Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 11 , Pages 1874-1879, November 2009

The Relationship of Self-Reported Pain and Functional Impairment to Gait Mechanics in Overweight and Obese Persons With Knee Osteoarthritis

  • Mary Beth Nebel, BSE

      Affiliations

    • Department of Biological Anthropology and Anatomy, Duke University, Durham, NC
    • Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC
    • ,
  • Ershela L. Sims, PhD

      Affiliations

    • Department of Biological Anthropology and Anatomy, Duke University, Durham, NC
    • Corresponding Author InformationCorrespondence to Ershela L. Sims, PhD, 203 Biological Science Building, Box 90383, Durham, NC 27708
    • ,
  • Francis J. Keefe, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
    • ,
  • Virginia B. Kraus, MD, PhD

      Affiliations

    • Department of Rheumatology and Immunology, Duke University, Durham, NC
    • ,
  • Farshid Guilak, PhD

      Affiliations

    • Department of Surgery, Duke University, Durham, NC
    • ,
  • David S. Caldwell, MD

      Affiliations

    • Department of Rheumatology and Immunology, Duke University, Durham, NC
    • ,
  • Jennifer J. Pells, PhD

      Affiliations

    • Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
    • ,
  • Robin Queen, PhD

      Affiliations

    • Department of Surgery, Duke University, Durham, NC
    • Michael W. Krzyzewski Human Performance Lab, Duke University, Durham, NC
    • ,
  • Daniel Schmitt, PhD

      Affiliations

    • Department of Biological Anthropology and Anatomy, Duke University, Durham, NC

Abstract 

Nebel MB, Sims EL, Keefe FJ, Kraus VB, Guilak F, Caldwell DS, Pells JJ, Queen R, Schmitt D. The relationship of self-reported pain and functional impairment to gait mechanics in overweight and obese persons with knee osteoarthritis.

Objective

To examine the degree to which 2 commonly used measures of pain and disability, the Arthritis Impact Measurement Scales (AIMS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), relate to objective gait measurements.

Design

A descriptive study of the influence of self-reported pain and perceived functional impairment on gait mechanics in osteoarthritic adults.

Setting

A university clinical research laboratory.

Participants

Overweight/obese adults with radiographic knee osteoarthritis (OA) as well as pain and disability associated with the disease (N=179).

Interventions

Not applicable.

Main Outcome Measures

The AIMS and WOMAC were administered to determine self-report measures of pain and disability. Speed, stride length, support time, knee angle, and peak vertical force (PVF) were determined from 3-dimensional kinematic and kinetic data collected on subjects walking at self-selected normal and fast speeds. Anthropometric data and radiographic levels of OA were also collected.

Results

Pearson correlation analysis showed that the AIMS physical disability score was inversely correlated with speed, stride length, and knee range of motion at both speeds and PVF at the fast speed. The WOMAC function score was inversely correlated with speed and stride length at both speeds and with PVF at fast speed. The WOMAC pain score was inversely correlated with speed and PVF at the fast speed. Regression analysis revealed that the AIMS physical disability score and body mass index accounted for the greatest variation in speed at the normal speed. Overall, AIMS physical disability and WOMAC function explained a larger proportion of variance in gait mechanics than radiographic measures of OA disease severity.

Conclusions

Taken together, the results suggest that the AIMS physical disability and WOMAC function scores are associated with some important measures of gait impairment.

Key Words: Gait, Joint diseases, Osteoarthritis, Pain, Rehabilitation

List of Abbreviations: AIMS, Arthritis Impact Measurement Scales, BMI, body mass index, K/L, Kellgren/Lawrence, KROM, knee range of motion, OA, osteoarthritis, PVF, peak vertical force, RDS, radiographic disease severity, SL, stride length, WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index

 

 Supported by the National Institutes of Health (grant no. AR50245).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(09)00670-4

doi:10.1016/j.apmr.2009.07.010

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 11 , Pages 1874-1879, November 2009

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