Characteristics in Subjects With Locomotive Syndrome Using the Wearable Gait Sensors

“…On the other hand, LS-stage 2 and LS-stage 1 groups had signi cantly lower peak hip abduction angles during the swing phase compared to the Non-LS group. However, these differences between groups were within the measurement error [12]. Therefore, there is no signi cant difference in the gait kinematics of the hip joint on the frontal plane, and the gait kinematics in the sagittal plane should be focused on in order to detect the difference between LS and Non-LS.…”

“…This system can analyze the motion characteristics of lower limbs without optical tracking by using seven wearable sensors consisting of three-axis outside the laboratory in a short time [10]. Although the previous study suggested the application to the knee osteoarthritis (OA) patients [11] and that to the hip OA patients [12], this system could apply to the subjects of LS in community-dwelling elderly.…”