Hip, Knee, and Ankle Osteoarthritis Negatively Affects Mechanical Energy Exchange

Abstract

Background Individuals with osteoarthritis (OA) of the lower limb find normal locomotion tiring compared with individuals without OA, possibly because OA of any lower limb joint changes limb mechanics and may disrupt transfer of potential and kinetic energy of the center of mass during walking, resulting in increased locomotor costs. Although recovery has been explored in asymptomatic individuals and in some patient populations, the effect of changes in these gait parameters on center of mass movements and mechanical work in patients with OA in specific joints has not been well examined. The results can be used to inform clinical interventions and rehabilitation that focus on improving energy recovery. Questions/purposes We hypothesized that (1) individuals with end-stage lower extremity OA would exhibit a decrease in walking velocity compared with asymptomatic individuals and that the joint affected with OA would differntially influence walking velocity, (2) individuals with end-stage lower extremity OA would show decreased energy recovery compared with asymptomatic individuals and that individuals with end-stage hip and ankle OA would have greater reductions in recovery than would individuals with end-stage knee OA owing to restrictions in hip and ankle motion, and (3) that differences in the amplitude and congruity of the center of mass would explain the differences in energy recovery that are observed in each population. Methods Ground reaction forces at a range of self-selected walking speeds were collected from individuals with end-stage radiographic hip OA (n = 27; 14 males, 13 females; average age, 55.6 years; range, 41-70 years), knee OA (n = 20; seven males, 13 females; average age, 61.7 years; range, 49-74 years), ankle OA (n = 30; 14 males, 16 females; average age, 57 years; range, 45-70 years), and asymptomatic individuals (n = 13; eight males, five females; average age, 49.8 years; range, 41-67 years). Participants were all patients with end-stage OA who were scheduled to have joint replacement surgery within 4 weeks of testing. All patients were identified by the orthopaedic surgeon as having end-stage radiographic disease and to be a candidate for joint replacement surgery. Patients were excluded if they had pain at any other lower Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his or...

Step Length Asymmetry and Its Associations With Mechanical Energy Exchange, Function, and Fatigue After Total Hip Replacement

“…Comparisons to the literature suggest that reduced mechanical energy exchange was seen for the hip osteoarthritis patients compared to normal . THR participants in our study had a mechanical energy exchange that was similar to the hip osteoarthritis group reported by Queen et al ( R =54.0±10.0%), and significantly lower than the asymptomatic group in that study ( R =65.0±3.0%). Low mechanical energy exchange may increase the muscular effort to accelerate and decelerate the COM.…”

“…We cannot confirm whether or not the result in the THR patients would be different than that in healthy subjects. However, we note that the mechanical energy exchange was lower than that seen in the control sample of Queen's study . Finally, the cross‐sectional study design precludes inferring causation.…”

“…Mechanical energy exchange refers to the energy transfer between the potential and kinetic energy of the inverted pendulum movement of the COM during gait . For a healthy subject, the efficiency of the mechanical energy exchange is 70% at a self‐selected walking speed . Recently, Queen et al showed that the efficiency of mechanical energy exchange in people with hip OA is 54%, which was significantly lower than that in asymptomatic subjects.…”

“…For a healthy subject, the efficiency of the mechanical energy exchange is 70% at a self‐selected walking speed . Recently, Queen et al showed that the efficiency of mechanical energy exchange in people with hip OA is 54%, which was significantly lower than that in asymptomatic subjects. However, mechanical energy exchange in people with THRs has not been studied.…”

Adaptation of Ruffier’s Test for Assessment of Heart Workability of Students With Health Problems

“…As specialists note [27,30,31,35] knee pain when ascending staircase or walking on even inclined surfaces is an evident factor, limiting physical activity with OA of knee joint. It is proved also be the data of other scientists [64,69,70]. The authors found that it is tiresome for people with lower limbs' OA to fulfill ordinary movements, because joint changes can block transition of potential and kinetic energy of mass centers during walking.…”