Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading

Abstract Background: Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed.Methods: Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moments changes during gait were compared between types.Results: The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC.Conclusions: Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading

Arthritis Research & Therapy ◽

10.1186/s13075-021-02514-x ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Hiroshige Tateuchi ◽

Haruhiko Akiyama ◽

Koji Goto ◽

Kazutaka So ◽

Yutaka Kuroda ◽

...

Keyword(s):

Physical Function ◽

Gait Speed ◽

Stride Length ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Hip Pain ◽

Rate Of Increase ◽

Type C ◽

Space Width

Abstract Background Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. Methods Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. Results The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. Conclusions Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading

10.21203/rs.3.rs-50108/v3 ◽

2020 ◽

Author(s):

Hiroshige Tateuchi ◽

Haruhiko Akiyama ◽

Koji Goto ◽

Kazutaka So ◽

Yutaka Kuroda ◽

...

Keyword(s):

Physical Function ◽

Gait Speed ◽

Stride Length ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Hip Pain ◽

Rate Of Increase ◽

Type C ◽

Space Width

Abstract Background: Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed.Methods: Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moments changes during gait were compared between types.Results: The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC.Conclusions: Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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Location-specific hip joint space width for progression of hip osteoarthritis: predictive validity and responsiveness of a new computerized measure

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.02.492 ◽

2014 ◽

Vol 22 ◽

pp. S259-S260

Author(s):

C. Ratzlaff ◽

C.B. Van Wyngaarden ◽

J. Duryea

Keyword(s):

Predictive Validity ◽

Hip Joint ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Space Width

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Location-specific hip joint space width for progression of hip osteoarthritis – Data from the Osteoarthritis Initiative

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.05.017 ◽

2014 ◽

Vol 22 (10) ◽

pp. 1481-1487 ◽

Cited By ~ 5

Author(s):

C. Ratzlaff ◽

C. Van Wyngaarden ◽

J. Duryea

Keyword(s):

Hip Joint ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Osteoarthritis Initiative ◽

Space Width

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Osteophyte size and location on hip DXA scans are associated with hip pain: findings from a cross sectional study in UK Biobank

10.1101/2021.04.26.21255905 ◽

2021 ◽

Author(s):

Benjamin G Faber ◽

Raja Ebsim ◽

Fiona R Saunders ◽

Monika Frysz ◽

Claudia Lindner ◽

...

Keyword(s):

Femoral Head ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Cross Sectional Study ◽

Hip Pain ◽

Uk Biobank ◽

Cross Sectional ◽

Automated Method ◽

The Relationship

Objective It remains unclear how the different features of radiographic hip osteoarthritis (rHOA) contribute to hip pain. We examined the relationship between rHOA, including its individual components, and hip pain using a novel dual-energy x-ray absorptiometry (DXA)-based method. Methods Hip DXAs were obtained from UK Biobank. An automated method was developed to obtain minimum joint space width (mJSW) from points placed around the femoral head and acetabulum. Osteophyte areas at the lateral acetabulum, superior and inferior femoral head were derived manually. Semi-quantitative measures of osteophytes and joint space narrowing (JSN) were combined to provide a measure of rHOA. Logistic regression was used to examine the relationships between these variables and hip pain, obtained via questionnaires. Results 6,807 hip DXAs were examined. rHOA was present in 353 [5.2%] individuals and was associated with hip pain [OR 2.07 (95% CI 1.54-2.80)] and hospital diagnosed OA [5.73 (2.89-11.36)]. Total osteophyte area and mJSW were associated with hip pain [1.29 (1.21-1.36), 0.84 (0.77-0.92) respectively] in unadjusted models. After mutually adjusting and adding demographic covariates, total osteophyte area continued to have strong evidence of association with hip pain [1.31 (1.23-1.39)] but mJSW did not [0.95 (0.87-1.04)]. Acetabular, superior and inferior femoral osteophyte areas were all independently associated with hip pain [1.19 (1.13-1.26), 1.22 (1.15-1.29), 1.21 (1.14-1.28) respectively]. Conclusion The relationship between DXA-derived rHOA and prevalent hip pain is explained by osteophyte area rather than mJSW. Osteophytes at different locations showed important, potentially independent, associations with hip pain, possibly reflecting the contribution of distinct biomechanical pathways.

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