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/v1 ◽

2020 ◽

Author(s):

Hiroshige Tateuchi ◽

Haruhiko Akiyama ◽

Koji Goto ◽

Kazutaka So ◽

Yutaka Kuroda ◽

...

Keyword(s):

Physical Function ◽

Hip Joint ◽

Gait Speed ◽

Stride Length ◽

Three Dimensional ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Hip Pain ◽

Type C

Abstract Background Change in gait speed is required in various situations in daily life, and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on the hip joint and on physical function. Our primary purpose was to determine the effects of strategies for increasing gait speed on hip pain and physical function in patients with hip osteoarthritis (OA). The secondary purpose was to examine the effects of strategies for increasing gait speed on the changes in hip loading during gait. 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 joint moment were measured during gait at self-selected normal and fast gait speeds, using a three-dimensional motion analysis system. The patients were classified as types S (increasing mainly stride length), C (increasing mainly cadence), and SC (increasing stride length and cadence) according to whether they used changes in stride length and/or cadence to transition from a normal to a fast gait. Hip pain, physical function, and change in hip moments during gait were compared between the types. Results The distribution of the patients was as follows: types S, 23.4%; C, 48.9%; and SC, 27.7%. Physical function status was higher in types C (P = 0.018) and SC (P = 0.015) than in type S, even after adjustment for age and minimum joint space width. Hip pain was not significantly different between the types. The robustness of those results was confirmed by a sensitivity analysis. The rates of the 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 joint moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging use of a cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.

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Measurement of joint space width in hip osteoarthritis: influence of joint positioning and radiographic procedure

Rheumatology ◽

10.1093/rheumatology/40.4.414 ◽

2001 ◽

Vol 40 (4) ◽

pp. 414-419 ◽

Cited By ~ 38

Author(s):

G.-R. Auleley

Keyword(s):

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Space Width

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Impact of repeated measures of joint space width on the sample size calculation: An application to hip osteoarthritis

Joint Bone Spine ◽

10.1016/j.jbspin.2014.10.006 ◽

2015 ◽

Vol 82 (3) ◽

pp. 172-176 ◽

Cited By ~ 3

Author(s):

Paul Ornetti ◽

Laure Gossec ◽

Davy Laroche ◽

Christophe Combescure ◽

Maxime Dougados ◽

...

Keyword(s):

Sample Size ◽

Repeated Measures ◽

Sample Size Calculation ◽

Joint Space Width ◽

Hip Osteoarthritis ◽

Joint Space ◽

Space Width

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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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Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽

10.1093/rheumatology/keaa141 ◽

2020 ◽

Vol 59 (11) ◽

pp. 3390-3399

Author(s):

Alan M Rathbun ◽

Michelle D Shardell ◽

Alice S Ryan ◽

Michelle S Yau ◽

Joseph J Gallo ◽

...

Keyword(s):

Disease Progression ◽

Disease Severity ◽

Gait Speed ◽

Joint Space Width ◽

Joint Space ◽

Knee Oa ◽

Increased Risk ◽

Pain Subscale ◽

Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale <16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

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