Gait strategies for individuals with knee osteoarthritis when transitioning between floor and stair walking

Yatai Chai; Jian Chen; Meijin Hou; Jiaqi Zheng; Lu Liu; Yongkang Chen; Shengxing Fu; Ye Ma; Tiansheng Hong; Xiangbin Wang

doi:10.3389/fphys.2023.1026299

Gait strategies for individuals with knee osteoarthritis when transitioning between floor and stair walking

Front Physiol. 2023 Jan 24:14:1026299. doi: 10.3389/fphys.2023.1026299. eCollection 2023.

Authors

Yatai Chai^{1

2}, Jian Chen³, Meijin Hou^{2

4}, Jiaqi Zheng^{2

5}, Lu Liu^{1

2}, Yongkang Chen^{2

5}, Shengxing Fu^{2

4}, Ye Ma^{2

4

6}, Tiansheng Hong⁷, Xiangbin Wang^{2

5

8}

Affiliations

¹ Fujian University of Traditional Chinese Medicine, Fuzhou, China.
² Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
³ Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China.
⁴ National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China.
⁵ College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
⁶ Faculty of Sports Sciences, Research Academy of Grand Health, Ningbo University, Ningbo, China.
⁷ Jinjiang city hospital, Quanzhou, China.
⁸ Rehabilitation Department of the Affiliated 3rd Peoples' Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

Abstract

Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs. Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D). Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion (p = 0.01) decreased, hip flexion (p = 0.02) and trunk lateral tilt (p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side (p = 0.003) and pelvic rotation (p = 0.03) increased, while hip abduction of the swing leg (p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis. Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.

Keywords: Kinematics; fall risk; knee osteoarthritis; motion analysis; stair transition.

Grants and funding

This study was supported by the National Natural Science Foundation of China (Grant Nos. 82074515 and 81774384) and Fujian University of Traditional Chinese Medicine (Grant No. XB2021150).