Identification of movement strategies during the sit-to-walk movement in patients with knee osteoarthritis

D. S. Komaris, C. Govind, P. Riches, A. Murphy, A. Ewen, F. Picard, J. Clarke

Research output: Contribution to journalConference Contribution

Abstract

Patients with osteoarthritis (OA) of the knee commonly alter their movement to compensate for deficiencies. This study presents a new numerical procedure for classifying sit-to-walk (STW) movement strategies.
Ten control and twelve OA participants performed the STW task in a motion capture laboratory. A full body biomechanical model was used. Participants were instructed to sit in a comfortable self-selected position on a stool height adjusted to 100% of their knee height and then stand and pick up an object from a table in front of them. Three matrices were constructed defining the progression of the torso, feet and hands in the sagittal plane along with a fourth expressing the location of the hands relative to the knees. Hierarchical clustering (HC) was used to identify different strategies. Trials were also classified as to whether the left (L) and right (R) extremities used a matching strategy (bilateral) or not (asymmetrical). Fisher’s exact test was used to compare this between groups.
Clustering of the torso matrix dichotomised the trials in two major clusters; subjects leaning forward (LF) or not. The feet and hands matrices revealed sliding the foot backward (FB) and moving an arm forward (AF) strategies respectively. Trials not belonging in the AF cluster were submitted to the last HC of the fourth matrix exposing three additional strategies, the arm pushing through chair (PC), arm pushing through knee (PK) and arm not used (NA). The control participants used the LF+FBR+PK combination most frequently whereas the OA participants used the AFR+PCL. OA patients used significantly more asymmetrical arm strategies, p=0.034.
The results demonstrated that control and OA participants favour different STW strategies. The OA patients asymmetrical arm behaviour possibly indicates compensating for weakness of the affected leg. These strategy definitions may be useful to assess post-operative outcomes and rehabilitation progress.

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Keywords

  • total knee arthroplasty
  • motion analaysis
  • movement patterns
  • hierarchical clustering
  • motion capture

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Komaris, D. S. ; Govind, C. ; Riches, P. ; Murphy, A. ; Ewen, A. ; Picard, F. ; Clarke, J. / Identification of movement strategies during the sit-to-walk movement in patients with knee osteoarthritis. In: Orthopaedic Proceedings. 2016 ; Vol. 98-B, No. Supp 16.
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title = "Identification of movement strategies during the sit-to-walk movement in patients with knee osteoarthritis",
abstract = "Patients with osteoarthritis (OA) of the knee commonly alter their movement to compensate for deficiencies. This study presents a new numerical procedure for classifying sit-to-walk (STW) movement strategies.Ten control and twelve OA participants performed the STW task in a motion capture laboratory. A full body biomechanical model was used. Participants were instructed to sit in a comfortable self-selected position on a stool height adjusted to 100{\%} of their knee height and then stand and pick up an object from a table in front of them. Three matrices were constructed defining the progression of the torso, feet and hands in the sagittal plane along with a fourth expressing the location of the hands relative to the knees. Hierarchical clustering (HC) was used to identify different strategies. Trials were also classified as to whether the left (L) and right (R) extremities used a matching strategy (bilateral) or not (asymmetrical). Fisher’s exact test was used to compare this between groups.Clustering of the torso matrix dichotomised the trials in two major clusters; subjects leaning forward (LF) or not. The feet and hands matrices revealed sliding the foot backward (FB) and moving an arm forward (AF) strategies respectively. Trials not belonging in the AF cluster were submitted to the last HC of the fourth matrix exposing three additional strategies, the arm pushing through chair (PC), arm pushing through knee (PK) and arm not used (NA). The control participants used the LF+FBR+PK combination most frequently whereas the OA participants used the AFR+PCL. OA patients used significantly more asymmetrical arm strategies, p=0.034.The results demonstrated that control and OA participants favour different STW strategies. The OA patients asymmetrical arm behaviour possibly indicates compensating for weakness of the affected leg. These strategy definitions may be useful to assess post-operative outcomes and rehabilitation progress.",
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author = "Komaris, {D. S.} and C. Govind and P. Riches and A. Murphy and A. Ewen and F. Picard and J. Clarke",
year = "2016",
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journal = "Bone & Joint Journal : Orthopaedic Proceedings Supplement",
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Identification of movement strategies during the sit-to-walk movement in patients with knee osteoarthritis. / Komaris, D. S.; Govind, C.; Riches, P.; Murphy, A.; Ewen, A.; Picard, F.; Clarke, J.

