Gait Compensations, Pain, and Functional Performance During the Six Minute Walk Test in Individuals with Unilateral Hip Osteoarthritis

Overview

Journal Clin Biomech (Bristol)

Date 2024 Nov 3

PMID 39490051

Authors

Hope Davis-Wilson

Rashelle Hoffman

Victor Cheuy

Jesse Christensen

Jeri E Forster

Dana L Judd

Jennifer Stevens-Lapsley

Cory L Christiansen

Affiliations

Soon will be listed here.

Abstract

Background: Individuals with unilateral hip osteoarthritis walk with kinematic and spatiotemporal compensations compared to healthy individuals. Our purpose was to determine associations between gait, pain, and functional performance during the six-minute walk test.

Methods: Trunk and hip kinematics and spatiotemporal gait outcomes were recorded from individuals with unilateral hip osteoarthritis using inertial sensors (Xsens Technologies). Pain was collected prior to and at the end of the six-minute walk test. Paired t-tests were conducted to evaluate gait between limbs and between the first and final minutes of walking. Correlations were conducted between gait, pain, and six-minute walk test performance.

Findings: Nineteen participants (8 females, age: 63 ± 5 yrs.

, Bmi: 29.0 ± 4.5 kg/m) completed the study. Between-limb differences in hip flexion, hip extension, and trunk forward flexion peak angles were observed during the six-minute walk test (P < .05). Participants demonstrated an increase in trunk forward flexion of the osteoarthritis side (t = -2.34, P = .031) and a bilateral decrease in stride length (osteoarthritis limb: t = 2.98, P = .008, non- osteoarthritis limb: t = 3.17, P = .006) from the first to the final minute of walking. Greater pain was associated with greater osteoarthritis limb hip extension (first minute: r = -0.506, P = .027, final minute: r = -0.53, P = .020) and greater hip abduction (r = 0.46, P = .046) during the final minute of walking.

Interpretations: Gait compensations increase throughout the six-minute walk test, and pain associates with hip kinematics during the six-minute walk test. Wearable technology may allow for more accurate clinical movement assessments.

References

Unver B, Kahraman T, Kalkan S, Yuksel E, Karatosun V . Reliability of the six-minute walk test after total hip arthroplasty. Hip Int. 2013; 23(6):541-5. DOI: 10.5301/hipint.5000073. View

Judd D, Cheuy V, Forster J, Christiansen C, Stevens-Lapsley J . Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial. Phys Ther. 2019; 99(11):1453-1460. PMC: 8284176. DOI: 10.1093/ptj/pzz109. View

Murphy L, Helmick C, Schwartz T, Renner J, Tudor G, Koch G . One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010; 18(11):1372-9. PMC: 2998063. DOI: 10.1016/j.joca.2010.08.005. View

Debertin D, Wargel A, Mohr M . Reliability of Xsens IMU-Based Lower Extremity Joint Angles during In-Field Running. Sensors (Basel). 2024; 24(3). PMC: 10856827. DOI: 10.3390/s24030871. View

Queen R, Dickerson L, Ranganathan S, Schmitt D . A novel method for measuring asymmetry in kinematic and kinetic variables: The normalized symmetry index. J Biomech. 2019; 99:109531. PMC: 6960348. DOI: 10.1016/j.jbiomech.2019.109531. View

Ismailidis P, Kaufmann M, Clauss M, Pagenstert G, Eckardt A, Ilchmann T . Kinematic changes in severe hip osteoarthritis measured at matched gait speeds. J Orthop Res. 2020; 39(6):1253-1261. DOI: 10.1002/jor.24858. View

Zeni Jr J, Pozzi F, Abujaber S, Miller L . Relationship between physical impairments and movement patterns during gait in patients with end-stage hip osteoarthritis. J Orthop Res. 2014; 33(3):382-9. PMC: 4346450. DOI: 10.1002/jor.22772. View

Eitzen I, Fernandes L, Nordsletten L, Risberg M . Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study. BMC Musculoskelet Disord. 2012; 13:258. PMC: 3542161. DOI: 10.1186/1471-2474-13-258. View

Kumar D, Wyatt C, Chiba K, Lee S, Nardo L, Link T . Anatomic correlates of reduced hip extension during walking in individuals with mild-moderate radiographic hip osteoarthritis. J Orthop Res. 2015; 33(4):527-34. PMC: 4376613. DOI: 10.1002/jor.22781. View

10.

