Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study

Abstract

Title: Gait-and posture-related factors associated with changes in hip pain and physical function in patients with secondary hip osteoarthritis: a prospective cohort study ABSTRACT Objective: To identify gait-and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). Design: Prospective cohort study Setting: Clinical biomechanics laboratory of a university Participants: Consecutive sample of 30 female patients with mild-to-moderate secondary hip OA. Main Outcome Measures: Hip pain (visual analog scale) and physical function (physical component summary of the 36-Item Short Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait-and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angle of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were gait speed, steps/day, and three-dimensional hip joint angles, external hip joint moment impulses, and daily cumulative hip moments. Results: Multiple linear regression analyses showed that less hip extension (adjusted standardized B coefficient [95% CI]; −0.51 [−0.85 to −0.17]) and less external rotation angle (−0.52 [−0.88 to −0.17]) during gait were associated with worsening of hip pain. A larger thoracic kyphosis (−0.54 [−0.99 to −0.09]), less sacral anterior tilt (0.40 [0.01 to 0.79]), less thoracic spine mobility (0.59 [0.23 to 0.94]), less steps/day (0.53 [0.13 to 0.92]), and slower gait speed (0.45 [0.04 to 0.86]) were associated with deterioration of physical function. Conclusions: Gait-and posture-related factors should be considered when assessing risk and designing preventive interventions for clinical progression of secondary hip OA.

Gait kinematics of the hip, pelvis, and trunk associated with external hip adduction moment in patients with secondary hip osteoarthritis: toward determination of the key point in gait modification

“…Conversely, Zeni et al [29] have confirmed that there were no gait parameters, including hip moment, associated with hip pain. Moreover, previous prospective cohort studies have shown that the HAM impulse is associated with radiographical (i.e., structural) hip OA progression but not with worsening of hip pain [2,31]. The relationship between hip pain and gait biomechanics may be modified by various factors such as the condition of joint structures and difference in compensatory strategies for gait using parts other than the hip joint such as the trunk; therefore, hip pain might not be directly related to the HAM impulse.…”

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

“…The relationship between worse and more abnormal gait patterns during a walking test and pain after daily walking was partially explained in some previous studies that suggested that abnormal walking patterns exacerbated joint pain. 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 ].…”

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

“…While the strength of that study is that the kinematics of the entire limb was considered, the computation obscures the contribution of each of the joints to the gait deviation. Moreover, Tateuchi et al [ 46 ] showed that limited hip extension during gait is one of the factors that was related to a deterioration in physical function in patients with hip OA, suggesting that deviations from kinematics in healthy persons may not only reflect the functional status of patients but are also valuable for predicting outcome.…”