In: Orthopaedic Proceedings, Vol. 98-B, No. Supp 16, 29, 27.10.2016.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Identification of movement strategies during the sit-to-walk movement in patients with knee osteoarthritis

AU - Komaris, D. S.

AU - Govind, C.

AU - Riches, P.

AU - Murphy, A.

AU - Ewen, A.

AU - Picard, F.

AU - Clarke, J.

PY - 2016/10/27

Y1 - 2016/10/27

N2 - Patients with osteoarthritis (OA) of the knee commonly alter their movement to compensate for deficiencies. This study presents a new numerical procedure for classifying sit-to-walk (STW) movement strategies.Ten control and twelve OA participants performed the STW task in a motion capture laboratory. A full body biomechanical model was used. Participants were instructed to sit in a comfortable self-selected position on a stool height adjusted to 100% of their knee height and then stand and pick up an object from a table in front of them. Three matrices were constructed defining the progression of the torso, feet and hands in the sagittal plane along with a fourth expressing the location of the hands relative to the knees. Hierarchical clustering (HC) was used to identify different strategies. Trials were also classified as to whether the left (L) and right (R) extremities used a matching strategy (bilateral) or not (asymmetrical). Fisher’s exact test was used to compare this between groups.Clustering of the torso matrix dichotomised the trials in two major clusters; subjects leaning forward (LF) or not. The feet and hands matrices revealed sliding the foot backward (FB) and moving an arm forward (AF) strategies respectively. Trials not belonging in the AF cluster were submitted to the last HC of the fourth matrix exposing three additional strategies, the arm pushing through chair (PC), arm pushing through knee (PK) and arm not used (NA). The control participants used the LF+FBR+PK combination most frequently whereas the OA participants used the AFR+PCL. OA patients used significantly more asymmetrical arm strategies, p=0.034.The results demonstrated that control and OA participants favour different STW strategies. The OA patients asymmetrical arm behaviour possibly indicates compensating for weakness of the affected leg. These strategy definitions may be useful to assess post-operative outcomes and rehabilitation progress.

AB - Patients with osteoarthritis (OA) of the knee commonly alter their movement to compensate for deficiencies. This study presents a new numerical procedure for classifying sit-to-walk (STW) movement strategies.Ten control and twelve OA participants performed the STW task in a motion capture laboratory. A full body biomechanical model was used. Participants were instructed to sit in a comfortable self-selected position on a stool height adjusted to 100% of their knee height and then stand and pick up an object from a table in front of them. Three matrices were constructed defining the progression of the torso, feet and hands in the sagittal plane along with a fourth expressing the location of the hands relative to the knees. Hierarchical clustering (HC) was used to identify different strategies. Trials were also classified as to whether the left (L) and right (R) extremities used a matching strategy (bilateral) or not (asymmetrical). Fisher’s exact test was used to compare this between groups.Clustering of the torso matrix dichotomised the trials in two major clusters; subjects leaning forward (LF) or not. The feet and hands matrices revealed sliding the foot backward (FB) and moving an arm forward (AF) strategies respectively. Trials not belonging in the AF cluster were submitted to the last HC of the fourth matrix exposing three additional strategies, the arm pushing through chair (PC), arm pushing through knee (PK) and arm not used (NA). The control participants used the LF+FBR+PK combination most frequently whereas the OA participants used the AFR+PCL. OA patients used significantly more asymmetrical arm strategies, p=0.034.The results demonstrated that control and OA participants favour different STW strategies. The OA patients asymmetrical arm behaviour possibly indicates compensating for weakness of the affected leg. These strategy definitions may be useful to assess post-operative outcomes and rehabilitation progress.

KW - total knee arthroplasty

KW - motion analaysis

KW - movement patterns

KW - hierarchical clustering

KW - motion capture

UR - http://www.borsoc.org.uk/docs/BORS%20programme%20Glasgow%202016.pdf

UR - http://www.bjjprocs.boneandjoint.org.uk/content/98-B/SUPP_16/29

M3 - Conference Contribution

VL - 98-B

JO - Bone & Joint Journal : Orthopaedic Proceedings Supplement

T2 - Bone & Joint Journal : Orthopaedic Proceedings Supplement

JF - Bone & Joint Journal : Orthopaedic Proceedings Supplement

SN - 1358-992X

IS - Supp 16

M1 - 29

ER -