Zhang J, Novak A, Brouwer B, Li Q . Concurrent validation of Xsens MVN measurement of lower limb joint angular kinematics. Physiol Meas. 2013; 34(8):N63-9. DOI: 10.1088/0967-3334/34/8/N63. View

11.

Christiansen C, Bade M, Paxton R, Stevens-Lapsley J . Measuring movement symmetry using tibial-mounted accelerometers for people recovering from total knee arthroplasty. Clin Biomech (Bristol). 2015; 30(7):732-7. PMC: 4523451. DOI: 10.1016/j.clinbiomech.2015.04.013. View

12.

Farkas G, Schlink B, Fogg L, Foucher K, Wimmer M, Shakoor N . Gait asymmetries in unilateral symptomatic hip osteoarthritis and their association with radiographic severity and pain. Hip Int. 2018; 29(2):209-214. PMC: 7333443. DOI: 10.1177/1120700018773433. View

13.

Yelin E, Weinstein S, King T . The burden of musculoskeletal diseases in the United States. Semin Arthritis Rheum. 2016; 46(3):259-260. DOI: 10.1016/j.semarthrit.2016.07.013. View

14.

Sanchez-Adams J, Leddy H, McNulty A, OConor C, Guilak F . The mechanobiology of articular cartilage: bearing the burden of osteoarthritis. Curr Rheumatol Rep. 2014; 16(10):451. PMC: 4682660. DOI: 10.1007/s11926-014-0451-6. View

15.

Christensen J, Quammen D, Rigby J, Christiansen C, Stevens-Lapsley J . Trunk movement compensation identified by inertial measurement units is associated with deficits in physical performance, muscle strength and functional capacity in people with hip osteoarthritis. Clin Biomech (Bristol). 2021; 88:105436. PMC: 8691225. DOI: 10.1016/j.clinbiomech.2021.105436. View

16.

Watelain E, Dujardin F, Babier F, Dubois D, Allard P . Pelvic and lower limb compensatory actions of subjects in an early stage of hip osteoarthritis. Arch Phys Med Rehabil. 2001; 82(12):1705-11. DOI: 10.1053/apmr.2001.26812. View

17.

Nuesch C, Ismailidis P, Koch D, Pagenstert G, Ilchmann T, Eckardt A . Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis. Sensors (Basel). 2021; 21(16). PMC: 8398113. DOI: 10.3390/s21165363. View

18.

Ismailidis P, Nuesch C, Kaufmann M, Clauss M, Pagenstert G, Eckardt A . Measuring gait kinematics in patients with severe hip osteoarthritis using wearable sensors. Gait Posture. 2020; 81:49-55. DOI: 10.1016/j.gaitpost.2020.07.004. View

19.

Wada O, Asai T, Hiyama Y, Nitta S, Mizuno K . Gait Variability in Women With Hip Osteoarthritis Before and After Total Hip Replacement: A Prospective Cohort Study. Am J Phys Med Rehabil. 2019; 98(10):866-871. DOI: 10.1097/PHM.0000000000001206. View

20.

Culliford D, Maskell J, Kiran A, Judge A, Javaid M, Cooper C . The lifetime risk of total hip and knee arthroplasty: results from the UK general practice research database. Osteoarthritis Cartilage. 2012; 20(6):519-24. DOI: 10.1016/j.joca.2012.02.636. View