Article

Knee osteoarthritis (OA) has been shown to be a risk factor for falls.
Reductions in foot clearance during the swing phase of walking can cause a trip
and potentially lead to a fall. This study examined the swing phase mechanics of
people with and without knee OA during walking. DESIGN: Minimum toe clearance
(MTC) height, joint angles at the time of MTC and the influence of the angular
changes of the hip, knee and ankle of the swing leg on foot clearance using
sensitivity analysis were investigated in 50 knee OA participants and 28
age-matched asymptomatic controls. RESULTS: Although both groups had a similar
MTC height (controls: 12.8+/-6.7 mm, knee OA: 13.4+/-7.0 mm), the knee OA group
used a different strategy to achieve the same foot clearance, as evidenced by
greater knee flexion (52.5+/-5.3 degrees vs 49.4+/-4.8 degrees , p=0.007),
greater hip abduction (-3.6+/-3.3 degrees vs -1.8+/-3.3 degrees , p=0.03) and
less ankle adduction (2.8+/-1.9 degrees vs 4.2+/-2.1 degrees , p=0.01).
CONCLUSION: MTC height was comparable between the groups, however a different
swing phase mechanism was used by the knee OA. Although adequate MTC is an
important component of safe locomotion, it does not appear to be impaired in
people with knee OA. Other factors, such as inadequate responses to postural
perturbation, may be responsible for falls in this group.
CI - Copyright (c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS