Advertisement

Aging Clinical and Experimental Research

, Volume 21, Issue 6, pp 463–469 | Cite as

Racial differences in gait mechanics associated with knee osteoarthritis

  • Ershela L. SimsEmail author
  • Francis J. Keefe
  • Virginia B. Kraus
  • Farshid Guilak
  • Robin M. Queen
  • Daniel Schmitt
Original Articles

Abstract

Background and aims: This study examines racial differences in gait mechanics in persons with knee osteoarthritis and the influence of anthropometrics, educational level, radiographic disease severity (rOA), and self-report measures of pain and disability on racial differences in gait. Methods: One hundred seventy five (64 black and 111 white) adults with radiographie knee OA were tested. 3-D kinematic and kinetic data were collected while subjects walked at two self-selected speeds (normal and fast). Anthropometrie data, radiographie level of OA, and self-report measures of pain and disability were also collected. Gait patterns were compared across groups and within groups. Results: Black and white subjects did not differ significantly in radiographie OA. However, blacks walked significantly more slowly when asked to walk fast. At the normal speed, blacks had a smaller knee range of motion and loading rate than whites. Blacks also took longer to reach their peak maximum ground reaction force than whites. Within black subjects variations in gait mechanics were primarily explained by BMI, rOA, self-reported psychological disability, and pain self-efficacy. In white subjects, variations in gait mechanics were primarily explained by weight, age, velocity, psychological disability, and self-efficacy. Conclusions: Blacks in this study had a pattern of gait mechanics generally associated with high levels of osteoarthritis, though they did not differ significantly in rOA from whites. The variability in gait patterns exhibited by blacks was most strongly related to variance in walking speed, anthropometries, and perceived physical ability. Taken together, these results suggest that race is an important factor that must be considered in the treatment and study of osteoarthritis.

