Sit-to-stand alterations in advanced knee osteoarthritis

Abstract

This study investigated the full-body strategies utilized during a sit-to-stand (STS) task in patients with knee osteoarthritis (OA) and the association between STS alterations and clinical measurements. Twenty-five patients with advanced knee OA and twenty healthy elderly adults were recruited to participate in this study. Patients were asked to stand up from a chair four times without using their arms. A 3D motion analysis system was used to capture the full-body kinematics during the task. Two force plates were used to capture the forces under each leg. The following parameters were investigated in the knee OA group and compared with the control group: the time to realize STS, the force ratio between both limbs, the knee and hip kinetics and the trunk kinematics. The pain and functional capacity were obtained from the WOMAC. The results showed that patients with knee OA put 10% additional weight on the contralateral side when compared with the symmetrical strategy of the control group. Patients with knee OA showed a significantly lower knee flexion moment (0.51 Nm/kg vs. 0.72 Nm/kg), a higher maximal trunk flexion (46.4° vs. 37.5°), and a higher lateral trunk lean on the contralateral side (2.4° vs. 0.9°) when compared with the control group. The main correlations were found between pain and the averaged time to complete the STS task (r=0.55). With the quantification of the full-body mechanisms utilized during the STS task, which includes both distal and proximal compensations, our study brings new insights, leading to a better understanding of the functional alterations in patients with advanced knee OA.