Osteoarthritis (OA) is the most common joint disease, which is one of the causes of Locomotive Syndrome (LS) and causes pain in elderly patients.
<>The results from the present study suggest that glucosamine-containing supplements may increase the walking speed through increased stride length and angle of kicking from the ground during steps, which is likely to be associated with alleviated knee pain.
Osteoarthritis (OA) is the most common joint disease, which is one of the causes of Locomotive Syndrome (LS) and causes pain in elderly patients. According to the Research on Osteoarthritis Against Disability, more than 25 million Japanese people aged 40 years and older are estimated to have radiographic knee OA. It has been suggested that knee OA impairs locomotor functions because of the pain, and the biomechanical mechanism of impaired locomotor functions such as walking speed and stride length in patients with knee OA has been investigated. Glucosamine-containing supplements have been used widely for improving knee pain in OA. In previous studies, it has been found that glucosamine-containing supplements “GCQ” or “GCQID” (glucosamine hydrochloride, chondroitin sulfate, type II collagen peptides, quercetin glycosides, imidazole peptides, proteoglycan and vitamin D) were effective for relieving knee pain and/or locomotor functions in randomized, placebo-controlled trials. The effects of thermal and exercise therapies on locomotor functions and their mechanism in patients with knee OA have been elucidated with biomechanical methods, but the biomechanical mechanism of the effects of supplements such as GCQID on locomotor functions has not been reported.
Rationale behind research:
Previous studies have demonstrated that glucosamine-containing supplementation was effective for improving locomotor functions, especially walking speed. However, the biomechanical mechanism of efficacy has not been elucidated. The present study aimed to address this challenge in subjects with knee pain, using a motion capture system.
Objective:
To investigate the biomechanical mechanism for the improving effects of GCQID on locomotor functions in subjects with knee pain.
Study outcomes
Time Points: Baseline and every 4 weeks to 16 weeks
Motion Capture Analysis: Baseline and at 8 and 16 weeks.
Outcomes
This study showed that GCQID improved functions of locomotion that involve the knee joint, as evidenced by JKOM and GLFS-5 scores, suggesting that GCQID supplementation exerted effects on knee pain in daily life and on QOL. The motion capture analysis revealed that GCQID simultaneously increased normal walking speed and stride (and step) length, but that cadence was not changed. As it has been reported that walking speed is mainly controlled by stride length and cadence, GCQID’s effect of increasing normal walking speed was likely attributable to increased stride length. In addition, GCQID increased the angle of soles at the end of the stance phase, which could indicate increased kicking force of the ground and enhanced driving power. As the change in stride length at 16 weeks was correlated with the change in the angle of soles at the end of the stance phase (r=0.66), it was considered that GCQID might increase stride length through enhanced driving power.
OA patients with knee pain had shorter stride lengths compared with healthy subjects, and the driving power subjects needed to make longer strides could have been restricted because of knee pain. Because the change in stride length at 16 weeks was correlated with changes in JKOM total score and GLFS-5 score, GCQID might increase stride length through alleviated knee pain and improved functions of locomotor system in daily life. In addition, GCQID increased angle of toe at the beginning of the stance phase, which could indicate that the manner of gait control of subjects was changed to one in which toes were raised higher. The change in angle of toe at the beginning of the stance phase at 16 weeks was correlated with the change in stride length (r=0.42), suggesting the possibility of a contribution of increased stride length to higher toe angle by GCQID. As GCQID decreased frequency of tripping while walking, according to the questionnaires, GCQID might actually change the gait in a way that makes subjects less likely to be tripped.
GCQID supplements can increase walking speed through increased stride length and increased force of kicking from the ground during steps, and these improvements may be associated mainly with alleviated knee pain and direct effects on muscle.
Clinical Interventions in Aging 2016; 11:835–841
Glucosamine-containing supplement improves locomotor functions in subjects with knee pain - a pilot study of gait analysis.
Kanzaki N et al.
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