Frontal plane kinematics in walking with moderate hip osteoarthritis: Stability and fall risk.

Abstract

Hip abductor weakness and unilateral pain in patients with moderate hip osteoarthritis may induce changes in frontal plane kinematics during walking that could affect stability and fall risk. In 12 fall-prone patients with moderate hip osteoarthritis, 12 healthy peers, and 12 young controls, we assessed the number of falls in the preceding year, hip abductor strength, fear of falling, Harris Hip Score, and pain. Subjects walked on a treadmill with increasing speeds, and kinematics were measured opto-electronically. Parameters reflecting gait stability and regressions of frontal plane center of mass movements on foot placement were calculated. We analyzed the effects of, and interactions with group, and regression of all variables on number of falls. Patients walked with quicker and wider steps, stood shorter on their affected leg, and had larger peak speeds of frontal plane movements of the center of mass, especially toward their unaffected side. Patients' static margins of stability were larger, but the unaffected dynamic margin of stability was similar between groups. Frontal plane position and acceleration of the center of mass predicted subsequent step width. The peak speed of frontal plane movements toward unaffected had 55% common variance with number of falls, and adding the Harris Hip Score into bivariate regression led to 83% "explained" variance. Quickening and widening steps probably increase stability. Shorter affected side stance time to avoid pain, and/or weakened affected side hip abductors, may lead to faster frontal plane trunk movements toward the unaffected side, which could contribute to fall risk.