Physical Therapy Publications
Document Type
Article
Publication Date
Fall 10-1-2023
Journal
Gait and Posture
Volume
107
URL with Digital Object Identifier
https://doi.org/10.1016/j.gaitpost.2023.09.009
Abstract
Background
Patellofemoral osteoarthritis (OA) is an important subgroup of knee OA. However, the influence of sex on gait characteristics in patients with patellofemoral OA is unknown.
Research question
Compare gait characteristics in females and males with patellofemoral OA and investigate their associations with patellofemoral joint-related symptoms and limitations.
Methods
Mixed effects polynomial regression models compared knee flexion-extension and adduction moments, knee flexion angles, and vertical ground reaction forces over 100% of stance between 26 females and 22 males with patellofemoral OA, with and without adjustment for walking speed and body mass. Multivariable linear regression models were then used to investigate the associations of gait characteristics with symptoms and limitations measured with the Knee injury and Osteoarthritis Outcome Score Patellofemoral Pain and Osteoarthritis (KOOS-PF) Subscale. Models included a sex-by-gait interaction term, and if significant, separate models were built for females and males.
Results
While controlling for walking speed and body mass, females had lower knee flexion moment (6–19% and 97–100% of stance), knee extension moment (45–86% of stance), knee adduction moment (3–37% and 69–99% of stance), vertical ground reaction force (1–97% of stance) and knee flexion angle (90–100% of stance) compared with males, when fitted over 100% of stance. Lower cadence, lower knee flexion angular impulse, and higher peak knee flexion angle were associated with worse KOOS-PF scores. Associations were not modified by sex.
Significance
There are distinct sex-based differences in gait characteristics throughout stance with patellofemoral OA when adjusting for body mass and walking speed. Lower cadence and knee flexion angular impulse, and higher peak knee flexion angle were associated with more extreme patellofemoral joint-related symptoms and limitations.
Citation of this paper:
Hart, H., Birmingham, T., Sritharan, P., Primeau, C., King, M., Fischer, L. (2023). Sex-related differences in gait characteristics and their associations with symptoms in individuals with patellofemoral osteoarthritis. Gait & Posture, 107, 35-41. https://doi.org/10.1016/j.gaitpost.2023.09.009
