Altered Spatiotemporal and Kinematic Gait in Patients with Knee Osteoarthritis

Background: Knee osteoarthritis (KOA) is a major cause of pain, mobility limitation, and increased fall risk among older adults. Gait dysfunction, characterized by spatiotemporal and kinematic alterations, is a key functional consequence of KOA. While sagittal-plane gait deviations are well-established, multiplanar kinematic changes-particularly in the frontal and transverse planes-remain less clearly understood. This study aimed to compare three-dimensional gait characteristics between older adults with and without KOA. Methods: Ninety older adults (45 with KOA and 45 controls) completed gait assessments using a VICON™ motion capture system. Participants walked at a self-selected speed along a straight walkway without turning movements during data collection. Spatiotemporal parameters and lower-limb joint kinematics (hip, knee, and ankle) were recorded during key gait phases: initial contact, mid-stance, toe-off, and mid-swing. Group comparisons were performed using independent t-tests with statistical significance set at p < 0.05. Results: Compared with controls, participants with KOA demonstrated significantly slower gait velocity (p = 0.001), reduced cadence (p = 0.020), shorter stride length (p = 0.011), increased step time (p = 0.006), prolonged double support time (p = 0.009), and reduced single support time (p = 0.012). Kinematic analysis revealed greater knee adduction at initial contact (p = 0.001), reduced hip adduction (p = 0.002) and greater knee adduction (p = 0.003) during mid-stance, and increased ankle plantarflexion at toe-off (p = 0.004) in the KOA group. No significant between-group differences were observed during the mid-swing phase. Conclusions: Older adults with KOA exhibit distinct spatiotemporal and multiplanar kinematic gait alterations, particularly during weight-bearing phases. These changes may reflect adaptive gait patterns associated with joint dysfunction rather than definitive compensatory mechanisms. Three-dimensional gait analysis may provide valuable biomechanical insights to support early identification of mobility impairments and inform targeted rehabilitation planning in individuals with KOA.