The effect of fear of movement on gait characteristics in patients with knee osteoarthritis.

BACKGROUND

Knee osteoarthritis (KOA) is a disease with a high prevalence in the elderly population, it has placed a significant burden on families and society.To investigate the relationship between fear of movement(FOM) and gait characteristics in KOA patients.

METHODS

Cross-sectional data from 30 elderly patients with KOA (age 40-65 years) were used. They were divided into a high-fear group (n = 15) and a low-fear group (n = 15) on the basis of the discriminative question (Q9) on the Tampa Scale for Kinesiophobia (TSK-17). Additionally, 15 healthy subjects were selected as the control group. All participants were instructed to cross an obstacle with a height of 20% of the leg length. Gait parameters including hip, knee, and ankle joint angles and moments of both lower extremities were assessed using a 3D motion capture system.

RESULTS

In within-group comparisons, difference between unaffected and affected sides in high-fear group were revealed for knee flexion angle(KFA, P = 0.04, ES = 0.70), peak ankle adduction /abduction moment(PAAM, P = 0.001, ES = 0.90)and peak knee adduction /abduction moment(PKAM, P = 0.006, ES = 0.97) during swing phase. Difference were revealed for peak hip internal /external rotation moment(PHIM, P = 0.005, ES = 0.87)and PKAM(P<0.001, ES = 0.91) during stance phase.In between-group comparisons, difference between high-fear and low-fear group were revealed for SI of HAA(P = 0.003)during swing phase. The control group were greater than high-fear group for SI of PAAM(P = 0.004)、PHIM(P = 0.002)during stance phase. Correlation analysis revealed that TSK-17 scores were strongly correlated with the SI of PKAM (r = 0.80, P < 0.01) and PHIM (r = 0.81, P < 0.01).

CONCLUSION

High-fear KOA patients might perform a protective movement strategy, which may lead to asymmetry in movement patterns by reducing weight bearing on the affected side. FOM can significantly affect patients' kinematic and kinetic parameters, especially PHIM and PKAM.Therefore, psychology-related interventions for treating KOA must be valued to improve patients' overall sports function and quality of life.

TRIAL REGISTRATION

The study was retrospectively registered on Chinese Trial Registry (PID: 246580).