Your Gait and How It May Be Impacted by Arthritis

Gait refers to the manner in which you walk, including the speed, cadence, and stride. Gait abnormalities are typically associated with a physical disease, condition, or deformity. Arthritis is among the conditions that can cause an abnormal gait. Joint pain, limited range-of-motion of a joint, or joint deformity associated with arthritis may be factors associated with an abnormal gait.

With arthritis, people begin to take smaller steps, limp, or alter their gait to compensate for painful or damaged joints -- especially when weight-bearing joints are involved. Gait analysis is being used more and more to study the impact of arthritis.

Gait Changes With Rheumatoid Arthritis

Second only to the hand, the foot is the most frequently involved joint at the onset of rheumatoid arthritis. Study results, from a 2008 study published in Acta Orthopaedica, revealed that the foot is the cause of walking disability in 3 out of 4 rheumatoid arthritis patients. Four times as often as the knee or hip, the foot was linked to gait impairment.

In 2012, a systematic review turned up 78 rheumatoid arthritis gait studies which together concluded that a slower walk, longer double support time, and an avoidance of extreme positions were characteristic. Double support time is defined as the step of a walking cycle when both feet are on the ground. In the review, commonly found features of rheumatoid arthritis that affected the gait were hallux valgus (bunions), pes planovalgus (flat feet), and hindfoot abnormalities.

A study, published in Arthritis and Rheumatism in 2015, suggested that there are several non-articular (non-joint) factors which were associated with slower walking speed in a group of rheumatoid arthritis patients. Those factors included: older age, higher depression scores, higher reported pain and fatigue, higher numbers of swollen or replaced joints, higher exposure to prednisone, and lack of treatment with DMARDs (disease-modifying anti-rheumatic drugs). The study concluded that paying attention to non-articular factors is important, including body composition. Physical training can help rheumatoid arthritis patients improve body composition (reduce fat and increase muscle mass), decrease disability, and improve physical function. 

Gait Changes Related to Knee Osteoarthritis

Gait abnormalities associated with osteoarthritis are more common with medial (inner) knee osteoarthritis than lateral (side) knee osteoarthritis. That is largely because the medial knee compartment bears a higher joint load (i.e., force) than the lateral knee compartment. In other words, the burden is greater on the medial compartment and it has been postulated that shifting the force off of the medial compartment might improve a patient's gait and perhaps reduce pain.