Phase-dependent changes in local dynamic stability during walking in elderly with and without knee osteoarthritis

JOURNAL OF BIOMECHANICS

卷:49

Article

Mahmoudian, Armaghan¹  Bruijn, Sjoerd M.^2,3  Yakhdani, Hamid Reza F.⁴  Meijer, Onno G.^2,5  Verschueren, Sabine M. P.¹  van Dieen, Jaap H.² 

[1] Katholieke Univ Leuven, Dept Rehabil Sci, Leuven, Belgium

[2] Vrije Univ Amsterdam, Fac Human Movement Sci, MOVE Res Inst Amsterdam, van der Boechorststr 9, NL-1081 BT Amsterdam, Netherlands

[3] Fujian Med Univ, Affiliated Hosp 1, Dept Orthoped, Fuzhou, Fujian, Peoples R China

[4] Yazd Univ, Dept Phys Educ, Yazd, Iran

[5] Fujian Med Univ, Affiliated Hosp 2, Orthopaed Biomech Lab, Quanzhou, Fujian, Peoples R China

关键词: Knee osteoarthritis;    Gait;    Gait stability;    Local divergence exponents;   

DOI  :  10.1016/j.jbiomech.2015.11.018

来源: Elsevier

【 摘 要 】

Previously, we reported reduced time-averaged knee local stability, in the unaffected, but not the affected leg of elderly with knee osteoarthritis OA compared to controls. Since stability may show phase-related changes, we reanalyzed the dataset reported previously using time-dependent local stability, lambda(t), and also calculated time-averaged local stability, for comparison. We studied treadmill walking at increasing speeds, focusing on sagittal plane knee movements. 16 patients, 12 healthy peers and 15 young subjects were measured. We found a clear maximum in lambda(t) (i.e. minimum in stability) at around 60% of the stride cycle (StanceMax lambda(t)), a second clear maximum (SwingMax lambda(t)) at around 95% followed by a minimum between 70% and 100% (SwingMin lambda(t)). StanceMax lambda(t) of both legs was significantly higher in the OA than the young control group. Values for healthy elderly fell between those of the other groups, were significantly higher than in young adults, but there was only a trend towards a significant difference with the StanceMax At) of the OA, group's affected side. Time-averaged and time-dependent stability measures within one leg were uncorrelated, while time-dependent stability measures at the affected side were inversely correlated with 2 at the unaffected side. The results indicate that time-dependent local dynamic stability might provide a more detailed insight into the problems of gait stability in OA than conventional averaged local dynamic stability measures and support the notion that the paradoxical decline in unaffected side time-averaged local stability may be caused by a trade-off between affected and unaffected side stability. (C) 2015 Elsevier Ltd. All rights reserved.

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