Combined effects of knee extension strength, visual acuity, and knee-joint pain on older women’s gait

Tomohiro Demura, Shinichi Demura

Child Education, Jinai Women’s College, Fukui, Japan.
Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa, Japan.

DOI: 10.4236/health.2013.53060                

Abstract

The purpose of this study was to examine the combined effects of knee extension strength (KES), visual acuity (VA), and knee joint pain (KP) on gait in 212 older women. Including, walking speed, cadence, were selected as gait parameters. Knee extension strength was measured by isometric knee extension strength, while knee joint pain and decreased visual acuity were evaluated by subjective judgment. The combine effect of KP and KES factors was examined. Stance time was significantly longer in persons with both-KP than in persons with no KP. In addition, people with superior KES had significantly greater values in walking speed, cadence, and step length, and lower values in stance time and walking angle than those with inferior KES. Furthermore, double support time showed that persons with both-KP have significantly greater values than persons with no or one-KP in the inferior KES group. Also, persons with the inferior KES had significantly greater values in persons with both-KP. The combine effect of KES and VA factors was examined. There are significant differences between the superior and the inferior KES groups. In conclusion, the elderly with both the factors of decreasing KES and both-KP, as compared to the elderly with just one of those factors, have markedly different gait properties.

Keywords

Community-Dwelling Elderly; Gait; Knee Joint Pain; Vision Acuity

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Yamazaki, K., Kushida, K., Okui, K., Suzuki, M., Suzuki, K., Tamura, T., Saitoh, I. and Inoue, T. (1998) Investigation of factors to “bedridden” from “fractures”. Osteoporosis Japan, 6, 265-268.
[2]	Lord, S.R., Ward, J.A., Williams, P. and Anstey, K. (1994) Physiological factors associated with falls in older communitydwelling women. Journal of the American Geriatrics Society, 42, 1110-1117.
[3]	Nevitt, M.C. (1997) Gait disorders of aging. Lippincott-Raven, Philadelphia, New York.
[4]	Murray, M.P., Kory, R.C. and Clarkson, B.H. (1969) Walking patterns in healthy old men. Journal of Gerontology, 24, 169-178. doi:10.1093/geronj/24.2.169
[5]	Murray, M.P., Kory, R.C. and Sepic, S.B. (1970) Walking patterns of normal women. Archives of Physical Medicine and Rehabilitation, 51, 637-650.
[6]	Kaneko, M., Morimoto, Y., Kimura, M., Fuchimoto, K. and Fuchimoto, T. (1991) A kinematic analysis of walking and physical fitness in elderly women. Canadian Journal of Sport Sciences, 16, 223-228.
[7]	Guralnik, J.M., Simonsick, E.M., Ferrucci, L., Glynn, R.J., Berkman, L.F., Blazer, D.G., Scherr, P.A. and Wallace, R.B. (1994) A short physical performance battery assessing lower extremity function: Association with self-reported disability and prediction of mortality and nursing home admission. Journal of Gerontology, 49, M85-M94. doi:10.1093/geronj/49.2.M85
[8]	Guralnik, J.M., Ferrucci, L., Simonsick, E.M., Salive, M.E. and Wallage, R.B. (1995) Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556-561. doi:10.1056/NEJM199503023320902
[9]	Van Swearingen, J.M., Paschal, K.A., Bonino, P. and Chen, T.W. (1997) Assessing recurrent fall risk of community-dwelling, frail older veterans using specific tests of mobility and the physical performance test of function. Journals of Gerontology Series A, Biological Sciences and Medical Sciences, 53A, M457-M464. doi:10.1093/gerona/53A.6.M457
[10]	Montoye, H.J. and Lamphiear, D.J. (1977) Grip and arm strength in males and females, age 10 to 69. Research Quarterly, 48, 109-120.
[11]	Frontera, W.R., Hughes, V.A., Lutz, K.J. and Evans, W.J. (1991) A cross-sectional study of muscle strength and mass in 45-to 78-yr-old men and women. Journal of Applied Physiology, 71, 644-650.
[12]	Murray, M.P., Duthie Jr., E.H., Gambert, S.R., Sepic, S.B. and Mollinger, L.A. (1985) Age-related differences in knee muscle strength in normal women. Journal of Gerontology, 40, 275-280. doi:10.1093/geronj/40.3.275
[13]	Singh, M.M. and Malhotra, H.S. (2003) Falls in the elderly—clinician’s approach. Journal of the Indian Medical Association, 101, 420, 422, 424.
