BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS.
Degree: PhD, 2017, McMaster University
Background: Knee osteoarthritis is a degenerative disease characterized by damaged joint tissues (e.g., cartilage) that leads to joint pain, and reduced mobility and quality of life. Various factors are involved in disease progression, including biomechanical, patient-reported outcome and mobility measures. This thesis provides important longitudinal data on the role of these factors in disease progression, and the trajectory of biomechanical factors in persons with knee osteoarthritis.
Objectives: (1) Determine the extent to which changes over 2.5 years in knee cartilage thickness and volume in persons with knee osteoarthritis were predicted by the knee adduction and flexion moment peaks, and knee adduction moment impulse and loading frequency. (2) Determine the extent to which changes over 2 years in walking and stair-climbing mobility in women with knee osteoarthritis were predicted by quadriceps strength and power, pain and self-efficacy. (3) Estimate the relative and absolute test-retest reliabilities of biomechanical risk factors for knee osteoarthritis progression.
Methods: Data were collected at 3-month intervals during a longitudinal (3-year), observational study of persons with clinical knee osteoarthritis (n=64). Magnetic resonance imaging of the study knee was acquired at the first and last assessments, and used to determine cartilage thickness and volume. Accelerometry and dynamometry data were acquired every 3 months, and used to determine knee loading frequency and knee muscle strength and power, respectively. Walking and stair-climbing mobility, as well as pain and self-efficacy data, were also collected every 3 months. Gait analyses were performed every 6 months, and used to calculate lower-extremity kinematics and kinetics.
Results: (1) The knee adduction moment peak and impulse each interacted with body mass index to predict loss of medial tibial cartilage volume over 2.5 years. These interactions suggested that larger joint loads in those with a higher body mass index were associated with greater loss of cartilage volume. (2) In women, lower baseline self-efficacy predicted decreased walking and stair ascent performances over 2 years. Higher baseline pain intensity/frequency also predicted decreased walking performance. Quadriceps strength and power each interacted with self-efficacy to predict worsening stair ascent times. These interactions suggested that the impact of lesser quadriceps strength and power on worsening stair ascent performance was more important among women with lower self-efficacy. (3) Relative reliabilities were high for the knee adduction moment peak and impulse, quadriceps strength and power, and body mass index (i.e., intraclass correlation coefficients >0.80). Absolute reliabilities were high for quadriceps strength and body mass index (standard errors of measurement <15% of the mean). Data supported the use of interventions effective in reducing the knee adduction moment and body mass index, and increasing quadriceps strength, in persons with knee…
Advisors/Committee Members: Maly, Monica, Rehabilitation Science.
Subjects/Keywords: biomechanics; gait analysis; motion analysis; muscle strength; muscle power; patient-reported outcomes; self-reported outcomes; osteoarthritis; knee; kinematics; kinetics; dynamometry; accelerometry; magnetic resonance imaging; MRI; cartilage; obesity; loading frequency; physical activity; knee adduction moment; knee flexion moment; body mass index; BMI; pain; self-efficacy; mobility; walking; stair-climbing
to Zotero / EndNote / Reference
APA (6th Edition):
Brisson, N. (2017). BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS. (Doctoral Dissertation). McMaster University. Retrieved from http://hdl.handle.net/11375/22037
Chicago Manual of Style (16th Edition):
Brisson, Nicholas. “BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS.” 2017. Doctoral Dissertation, McMaster University. Accessed October 18, 2017.
MLA Handbook (7th Edition):
Brisson, Nicholas. “BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS.” 2017. Web. 18 Oct 2017.
Brisson N. BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS. [Internet] [Doctoral dissertation]. McMaster University; 2017. [cited 2017 Oct 18].
Available from: http://hdl.handle.net/11375/22037.
Council of Science Editors:
Brisson N. BIOMECHANICAL AND CLINICAL FACTORS INVOLVED IN THE PROGRESSION OF KNEE OSTEOARTHRITIS. [Doctoral Dissertation]. McMaster University; 2017. Available from: http://hdl.handle.net/11375/22037