Celecoxib improves the efficiency of the locomotor mechanism in patients with knee osteoarthritis. A randomised, placebo, double-blind and cross-over trial.

OBJECTIVE: To compare the effect of celecoxib vs placebo treatment on clinical and gait variables in knee osteoarthritis (OA) patients; focusing on the efficiency of the locomotor mechanism. STUDY DESIGN: A prospective, randomised, double-blind placebo-controlled trial. PATIENTS: Eight adult patients with painful OA of the knee. OUTCOME MEASURES: Clinical assessment included knee pain assessed by the visual analogue scale, range of knee motion assessed by goniometer, and locomotor function status assessed by a Knee Score Scale. Gait was assessed by means of instrumented analysis including synchronous kinematic, dynamic, electromyographic, and energetic recordings. STATISTICAL ANALYSIS: The effect of treatment on the primary variable, the efficiency of the locomotor mechanism, and on secondary clinical and gait variables was assessed by the Hills and Armitage non-parametric approach. RESULTS: Celecoxib treatment improved the efficiency of the locomotor mechanism significantly. Among the secondary outcome measures assessed, celecoxib treatment improved walking cadence and reduced the knee pain significantly. CONCLUSION: This study shows that celecoxib is effective in improving locomotor function and pain in patients with knee OA.

Usefulness of gait analysis combined with motor point block in a stroke patient.

This clinical note describes a typical case of dynamic varus deformity of the rear foot in a stroke patient. An overactive Tibialis Posterior muscle seemed mainly responsible for the varus deformity. However, this hypothesis was not confirmed by a motor point block of this muscle. It appeared that the Tibialis Posterior and Extensor Hallucis Longus muscles were both involved in the varus deformity. A double motor point block of both the Tibialis Posterior and Extensor Hallucis Longus muscles was performed. Kinematic and kinetic data showed improvement. This case report illustrates the usefulness of gait analysis combined with motor point block in the diagnosis and management of gait disturbance.

Motion of the body centre of gravity as a summary indicator of the mechanics of human pathological gait.

Abnormal movements of the body segments due to lowest level gait disorders such as musculoskeletal disorders, peripheral neuropathies and radiculopathies or middle-level disorders such as hemiplegia, paraplegia and dystonia influence the motion of the centre of gravity (CG) during walking. The translation of the CG can be studied by the work done by muscles (WExt) with respect to the ground. The efficacy of gait's mechanism can be quantified by the energy transferred between gravitational potential and kinetic energies (recovery). WExt and recovery were investigated in lowest and middle-level gait disorders during level walking. No statistical significant difference was observed between patients with lowest-level gait disorders and normal subjects. However, WExt was increased for the patients with middle-level gait disorders and recovery decreased up to 20%. The measurement of changes in mechanical energy of the CG might be a summary indicator for the mechanics of pathological gait.