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

References 

  1. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33:2271–2279
  2. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham study. Am J Public Health. 1994;84:351–358
  3. Martin DF. Pathomechanics of knee osteoarthritis. Med Sci Sports Exerc. 1994;26:1429–1434
  4. Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum. 2003;48:3359–3370
  5. Messier SP. Osteoarthritis of the knee and associated factors of age and obesity: effects on gait. Med Sci Sports Exerc. 1994;26:1446–1452
  6. Baliunas AJ, Hurwitz DE, Ryals AB, et al. Increased knee joint loads during walking are present in subjects with knee osteoarthritis. Osteoarthritis Cartilage. 2002;10:573–579
  7. Brinkmann JR, Perry J. Rate and range of knee motion during ambulation in healthy and arthritic subjects. Phys Ther. 1985;65:1055–1060
  8. Stauffer RN, Chao EY, Gyory AN. Biomechanical gait analysis of the diseased knee joint. Clin Orthop Relat Res. 1977;(126):246–255
  9. Al-Zahrani KS, Bakheit AM. A study of the gait characteristics of patients with chronic osteoarthritis of the knee. Disabil Rehabil. 2002;24:275–280
  10. Messier SP, Loeser RF, Hoover JL, Semble EL, Wise CM. Osteoarthritis of the knee: effects on gait, strength, and flexibility. Arch Phys Med Rehabil. 1992;73:29–36
  11. Summers MN, Haley WE, Reveille JD, Alarcon GS. Radiographic assessment and psychologic variables as predictors of pain and functional impairment in osteoarthritis of the knee or hip. Arthritis Rheum. 1988;31:204–209
  12. Ettinger WH, Davis MA, Neuhaus JM, Mallon KP. Long-term physical functioning in persons with knee osteoarthritis from NHANES (I: Effects of comorbid medical conditions). J Clin Epidemiol. 1994;47:809–815
  13. Focht BC, Rejeski WJ, Ambrosius WT, Katula JA, Messier SP. Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;53:659–665
  14. Wadden TA, Foster GD. Behavioral treatment of obesity. Med Clin North Am. 2000;84:441–461
  15. Pollard B, Johnston M, Dixon D. Theoretical framework and methodological development of common subjective health outcome measures in osteoarthritis: a critical review. Health Qual Life Outcomes. 2007;5:14
  16. Hurwitz DE, Ryals AB, Case JP, Block JA, Andriacchi TP. The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain. J Orthop Res. 2002;20:101–107
  17. Mundermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum. 2005;52:2835–2844
  18. Maly MR, Costigan PA, Olney SJ. Contribution of psychosocial and mechanical variables to physical performance measures in knee osteoarthritis. Phys Ther. 2005;85:1318–1328
  19. Rejeski WJ, Craven T, Ettinger WH, McFarlane M, Shumaker S. Self-efficacy and pain in disability with osteoarthritis of the knee. J Gerontol B Psychol Sci Soc Sci. 1996;51:P24–P29
  20. Rejeski WJ, Miller ME, Foy C, Messier S, Rapp S. Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain. J Gerontol B Psychol Sci Soc Sci. 2001;56:S261–S265
  21. Stratford PW, Kennedy DM. Performance measures were necessary to obtain a complete picture of osteoarthritic patients. J Clin Epidemiol. 2006;59:160–167
  22. Cooper C, Snow S, McAlindon TE, et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43:995–1000
  23. Hannan M, Felson D, Pincus T. Analysis of the discordance between radiographic changes in knee pain in osteoarthritis of the knee. J Rheumatol. 2000;27:1513–1517
  24. Peterfy C, Li J, Siam S, Duryea J, Lynch J, Miaux Y. Comparison of fixed-flexion positioning with fluoroscopic semi-flexed positioning for quantifying radiographic joint-space width in the knee: test-retest reproducibility. Skeletal Radiol. 2003;32:128–132
  25. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16:494–502
  26. Meenan RF, Gertman PM, Mason JH, Dunaif R. The arthritis impact measurement scales (Further investigations of a health status measure). Arthritis Rheum. 1982;25:1048–1053
  27. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840
  28. Brinkmann JJ, Perry JJ. Rate and range of knee motion during ambulation in healthy and arthritic subjects. Phys Ther. 1985;65:1055–1060
  29. Messier SP, DeVita P, Cowan RE, Seay J, Young HC, Marsh AP. Do older adults with knee osteoarthritis place greater loads on the knee during gait? (A preliminary study). Arch Phys Med Rehabil. 2005;86:703–709
  30. Li Y, Crompton RH, Alexander RM, Günther MM, Wang W. Characteristics of ground reaction forces in normal and chimpanzee-like bipedal walking by humans. Folia Primatol (Basel). 1996;66:137–159
  31. Schmitt D. Insights into the evolution of human bipedalism from experimental studies of humans and other primates. J Exp Biol. 2003;206:1437–1448
  32. Yaguramaki N, Nishizawa J, Adachi K, Endo B. The relationship between posture and external force in walking. Anthropol Sci. 1995;103:117–140
  33. Somers TJ, Keefe FJ, Pells JJ, et al. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage. 2009;37:863–872
  34. Field A. Discovering statistics using SPSS. 2nd ed.. London: Sage Publications; 2005;
  35. Weidenhielm L. Kinetic and kinematic characteristics of gait in patients with medial knee arthrosis. Acta Orthop Scand. 2003;74:369
  36. Sims E, Nebel M, Keefe K. Severity of knee osteoarthritis and its effect on gait mechanics in walking. Proceedings of the American Society of Biomechanics Annual Meeting. 2006;Blacksburg, VA
  37. Thorp LE, Sumner DR, Block JA, Moisio KC, Shott S, Wimmer MA. Knee joint loading differs in individuals with mild compared with moderate medial knee osteoarthritis. Arthritis Rheum. 2006;54:3842–3849
  38. DeVita P, Hortobagyi T. Obesity is not associated with increased knee joint torque and power during level walking. J Biomech. 2003;36:1355–1362
  39. Mattsson E, Evers Larsson U, Rossner S. Is walking too exhausting for obese women?. Int J Obes Relat Metab Disord. 1997;21:380–386
  40. Robon MJ, Perell KL, Fang M, Guererro E. The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain. Clin Biomech (Bristol, Avon). 2000;15:522–527
  41. Landry SC, McKean KA, Hubley-Kozey CL, Stanish WD, Deluzio KJ. Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. J Biomech. 2007;40:1754–1761
  42. Munderman A, Dyrby C, Hurwitz DE, Sharma L, Andriacchi T. Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed [published erratum appears in Arthritis Rheum 2004;50:4073]. Arthritis Rheum. 2004;50:1172–1178

 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

Article Tools