Reliability of principal components and discrete parameters of knee angle and moment gait waveforms in individuals with moderate knee osteoarthritis.

Gait measures are used to evaluate change in patients with knee osteoarthritis (OA), but reliability has not been fully established in this population. This study examined test-retest reliability of knee angle and moment gait waveform characteristics captured using discrete parameters and principal component analysis (PCA) in individuals with moderate knee OA. Participants (n=20) underwent three-dimensional gait analysis on two occasions. Motion and force data were captured using two camera banks, infrared light emitting diodes and force plate during self-selected walking. Knee angle and moment waveforms were calculated and analyzed using discrete parameters and by identifying waveform characteristics using PCA. Intraclass correlation coefficients (ICC2,k) examined test-retest reliability of discrete parameters and PCA derived scores (PC-scores). ICC2,k values ranged from 0.57 to 0.93 for discrete parameters, 0.52-0.86 for knee angle PC-scores and 0.30-0.94 for the knee moment PC-scores. However, 10 of 13 discrete parameters, six of nine knee angle PC-scores and seven of nine knee moment PC-scores had ICC2,k values greater than or equal to 0.70. Discrete parameters and PC-scores from flexion angles and adduction moments had the highest ICC2,k values while adduction angles, rotation angles, and rotation moments had the lowest. Most knee angle and moment waveform characteristics demonstrated ICC2,k values that could be interpreted as acceptable. Caution should be used when examining adduction and rotation angle magnitudes and early/mid-stance rotation moment magnitudes due to lower ICC2,k values.

[1]  C. Hubley‐Kozey,et al.  The effect of total knee arthroplasty on knee joint kinematics and kinetics during gait. , 2011, The Journal of arthroplasty.

[2]  Jack P Callaghan,et al.  Developing an estimate of daily cumulative loading for the knee: examining test-retest reliability. , 2009, Gait & posture.

[3]  J. L. Astephen,et al.  Biomechanical features of gait waveform data associated with knee osteoarthritis: an application of principal component analysis. , 2007, Gait & posture.

[4]  C. Charalambous Repeatability of Kinematic, Kinetic, and Electromyographic Data in Normal Adult Gait , 2014 .

[5]  M P Kadaba,et al.  Measurement of lower extremity kinematics during level walking , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  Thomas R Jenkyn,et al.  Test-retest reliability of the peak knee adduction moment during walking in patients with medial compartment knee osteoarthritis. , 2007, Arthritis and rheumatism.

[7]  C. Goldsmith,et al.  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. , 1988, The Journal of rheumatology.

[8]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[9]  J. L. Astephen,et al.  Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels. , 2008, Journal of biomechanics.

[10]  Kevin J Deluzio,et al.  Principal component analysis of lifting waveforms. , 2006, Clinical biomechanics.

[11]  R. Moskowitz,et al.  Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. , 1986, Arthritis and rheumatism.

[12]  H. Inoue,et al.  Epidemiology of Osteoarthritis of the Knee , 1995 .

[13]  T. Miyazaki,et al.  Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis , 2002, Annals of the rheumatic diseases.

[14]  K J Deluzio,et al.  Neuromuscular alterations during walking in persons with moderate knee osteoarthritis. , 2006, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[15]  T. Jenkyn,et al.  Time-varying behaviour, test-retest reliability and concurrent validity of lateral trunk lean and toe-out angles during prolonged treadmill walking. , 2011, Gait & posture.

[16]  M. Hunt,et al.  Lateral trunk lean explains variation in dynamic knee joint load in patients with medial compartment knee osteoarthritis. , 2008, Osteoarthritis and cartilage.

[17]  A Leardini,et al.  Position and orientation in space of bones during movement: experimental artefacts. , 1996, Clinical biomechanics.

[18]  Bing Yu,et al.  Effect of External Marker Sets on Between-Day Reproducibility of Knee Kinematics and Kinetics in Stair Climbing and Level Walking , 2003, Research in sports medicine.

[19]  C. Goldsmith,et al.  Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength data. , 1997, Physical therapy.

[20]  T. Andriacchi,et al.  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 , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[21]  K. Deluzio,et al.  Knee biomechanics of moderate OA patients measured during gait at a self-selected and fast walking speed. , 2007, Journal of biomechanics.

[22]  J. L. Astephen,et al.  Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[23]  L. Portney,et al.  Foundations of Clinical Research: Applications to Practice , 2015 .

[24]  E S Grood,et al.  A joint coordinate system for the clinical description of three-dimensional motions: application to the knee. , 1983, Journal of biomechanical engineering.

[25]  D. Lloyd,et al.  Pre‐surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[26]  Laure Gossec,et al.  Gait analysis as a quantifiable outcome measure in hip or knee osteoarthritis: a systematic review. , 2010, Joint, bone, spine : revue du rhumatisme.

[27]  Brian Caulfield,et al.  Increasing the number of gait trial recordings maximises intra-rater reliability of the CODA motion analysis system. , 2007, Gait & posture.

[28]  David G Lloyd,et al.  Repeatability of gait data using a functional hip joint centre and a mean helical knee axis. , 2003, Journal of biomechanics.

[29]  J. Fleiss,et al.  Intraclass correlations: uses in assessing rater reliability. , 1979, Psychological bulletin.