The association between obesity, knee pain, and gait during stair descent in older adults with knee osteoarthritis

• Published in: Clinical biomechanics (Bristol) 2024-04, Vol.114, p.106228-106228, Article 106228
• Main Authors: Rice, Paige E., Pate, Gabriel A., Hill, Ryan D., DeVita, Paul, Messier, Stephen P.
• Format: Article
• Language: English
• Subjects: Ankle; Force; Impulse; Mechanics; Moments
• ISSN: 0268-0033; 1879-1271
• DOI: 10.1016/j.clinbiomech.2024.106228

Obesity and knee osteoarthritis adversely affect activities of daily living in older adults. Together, the complexities of their interaction on mobility, including stair negotiation, are unresolved. The purpose of this study was to determine the relationship between obesity, pain, and stair negotiation in older adults with knee osteoarthritis. Older adults with symptomatic knee osteoarthritis and overweight or obesity participated in the study (n = 28; age range = 57.0–78.0 yrs.; body mass index range = 26.6–42.8 kg•m−2). The Western Ontario and McMaster Universities Osteoarthritis Index pain subscale was used to measure knee pain. Measurements included a three-dimensional biomechanical analysis during descent on a set of force plate-instrumented stairs and a timed stair descent test. Pearson's r was used to determine associations between body mass index and pain, stair descent weight-acceptance phase vertical ground reaction force (vGRF) variables and lower extremity joint kinematics and kinetics, and timed stair descent performance. Significant correlations existed between body mass index and pain (r = 0.41; p = 0.03), peak vGRF (r = 0.39; p = 0.04), vertical impulse (r = 0.49; p = 0.008), and peak ankle plantar flexor moments (r = 0.50; p = 0.007) in older adults with knee osteoarthritis. Greater obesity in older adults with knee osteoarthritis was associated with greater knee pain and higher ankle joint loads during stair descent. These results support the recommendations of osteoarthritis treatment guidelines for weight-loss as a first-line of treatment for older adults with obesity and knee osteoarthritis. •Obesity predicts pain in older adults with knee osteoarthritis.•Obesity predicts stair descent forces in older adults with knee osteoarthritis.•Obesity predicts stair descent ankle-joint load in people with knee osteoarthritis.