From: eleanor hoppe <>

Date: April 3, 2008 2:06:15 PM EDT

To: eleanor hoppe <>

Subject: ScienceDirect - Journal of Biomechanics : Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels

journal of biomechanics

Volume 41, Issue 4, 2008, Pages 868-876

Related Articles in ScienceDirect


Knee biomechanics of moderate OA patients measured duri...

Journal of Biomechanics


Gender differences exist in osteoarthritic gait

Clinical Biomechanics


Foot progression angle and the knee adduction moment: a...

Osteoarthritis and Cartilage


Toe-out gait in patients with knee osteoarthritis parti...

Journal of Biomechanics


Biomechanical features of gait waveform data associated...

Gait & Posture


View More Related Articles



View Record in Scopus

Cited By in Scopus (0)



Copyright © 2007 Elsevier Ltd All rights reserved.

Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels

Janie L. Astephena,  ,  , Kevin J. Deluziob, Graham E. Caldwellc, Michael J. Dunbard and Cheryl L. Hubley-Kozeya, e
aSchool of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada
bDepartment of Mechanical and Materials Engineering, Queen's University, Kingston, Ont., Canada
cDepartment of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
dDepartment of Orthopedic Surgery, Dalhousie University, Halifax, NS, Canada
eSchool of Physiotherapy, Dalhousie University, Halifax, NS, Canada
Accepted 29 October 2007.  Available online 20 February 2008.


Knee osteoarthritis (OA) is a multifactoral, progressive disease process of the musculoskeletal system. Mechanical factors have been implicated in the progression of knee OA, but the role of altered joint mechanics and neuromuscular control strategies in progressive mechanisms of the disease have not been fully explored. Previous biomechanical studies of knee OA have characterized changes in joint kinematics and kinetics with the disease, but it has been difficult to determine if these biomechanical changes are involved in the development of disease, are in response to degenerative changes in the joint, or are compensatory mechanisms in response to these degenerative changes or other related factors as joint pain. The goal of this study was to explore the association between biomechanical changes and knee OA severity in an effort to understand the changing role of biomechanical factors in the progression of knee OA. A three-group cross-sectional model was used that included asymptomatic subjects, subjects clinically diagnosed with moderate knee OA and severe knee OA subjects just prior to total joint replacement surgery. Principal component analysis and discriminant analysis were used to determine the combinations of electromyography, kinematic and kinetic waveform pattern changes at the knee, hip and ankle joints during gait that optimally separated the three levels of severity. Different biomechanical mechanisms were important in discriminating between severity levels. Changes in knee and hip kinetic patterns and rectus femoris activation were important in separating the asymptomatic and moderate OA gait patterns. In contrast, changes in knee kinematics, hip and ankle kinetics and medial gastrocnemius activity were important in discriminating between the moderate and severe OA gait patterns.

Keywords: Knee osteoarthritis; Severity; Gait analysis; Electromyography

 Corresponding author. Tel.: +1 902 880 5264; fax: +1 902 494 6621.

Journal of Biomechanics 

Volume 41, Issue 4, 2008, Pages 868-876





My Settings




About ScienceDirect  |  Contact Us  |  Terms & Conditions  |  Privacy Policy


Copyright © 2008 Elsevier B.V. All rights reserved. ScienceDirect® is a registered trademark of Elsevier B.V.