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Sensorimotor dysfunction and altered pain sensitivity in early hip osteoarthritis: associations with hip
Mastour Saeed Alshahrani1, Ravi Shankar Reddy1
1Physical Therapy Program, Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Background:
Early hip osteoarthritis is associated with subtle sensorimotor impairments and altered pain processing, which may contribute to functional limitations before advanced structural changes occur. However, the interplay between hip proprioception, postural control, and pain sensitivity remains insufficiently understood. To compare hip joint position sense between individuals with early hip osteoarthritis and asymptomatic controls, and to examine the associations among proprioception, posturographic balance, and pressure pain sensitivity.
Methods:
A cross-sectional study was conducted, including 38 participants with early hip osteoarthritis and 38 age- and sex-matched controls. Hip proprioception was assessed using a digital inclinometer-measured joint position sense. Postural stability was evaluated using force-platform posturography, and pressure pain thresholds were measured at local and remote sites. Between-group differences were analyzed using independent-samples t tests, while associations were examined using Pearson correlation and multiple linear regression analyses.
Results:
Participants with early hip osteoarthritis demonstrated significantly higher hip repositioning error (composite error: 5.51 ± 1.21° vs. 3.56 ± 0.92°, p < 0.001), higher postural sway (single-leg eyes closed COP velocity: 6.16 ± 1.51 vs. 4.64 ± 1.32 cm/s, p < 0.001), and lower local pressure pain thresholds (303.00 ± 68.00 vs. 415.00 ± 75.00 kPa, p < 0.001). Proprioceptive error was moderately associated with sway velocity (r = 0.56, p < 0.001) and inversely with local pain thresholds (r = -0.50, p = 0.001). Regression analyses indicated that proprioceptive error (β = 0.42, p = 0.004) and local pain sensitivity (β = -0.31, p = 0.021) independently predicted balance performance.
Conclusion:
Early hip osteoarthritis is characterized by concurrent proprioceptive deficits, balance impairments, and increased pain sensitivity, with significant interactions among these domains, suggesting that altered pain processing and sensorimotor dysfunction are interconnected features of early hip osteoarthritis.
