Gait analysis as a quantifiable outcome measure in hip or knee osteoarthritis: a systematic review

Kinematic gait analysis consisting of measuring gait parameters (stride length, gait speed, dynamic joint angles) is a potential outcome measure in osteoarthritis (OA). The aim of this study was to evaluate its psychometric properties.

A systematic literature search was performed in PUBMED and the Cochrane database until January 2008 by selecting manuscripts assessing any psychometric property of gait analysis in knee or hip OA. Were assessed feasibility (cost, time and access); reliability; discriminant capacity by differences between OA and non-OA patients; construct validity by correlation between gait analysis and OA symptoms: pain or functional disability (Lequesne/WOMAC); and responsiveness by improvement of gait analysis after treatment of OA using effect size.

Among the 252 articles identified, the final analysis included 30 reports (i.e., 781 knee OA patients and 343 hip OA patients). Gait analysis presents various feasibility issues and there was limited evidence regarding reliability (three studies, 67 patients). Discriminant capacity showed significant reduction of gait speed, stride length and knee flexion in OA patients compared to healthy subjects. Few data were available concerning construct validity (three studies, 79 patients). Responsiveness of gait speed was moderate to large with effect size ranging respectively from 0.33 to 0.89 for total knee replacement, and from 0.50 to 1.41 for total hip replacement.

Available data concerning validity and reliability of kinematic gait analysis are insufficient to date to consider kinematic parameters as valuable outcome measures in OA. Further studies evaluating a large number of patients are needed.