Association of Dynamic Joint Power With Functional Limitations in Older Adults With Symptomatic Knee Osteoarthritis

Neil A Segal; H. John Yack; Morgan Brubaker; James C Torner; Robert Wallace

doi:10.1016/j.apmr.2009.07.009

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Association of Dynamic Joint Power With Functional Limitations in Older Adults With Symptomatic Knee Osteoarthritis

Journal article

Peer reviewed

Association of Dynamic Joint Power With Functional Limitations in Older Adults With Symptomatic Knee Osteoarthritis

Neil A Segal, H. John Yack, Morgan Brubaker, James C Torner and Robert Wallace

Archives of physical medicine and rehabilitation, Vol.90(11), pp.1821-1828

2009

DOI: 10.1016/j.apmr.2009.07.009

PMCID: PMC2919341

PMID: 19887204

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Abstract

Segal NA, Yack HJ, Brubaker M, Torner JC, Wallace R. Association of dynamic joint power with functional limitations in older adults with symptomatic knee osteoarthritis. To determine which lower-limb joint moments and powers characterize the level of gait performance of older adults with symptomatic knee osteoarthritis (OA). Cross-sectional observational study. University motion analysis laboratory. Community-dwelling adults (N=60; 27 men, 33 women; age 50–79y) with symptomatic knee OA. Not applicable. Physical function was measured using the long-distance corridor walk, the Short Physical Performance Battery, and the Late Life Function and Disability Instrument (LLFDI Function). Joint moments and power were estimated using an inverse dynamics solution after 3-dimensional computerized motion analysis. Subjects aged 64.2±7.4 years were recruited. Ranges (mean ± SD) for the 400-m walk time and the LLFDI Advanced Lower-Limb Function score were 215.3 to 536.8 (304.1±62.3) seconds and 31.5 to 100 (57.0±14.9) points, respectively. In women, hip abductor moment (loading response), hip abductor power (midstance), eccentric hamstring moment (terminal stance), and power (terminal swing) accounted for 41%, 31%, 14%, and 48% of the variance in the 400-m walk time, respectively (model R 2=.61, P<.003). In men, plantar flexor and hip flexor power (preswing) accounted for 19% and 24% of the variance in the 400-m walk time, respectively (model R 2=.32, P=.025). There is evidence that men and women with higher mobility function tend to rely more on an ankle strategy rather than a hip strategy for gait. In higher functioning men, higher knee extensor and flexor strength may contribute to an ankle strategy, whereas hip abductor weakness may bias women with lower mobility function to minimize loading across the knee via use of a hip strategy. These parameters may serve as foci for rehabilitation interventions aimed at reducing mobility limitations.

Aging

Osteoarthritis

Knee

Rehabilitation

Details

Title: Subtitle: Association of Dynamic Joint Power With Functional Limitations in Older Adults With Symptomatic Knee Osteoarthritis
Creators: Neil A Segal - Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, IA
H. John Yack - Graduate Program in Physical Therapy and Rehabilitation Sciences, The University of Iowa, Iowa City, IA
Morgan Brubaker - Department of Orthopaedics and Rehabilitation, The University of Iowa, Iowa City, IA
James C Torner - Department of Epidemiology, The University of Iowa, Iowa City, IA
Robert Wallace - Department of Epidemiology, The University of Iowa, Iowa City, IA
Resource Type: Journal article
Publication Details: Archives of physical medicine and rehabilitation, Vol.90(11), pp.1821-1828
DOI: 10.1016/j.apmr.2009.07.009
PMID: 19887204
PMCID: PMC2919341
NLM abbreviation: Arch Phys Med Rehabil
ISSN: 0003-9993
eISSN: 1532-821X
Publisher: Elsevier Inc
Language: English
Date published: 2009
Academic Unit: Epidemiology; Surgery; Physical Therapy and Rehabilitation Science; Injury Prevention Research Center; Neurosurgery; Internal Medicine
Record Identifier: 9983995122102771

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