How Do Pain and Gait Mechanics Change in Response to Repeated Stair Climbing?

• Jaycob Iglesias, Biological Sciences, CUNY Hunter College
• Fany Alvarado Hernandez, Exercise Science, University of Delaware
• Millissia Murro, Exercise Science, University of Delaware
• Mayumi Wagatsuma, Exercise Science, University of Delaware

• Jocelyn Hafer, Kinesiology & Applied Physiology, University of Delaware

Knee osteoarthritis (OA) is associated with pain, altered gait mechanics, and reduced physical activity (Farrokhi et al., 2017). In response to activity-induced knee pain, individuals may increase hip and ankle loading to reduce mechanical demand at the knee. Altered gait mechanics may contribute to knee OA progression through reduced joint range of motion and changes in joint-loading patterns (Astephen et al., 2008; Mündermann et al., 2005). Understanding these gait changes could allow us to intervene to prevent and/or alleviate symptoms of knee OA and its progression. This study examined whether pain and gait mechanics changed after repeated stair climbing and whether changes in pain were related to changes in gait.

Thirteen older adults (64.3 ± 4.0 years) with symptomatic knee OA completed overground gait analysis using motion capture techniques, before and after repeated stair climbing. Outcome variables included peak knee flexion angle and hip, knee, and ankle joint moments, representing the rotational mechanical demands acting at each joint. Participants reported peak pain during the stair climbing using a 0–10 Numeric Rating Scale. Paired t-tests compared outcome variables pre- to post-stair climbing, and Pearson correlations assessed relationships between changes in pain and changes in gait mechanics.

Pre- to post-stair climbing, peak pain, peak knee flexion angle, and sagittal hip, frontal knee, and sagittal ankle moments did not change significantly (all p > .071). Changes in pain were not correlated with changes in gait (all p > 0.331; r = −0.293 to 0.221). These findings suggest that single bouts of stair climbing may not be sufficient to elicit pain or the gait adaptations associated with pain. Future research should investigate longer or more challenging stair-climbing protocols in larger cohorts to determine the pain threshold required to elicit problematic gait adaptations seen in those with knee OA.