Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA.
J Orthop Res. 2023 Dec;41(12):2629-2637. doi: 10.1002/jor.25624. Epub 2023 May 31.
Identifying potential contributing factors for physical inactivity in people with knee osteoarthritis is vital for designing practical activity promoting interventions. Walking is a common activity, but it is unknown how gait characteristics may influence physical activity and if psychological factors, specifically fear of movement (kinesiophobia), contribute to this relationship. The aim of our study was to investigate the contributions of select gait parameters and kinesiophobia to activity levels. Cross-sectional data from 40 participants (F 24|M 16; age 57.6 ± 8.9 years; BMI 34.7 ± 7.0 kg/m ) with uni- or bilateral knee osteoarthritis were included. Physical activity and kinesiophobia were assessed by self-report using the University of California, Los Angeles activity rating scale, and Tampa scale for kinesiophobia, respectively. Gait parameters were collected with three-dimensional gait analysis while participants walked on an instrumented split-belt treadmill at a self-selected speed. Higher peak sagittal plane joint moments at the ankle (ρ = 0.418, p = 0.007), and hip (ρ = 0.348, p = 0.028), faster self-selected gait speed (ρ = 0.553, p < 0.001), and less kinesiophobia or fear of movement (ρ = -0.695, p < 0.001) were independently related to higher physical activity level in adults with knee osteoarthritis. In hierarchical regression models, after accounting for covariates, only self-selected gait speed, and kinesiophobia significantly contributed to explaining the variation in physical activity level. Statement of clinical significance: Interventions aimed at improving physical activity participation in those with lower limb osteoarthritis should consider assessing the contribution of pain-related fear of movement.
确定膝骨关节炎患者体力活动不足的潜在影响因素对于设计实用的促进活动干预措施至关重要。步行是一种常见的活动，但尚不清楚步态特征如何影响体力活动，以及心理因素（特别是运动恐惧）是否对此关系有影响。我们的研究目的是调查选择的步态参数和运动恐惧对活动水平的贡献。共纳入 40 名参与者（F24|M16；年龄 57.6±8.9 岁；BMI34.7±7.0kg/m ）的横断面数据，这些参与者患有单侧或双侧膝骨关节炎。使用加利福尼亚大学洛杉矶活动评定量表和坦帕运动恐惧量表分别通过自我报告评估体力活动和运动恐惧。参与者以自我选择的速度在带仪器的分体式跑步机上行走时，通过三维步态分析收集步态参数。踝关节（ρ=0.418，p=0.007）和髋关节（ρ=0.348，p=0.028）矢状面关节峰值力矩较高、自我选择的步行速度较快（ρ=0.553，p<0.001）和运动恐惧或运动恐惧较低（ρ=-0.695，p<0.001）与膝骨关节炎成人的体力活动水平较高独立相关。在分层回归模型中，在考虑协变量后，只有自我选择的步行速度和运动恐惧对解释体力活动水平的变化有显著贡献。临床意义声明：旨在提高下肢骨关节炎患者参与体力活动的干预措施应考虑评估与疼痛相关的运动恐惧的影响。
