title: Knee joint stiffness during walking in knee osteoarthritis.
abstract: OBJECTIVE
  To investigate the construct validity of walking knee stiffness as a measure to differentiate between individuals with and without knee osteoarthritis (OA) and the construct validity of walking knee stiffness as related to self-reported knee stiffness. The contributors to walking stiffness and its relationship with loading rate and adduction moment are also investigated.
  
  
  METHODS
  Thirty-seven individuals with knee OA and 11 asymptomatic controls participated. Knee stiffness was calculated during walking as the change in knee flexion-extension moment divided by the change in knee flexion angle. Forward-stepwise regression models and Pearson's correlation coefficients were used to evaluate the relationships between variables.
  
  
  RESULTS
  Knee stiffness in walking was significantly greater in the OA group (mean +/- SD 10.1 +/- 4.4 Nm/ degrees /kg x 100) compared with the controls (mean +/- SD 5.6 +/- 1.5 Nm/degrees/kg x 100) (P < 0.001). Knee excursion range explained 39% of the variance in walking knee stiffness (B = -0.736, P < 0.001) and knee extensor moment a further 7% (B = 6.974, P = 0.045). In the OA group, walking knee stiffness was not associated with self-reported stiffness (r = 0.029; P = 0.863). For the OA group, greater self-reported stiffness was associated with lower peak knee adduction moment (B = -0.354, P < 0.001).
  
  
  CONCLUSIONS
  The construct validity of walking knee stiffness is supported. The poor correlation between walking stiffness and self-reported stiffness suggests the 2 measures evaluate different aspects of knee stiffness. Since a measure of walking stiffness is likely to provide valuable information, future research evaluating its clinical significance is merited.
authors.affiliation: University of Exeter, Exeter, UK. s.j.dixon@exeter.ac.uk
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Dixon
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hinman
authors.forename: Mark W
authors.initials: MW
authors.lastname: Creaby
authors.forename: Georgie
authors.initials: G
authors.lastname: Kemp
authors.forename: Kay M
authors.initials: KM
authors.lastname: Crossley
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000503:physiopathology*; D010147:Pain Measurement / Q000592:standards; D015203:Reproducibility of Results; D016138:Walking / Q000502:physiology* / Q000592:standards*