title: Gait Biomechanics and Patient-Reported Function as Predictors of Response to a Hip Strengthening Exercise Intervention in Patients with Knee Osteoarthritis.
abstract: OBJECTIVE
  Muscle strengthening exercises have been shown to improve pain and function in adults with mild-to-moderate knee osteoarthritis, but individual response rates can vary greatly. Predicting individuals who respond and those who do not is important in developing a more efficient and effective model of care for knee osteoarthritis (OA). Therefore, the purpose of this study was to use pre-intervention gait kinematics and patient-reported outcome measures to predict post-intervention response to a 6-week hip strengthening exercise intervention in patients with mild-to-moderate knee OA.
  
  
  METHODS
  Thirty-nine patients with mild-to-moderate knee osteoarthritis completed a 6-week hip-strengthening program and were subgrouped as Non-Responders, Low-Responders, or High-Responders following the intervention based on their change in Knee injury Osteoarthritis Outcome Score (KOOS). Predictors of responder subgroups were retrospectively determined from baseline patient-reported outcome measures and kinematic gait parameters in a discriminant analysis of principal components. A 3-4 year follow-up on 16 of the patients with knee OA was also done to examine long-term changes in these parameters.
  
  
  RESULTS
  A unique combination of patient-reported outcome measures and kinematic factors was able to successfully subgroup patients with knee osteoarthritis with a cross-validated classification accuracy of 85.4%. Lower patient-reported function in daily living (ADL) scores and hip frontal plane kinematics during the loading response were most important in classifying High-Responders from other sub-groups, while a combination of hip, knee, ankle kinematics were used to classify Non-Responders from Low-Responders.
  
  
  CONCLUSIONS
  Patient-reported outcome measures and objective biomechanical gait data can be an effective method of predicting individual treatment success to an exercise intervention. Measuring gait kinematics, along with patient-reported outcome measures in a clinical setting can be useful in helping make evidence-based decisions regarding optimal treatment for patients with knee OA.
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Dylan
authors.initials: D
authors.lastname: Kobsar
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Running Injury Clinic, Calgary, Alberta, Canada.
authors.forename: Sean T
authors.initials: ST
authors.lastname: Osis
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Running Injury Clinic, Calgary, Alberta, Canada.
authors.forename: Blayne A
authors.initials: BA
authors.lastname: Hettinga
authors.affiliation: Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; Running Injury Clinic, Calgary, Alberta, Canada.
authors.forename: Reed
authors.initials: R
authors.lastname: Ferber
mesh_terms: D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D055070:Resistance Training / Q000379:methods*