Knee OA Kinetics and Kinematics
|Principal Investigator: Charlie Hicks-Little|
|Keywords: knee osteoarthritis , gait analysis||Department: Exercise And Sport Science|
|IRB Number: 00045695||Co Investigator:|
|Specialty: Sports Medicine, Radiology, Physical Medicine and Rehabilitation|
|Sub Specialties: Musculoskeletal Imaging,|
Knee osteoarthritis (OA) is a painful and debilitating disease that contributes significantly to functional limitations and disability, negatively impacting physical function and quality of life of an estimated 20 million Americans. Normal activities of daily living (ADLs), such as climbing stairs, become a growing burden for those who suffer from knee OA. Surprisingly, few studies have examined stair climbing in osteoarthritic knees. Therefore, to better understand joint mechanics in people with knee OA we will examine the hip, knee and ankle joint kinematics and kinetics during stair ascent and descent in 30 subjects with knee OA and 30 age, height, mass and gender-matched healthy controls using a 3-D motion analysis system. Additionally radiographs and WOMAC osteoarthritis index will also be used to assess the extent of knee OA. A repeated measures MANOVA will be used to test for significant differences in lower extremity joint kinematics and kinetics between the subjects. We hypothesize that there will be decreased knee range of motion and external knee moments in knee OA subjects versus healthy subjects. Additionally, we hypothesize that knee OA subjects will experience increased hip and ankle range of motion and increased external hip and ankle moments compared to healthy subjects during stair climbing. Further we hypothesize that knee OA subjects will significantly compensate greatly for these differences with increased range of motion and external moments present in the contra-lateral joints. Understanding the knee joint mechanics in people with knee OA is essential for optimal management and rehabilitation to improve normal ADLs.
Specific Aims: 1.To compare the hip, knee and ankle joint kinematics and kinetics during stair ascent between knee OA subjects and age, sex, height, and body mass matched healthy controls. 2.To compare the hip, knee and ankle joint kinematics and kinetics during stair descent between knee OA subjects and age, sex, height, and body mass matched healthy controls. Research Hypotheses: 1.Increased angles and net moments in the sagittal and frontal planes will be present at foot strike, peak support and toe off in the hip and ankle joints in knee OA subjects compared to healthy matched controls during stair ascent and descent. 2.Time of peak angle during support and swing in the sagittal and frontal planes will be later in the gait cycle in knee OA subjects compared to healthy matched controls during stair ascent and descent.
Age greater than or equal to 40 years.
Unilateral or Bilateral Knee pain
Radiological evidence of knee OA (i.e. presence of osteophytes, joint space narrowing, subchondral sclerosis, or subchondral cysts).
Functional independence (not using any assistive devices).
Age, sex, height and body mass matched to OA subjects with No knee pain
Age greater than or equal to 80
Neurologic or neuromuscular disease effecting either knee
Post-traumatic, septic, inflammatory, or neuropathic arthritis
History of lower limb joint replacement or ORIF of hip, knee, or ankle fracture
Vestibular pathology (i.e. inner ear problems, vertigo, meniere's)
Diagnosis of Peripheral Neuropathy(Secondary to Diabetes Mellitus with loss toe proprioception)
Parkinson's Disease or History of CVA
Currently taking anti–convulsive medications
Diagnosis of symptomatic OA in hips or ankles
History of knee arthroscopy within 6 months of testing
Uncompensated cardiovascular disease or ongoing angina
Problems with ongoing dizziness due to medication or unknown cause
Presence of chronic, disabling back, hip, ankle or foot pain which impacts activities of daily living