The Knee, ISSN: 1873-5800, Vol: 24, Issue: 3, Page: 536-546

The impact of symptomatic knee osteoarthritis on overall gait pattern deviations and its association with performance-based measures and patient-reported outcomes

Naili, Josefine E; Esbjörnsson, Anna-Clara; Iversen, Maura D; Schwartz, Michael H; Hedström, Margareta; Häger, Charlotte K; Broström, Eva W


Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance-based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs.


Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease-specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson’s correlation and multiple linear regression.


Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r = −0.42) and 5STS (r = −0.33), while on the OA limb with TUG (r = −0.68), 5STS (r = −0.38), SLMS (r = −0.38), activities of daily living (r = 0.35) and Knee-related Quality of Life (r = 0.35). No significant associations existed between kinematic GDI scores, PBMs and PROs.


The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.

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