[14]	Elliott, D.B., Bullimore, M.A., Patla, A.E. and Whitaker, D. (1996) Effect of a cataract simulation on clinical and real world vision. British Journal of Ophthalmology, 80, 799-804. doi:10.1136/bjo.80.9.799
[15]	Moe-Nilssen, R., Helbostad, J.L., Akra, T., Birdedal, L. and Nygaard, H.A. (2006) Modulation of gait during visual adaptation to dark. Journal of Motor Behavior, 38, 118-125. doi:10.3200/JMBR.38.2.118-125
[16]	Klein, B.E.K., Moss, S.E., Klein, R., Lee, K.E. and Cruickshanks, K.J. (2003) Associations of visual function with physical outcomes and limitations 5 years later in an older population. Ophthalmology, 110, 644-650. doi:10.1016/S0161-6420(02)01935-8
[17]	Nevitt, M., Commings, S., Kidd, S. and Black, D. (1989) Risk factors for recurrent non-syncopal falls. Journal of the American Medical Association, 261, 2663-2668. doi:10.1001/jama.1989.03420180087036
[18]	Al-Zaharni, K.S. and Bakheit, A.M. (2002) A study of the gait characteristics of patients with chronic osteoarthritis of the knee. Disability and Rehabilitation, 24, 275-280. doi:10.1080/09638280110087098
[19]	Bejek, Z., Paroczai, R., Illyes, A. and Kiss, R.M. (2006) The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy, 14, 612-622. doi:10.1007/s00167-005-0005-6
[20]	Kaufman, K.R., Hughes, C., Morrey, B.F., Morrey, M. and An, K.N. (2001) Gait characteristics of patients with knee osteoarthritis. Journal of Biomechanics, 34, 907-915. doi:10.1016/S0021-9290(01)00036-7
[21]	McAlindon, T.E., Cooper, C., Kirwan, J.R. and Dieppe, P.A. (1992) Knee pain and disability in the community. Rheumatology, 31, 189-192. doi:10.1093/rheumatology/31.3.189
[22]	Peat, G., McCarney, P. and Croft, P. (2001) Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Annals of Rheumatic Diseases, 60, 91-97. doi:10.1136/ard.60.2.91
[23]	Dieppe, P. and Lim, K. (1998) Osteoarthritis and related disorders: Clinical features and diagnostic problems. In: Dlippel, J.H. and Kieppe, P.A., Eds., Rheumatology, 2nd Edition, Mosby, London.
[24]	Noro, M., Naito, K., Torii, S., Oka, K. and Nakamura, Y. (2007) Effects of knee pain improvement programs in middle-and older-aged women with knee pain. Japanese Journal of Physical Fitness and Sports, 56, 501-508.
[25]	Demura, T. and Demura, S. (2010) Relationship among gait parameters while walking with varying loads. Journal of Physiological Anthropology, 29, 29-34. doi:10.2114/jpa2.29.29
[26]	Nishijima, T., Koyama, R., Naito, I., Hatakeyama, S., Yamasaki, H. and Oku, T. (2004) Relationship between knee extension muscle strength and walking ability in the elderly patients. Rigakuryoho Kagaku, 19, 95-99. doi:10.1589/rika.19.95
[27]	Demura, S., Sato, S., Yokoya, T. and Sato, T. (2010) Examination of useful items for the assessment of fall risk in the community-dwelling elderly Japanese population. Environmental Health and Preventive Medicine, 15, 169-179. doi:10.1007/s12199-009-0124-7
[28]	Blain, H., Vuillemin, A., Teissier, A., Hanesse, B., Guillemin, F. and Jeandel, C. (2001) Influence of muscle strength and body weight and composition on regional bone mineral density in healthy women aged 60 years and over. Gerontology, 47, 207-212. doi:10.1159/000052800
[29]	Slemenda, C., Heilman, D.K., Brandt, K.D., Katz, B.P., Mazzuca, S.A., Braunstein, E.M. and Byrd, D. (1998) Reduced quadriceps strength relative to body weight. Arthritis and Rheumatism, 41, 1951-1959. doi:10.1002/1529-0131(199811)41:11<1951::AID-ART9>3.0.CO;2-9
[30]	Oliveria, S.A., Felson, D.T., Cirillo, P.A., Reed, J.I. and Walker, A.M. (1999) Body weight, body mass index, and incident symptomatic osteoarthritis of the hand, hip, and knee. Epidemiology, 10, 161-166. doi:10.1097/00001648-199903000-00013
[31]	Yamagishi, T. and Tokuda, T. (1975) Geriatric gait Photometric analysis. Japanese Journal of Rehabilitation Medicine, 12, 97-104. doi:10.2490/jjrm1963.12.97
[32]	Patla, A.E. (1997) Understanding the roles of vision in the control of human locomotion. Gait and Posture, 5, 54-69. doi:10.1016/S0966-6362(96)01109-5
[33]	Hageman, P.A. and Blanke, D.J. (1986) Comparison of gait of young women and elderly women. Physical Therapy, 66, 1382-1387.
[34]	Daubney, M.E. and Culham, E.G. (1999) Lower-extermi- ty muscle force and balance performance in adults aged 65 years and older. Physical Therapy, 79, 1177-1185.
[35]	Wolfson, L., Judge, J., Whipple, R. and King, M. (1995) Strength is a major factor in balance, gait, and the occurrence of falls. Journal of Gerontology, 50, 64-67.