Keywords

gait osteoarthritis racial differences 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 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: 2271–9.PubMedGoogle Scholar
  2. 2.
    Felson DT, Zhang Y, Hannan MT et al. Risk factors for incident radiographic knee osteoarthritis in the elderly. The Framingham Study. Arthritis Rheum 1997; 40: 728–33.CrossRefGoogle Scholar
  3. 3.
    Messier SP. Osteoarthritis of the knee and associated factors of age and obesity: effects on gait. Med Sci Sports Exerc 1994; 26: 1446–52.PubMedGoogle Scholar
  4. 4.
    McKean, KA, Landry SC, Hubley-Kozey CL, Dunbar MJ, Stanish WD, Deluzio KJ. Gender differences exist in osteoarthritic gait. Clin Biomech (Bristol, Avon) 2007; 22: 400–9.CrossRefGoogle Scholar
  5. 5.
    Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004; 50: 3145–52.PubMedCrossRefGoogle Scholar
  6. 6.
    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: 659–65.PubMedCrossRefGoogle Scholar
  7. 7.
    Summers MN, Haley WE, Reveille JD, Alarcón GS. Radiographic assessment and psychologic variables as predictors of pain and functional impairment in osteoarthritis of the knee or hip. Arthritis Rheum 1988; 31: 204–9.PubMedCrossRefGoogle Scholar
  8. 8.
    Abbate LM, Stevens J, Schwartz TA, Renner JB, Heimick CG, Jordan JM. Anthropometric measures, body composition, body fat distribution, and knee osteoarthritis in women. Obesity 2006; 14: 1274–81.PubMedCrossRefGoogle Scholar
  9. 9.
    Gaines JM, Talbot LA, Metter EJ. The relationship of arthritis self-efficacy to functional performance in older men and women with osteoarthritis of the knee. Geriatr Nurs 2002; 23: 167–70.PubMedCrossRefGoogle Scholar
  10. 10.
    Felson DT, Lawrence RC, Dieppe PA et al. Osteoarthritis: new insights. Part 1: The disease and its risk factors. Ann Intern Med 2000; 133: 635–46.CrossRefGoogle Scholar
  11. 11.
    Maly MR, Costigan PA, Olney SJ. Contribution of psychosocial and mechanical variables to physical performance measures in knee osteoarthritis. Phys Ther 2005; 85: 1318–28.PubMedGoogle Scholar
  12. 12.
    Martin DF. Pathomechanics of knee osteoarthritis. Med Sci Sports Exerc 1994; 26: 1429–34.PubMedGoogle Scholar
  13. 13.
    Rejeski WJ, Craven T, Ettinger WH Jr, McFarlane M, Shumaker S. Self-efficacy and pain in disability with osteoarthritis of the knee. J Gerontol B Psychol Sci Soc Sci 1996; 51: P24–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D. Physical functioning over three years in knee osteoarthritis. Arthritis Rheum 2003; 48: 3359–70.PubMedCrossRefGoogle Scholar
  15. 15.
    Baker TA, Green CR. Intrarace differences among black and white americans presenting for chronic pain management: The influence of age, physical health, and psychosocial factors. Pain Med 2005; 6: 29–38.PubMedCrossRefGoogle Scholar
  16. 16.
    Jordan JM, Heimick CG, Renner JB et al. Prevalence of knee symptoms and radiographie and symptomatic knee osteoarthritis in African Americans and Caucasians: The Johnston County Osteoarthritis Project. J Rheumatol 2007; 34: 172–80.PubMedGoogle Scholar
  17. 17.
    Jordan JM, Luta G, Renner JB et al. Self-reported functional status in osteoarthritis of the knee in a rural southern community: the role of sociodemographic factors, obesity, and knee pain. Arthritis Care Res 1996; 9: 273–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Sowers M, Lachance L, Hochberg M, Jamadar D. Radiographically defined osteoarthritis of the hand and knee in young and middle-aged African American and Caucasian women. Osteoarthritis Cartilage 2000; 8: 69–77.PubMedCrossRefGoogle Scholar
  19. 19.
    Golightly YM, Dominick KL. Racial variations in self-reported osteoarthritis symptom severity among veterans. Aging Clin Exp Res 2005; 17: 264–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Sowers MF, Jannausch ML, Gross M et al. Performance-based physical functioning in African-American and Caucasian women at midlife: considering body composition, quadriceps strength, and knee osteoarthritis. Am J Epidemiol 2006; 163: 950–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Altaian R, Asch E, Bloch D 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. Arthritis Rheum 1986; 29: 1039–49.Google Scholar
  22. 22.
    Peterfy C, Li J, Zaim S et al. Comparison of fixed-flexion positioning with fluoroscopic semi-flexed positioning for quantifying radiographie joint-space width in the knee: test-retest reproducibility. Skeletal Radiol 2003; 32: 128–32.PubMedCrossRefGoogle Scholar
  23. 23.
    Kellgren JH, Lawrence JC. Radiological assessment of osteoarthritis. Ann Rheum Dis 1957; 16: 494–501.PubMedCrossRefGoogle Scholar
  24. 24.
    Meenan RF, Gertman P, Mason J. Measuring health status in arthritis. The arthritis impact measurement scales. Arthritis Rheum 1980; 23: 142–52.Google Scholar
  25. 25.
    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: 1833–40.PubMedGoogle Scholar
  26. 26.
    Lorig K, Chastain RL, Ung E, Shoor S, Holman HR. Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 1989; 32: 37–44.PubMedCrossRefGoogle Scholar
  27. 27.
    Sowers MR, Crutchfield M, Richards K, et al. Sarcopenia is related to physical functioning and leg strength in middle-aged women. J Gerontol Biol Sci Med Sci 2005; 60: 486–90.CrossRefGoogle Scholar
  28. 28.
    Al-Zahrani KS, Bakheit AMO. A study of the gait characteristics of patients with chronic osteoarthritis of the knee. Disability Rehabil 2002; 24: 275–80.CrossRefGoogle Scholar
  29. 29.
    Kaufman KR, Hughes C, Morrey BF, Morrey M, An KN. Gait characteristics of patients with knee osteoarthritis. J Biomech 2001; 34: 907–15.PubMedCrossRefGoogle Scholar
  30. 30.
    Sims E et al. Biomechanical gender differences in knee osteoarthritis. Journal of Women and Aging 2009; 21: 154–70.CrossRefGoogle Scholar
  31. 31.
    Heuts P, Vlaeyen JW, Roelofs J et al. Pain-related fear and daily functioning in patients with osteoarthritis. Pain 2004; 110: 228–35.PubMedCrossRefGoogle Scholar
  32. 32.
    Ang DC. Ibrahim SA, Burant CJ, Kwoh CK. Is there a difference in the perception of symptoms between African Americans and whites with osteoarthritis? J Rheumatol 2003; 30: 1305–10.Google Scholar
  33. 33.
    Ibrahim SA, Burant CJ, Mercer MB, Siminoff LA, Kwoh CK. Older patients’ perceptions of quality of chronic knee or hip pain; differences by ethnicity and relationship to clinical variables. J Gerontol A Biol Sci Med Sci 2003; 58A: 472–7.CrossRefGoogle Scholar

Copyright information

© Springer Internal Publishing Switzerland 2009

Authors and Affiliations

  • Ershela L. Sims
    • 1
    Email author
  • Francis J. Keefe
    • 2
  • Virginia B. Kraus
    • 3
  • Farshid Guilak
    • 1
  • Robin M. Queen
    • 1
  • Daniel Schmitt
    • 4
  1. 1.Department of SurgeryDuke UniversityDurhamUSA
  2. 2.Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamUSA
  3. 3.Department of Rheumatology and ImmunologyDuke UniversityDurhamUSA
  4. 4.Department of Evolutionary AnthropologyDuke UniversityDurhamUSA

Personalised recommendations