| 제목 |
Effect of knee osteoarthritis on inter-joint coordination and gait variability by hip-knee cyclogram |
| 소속 |
Hanyang University Guri Hospital, Department of Rehabilitation Medicine1, Hanyang University, Department of Biomedical Engineering2, Hanyang University, Department of Arts & Technology3, Hanyang University Medical Center, Department of Rehabilitation Medicine4, Hanyang University College of Medicine, Department of Rehabilitation Medicine5 |
| 저자 |
Jae Hyeon Park1*, Hyo Jin Lee2, Jae-sung Cho3, Hoseok Lee1, Jae Young Lee 4, Jong Shill Lee2†, Seong-Ho Jang1,5† |
Introduction: Although differences of gait kinematics in patients with knee osteoarthritis (KOA) have been reported, inter-joint coordination and variability of gait has not been well investigated. Cyclograms are closed trajectories obtained by plotting the angle of multiple joints through entire gait cycle. Hip-knee cyclogram can visualize the relationship between the hip joint and knee joint simultaneously. Therefore, the aim of this study was to elucidate differences in inter-joint coordination and variability of gait with respect to severity of KOA.
Methods: Fifty participants with KOA and 20 healthy old participants (control group) without KOA were recruited. Participants with KOA were divided based on Kellgren-Lawrence (KL) grade into early KOA group (KL grade 1 & 2, n=20) and advanced KOA group (KL grade 3 & 4, n=30). All participants were examined using inertial measurement unit based gait analysis system while walking at self-selected walking speed. We analyzed inter-joint coordination of kinematics by the average value of hip-knee cyclogram parameters including range of motion (RoM), center of mass (CoM), perimeter (stance, swing and total) and area (stance, swing and total). Variability of gait was assessed by the coefficient of variance (CV) of hip-knee cyclogram parameters.
Results: Hip-knee cyclogram parameters that progressed with KOA severity included decreased knee ROM and total perimeter. Hip CoM increased only in early KOA group, whereas knee CoM decreased only in advanced KOA group. Patients with KOA (both early and advanced) had reduced hip-knee cyclogram parameters including perimeter of swing phase, area of swing phase, and total area compared to control group. While both KOA participants groups had greater variability of gait parameters including CV of CoM, knee RoM, perimeter (stance phase, swing phase and total) and area of swing phase than control group.
Conclusion: These results demonstrate that hip-knee cyclogram may provide insight into the inter-joint coordination and variability of gait in patients with KOA. |
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Figure 1. Representative hip-knee cyclogram. The shaded area represents the area of hip-knee cyclogram: stance phase area (grey shaded) and swing phase area (dotted shaded). Abbreviations: RoM, range of motion; CoM, center of mass.
Figure 2. Hip-knee cyclograms of three groups. Abbreviations: KOA, knee osteoarthritis; HS, heel strike; TO, toe off; CoM, center of mass; C, control; E, early OA; A, advanced OA.
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