{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:00:48Z","timestamp":1760821248679,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Symmetry"],"abstract":"<jats:p>Asymmetry during gait is associated with the evolution of secondary osteoarthritis. Kinematic asymmetry has been reported in advanced stages of hip osteoarthritis but has not been evaluated in earlier stages of the disease or has it been directly compared with unilateral and bilateral hip osteoarthritis. Our objective was to evaluate within-group symmetry and compare between-group asymmetry for three-dimensional pelvis, hip, knee, and ankle kinematics during walking and sit-to-stand in individuals with unilateral mild-to-moderate hip OA, bilateral mild-to-moderate hip osteoarthritis, and healthy controls. Twelve individuals with unilateral mild-to-moderate hip OA, nine individuals with bilateral mild-to-moderate symptomatic and radiographic hip OA, and 21 age-comparable healthy controls underwent three-dimensional motion analysis during walking and sit-to-stand. Pelvis and lower limb joint angles were calculated using inverse kinematics and between-limb symmetry was assessed for each group. Any resulting asymmetries (most affected minus contralateral limb) were compared between groups. Participants with unilateral hip osteoarthritis exhibited significantly less hip extension (7.90\u00b0), knee flexion (4.72\u00b0), and anterior pelvic tilt (3.38\u00b0) on their affected limb compared with the contralateral limb during the stance phase of walking. Those with unilateral hip osteoarthritis were significantly more asymmetrical than controls for sagittal plane hip and pelvis angles. No significant asymmetries were detected within- or between-groups for sit-to-stand. Individuals with unilateral hip osteoarthritis exhibited lower limb asymmetries consistent with those reported in advanced stages of disease during walking, but not sit-to-stand. Consideration of the possible negative effects of gait asymmetry on the health of the affected and other compensating joints appears warranted in the management of hip OA.<\/jats:p>","DOI":"10.3390\/sym13050768","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T22:29:07Z","timestamp":1619648947000},"page":"768","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Individuals with Unilateral Mild-to-Moderate Hip Osteoarthritis Exhibit Lower Limb Kinematic Asymmetry during Walking But Not Sit-to-Stand"],"prefix":"10.3390","volume":"13","author":[{"given":"Jeremy P.","family":"Higgs","sequence":"first","affiliation":[{"name":"Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia"},{"name":"School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2197-1856","authenticated-orcid":false,"given":"Laura E.","family":"Diamond","sequence":"additional","affiliation":[{"name":"Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia"},{"name":"School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia"}]},{"given":"David J.","family":"Saxby","sequence":"additional","affiliation":[{"name":"Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia"},{"name":"School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0826-0950","authenticated-orcid":false,"given":"Maria","family":"Constantinou","sequence":"additional","affiliation":[{"name":"School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD 4014, Australia"}]},{"given":"Rod S.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia"},{"name":"School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222, Australia"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"ref_1","unstructured":"(2020, April 13). Access Economics Arthritis Australia. Painful Realities: The Economic Impact of Arthritis in Australia in 2007. Available online: http:\/\/www.arthritisaustralia.com.au\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1749-6632.2010.05808.x","article-title":"Mechanical loading, cartilage degradation, and arthritis","volume":"1211","author":"Sun","year":"2010","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"320","DOI":"10.5435\/00124635-200109000-00005","article-title":"Primary osteoarthritis of the hip: Etiology and epidemiology","volume":"9","author":"Hoaglund","year":"2001","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0966-6362(00)00070-9","article-title":"Symmetry and limb dominance in able-bodied gait: A review","volume":"12","author":"Sadeghi","year":"2000","journal-title":"Gait Posture"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3185","DOI":"10.1002\/art.10649","article-title":"Nonrandom evolution of end-stage osteoarthritis of the lower limbs","volume":"46","author":"Shakoor","year":"2002","journal-title":"Arthritis Rheum."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.gaitpost.2011.08.006","article-title":"Contralateral hip and knee gait biomechanics are unchanged by total hip replacement for unilateral hip osteoarthritis","volume":"35","author":"Foucher","year":"2012","journal-title":"Gait Posture"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.apmr.2011.11.029","article-title":"Gait differs between unilateral and bilateral knee osteoarthritis","volume":"93","author":"Creaby","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.clinbiomech.2019.11.007","article-title":"Asymmetry in children with unilateral cerebral palsy during sit-to-stand movement: Cross-sectional, repeated-measures and comparative study","volume":"71","author":"Pena","year":"2020","journal-title":"Clin. Biomech."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.jbiomech.2018.09.021","article-title":"Biomechanical but not timed performance asymmetries persist between limbs 9months after acl reconstruction during planned and unplanned change of direction","volume":"81","author":"King","year":"2018","journal-title":"J. Biomech."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.gaitpost.2020.02.016","article-title":"Gait asymmetry pattern following stroke determines acute response to locomotor task","volume":"77","author":"Little","year":"2020","journal-title":"Gait Posture"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1002\/art.11034","article-title":"Asymmetric knee loading in advanced unilateral hip osteoarthritis","volume":"48","author":"Shakoor","year":"2003","journal-title":"Arthritis Rheum."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.joca.2016.09.023","article-title":"Osteoarthritis year in review 2016: Mechanics","volume":"25","author":"Saxby","year":"2017","journal-title":"Osteoarthr. Cartil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1002\/jor.22772","article-title":"Relationship between physical impairments and movement patterns during gait in patients with end-stage hip osteoarthritis","volume":"33","author":"Zeni","year":"2015","journal-title":"J. Orthop. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.jbiomech.2003.09.009","article-title":"Recovery of walking speed and symmetrical movement of the pelvis and lower extremity joints after unilateral tha","volume":"37","author":"Miki","year":"2004","journal-title":"J. Biomech."},{"key":"ref_15","first-page":"86","article-title":"Gait symmetry in patients with unilateral partial hip arthroplasty","volume":"21","author":"Oken","year":"2010","journal-title":"Eklem Hastalik. Cerrahisi"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.arth.2010.07.022","article-title":"Gait symmetry: A comparison of hip resurfacing and jumbo head total hip arthroplasty patients","volume":"26","author":"Queen","year":"2011","journal-title":"J. Arthroplast."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.clinbiomech.2007.11.010","article-title":"Asymmetric leg loading during sit-to-stand, walking and quiet standing in patients after unilateral total hip replacement surgery","volume":"23","author":"Talis","year":"2008","journal-title":"Clin. Biomech."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"787","DOI":"10.2340\/16501977-0849","article-title":"Changes in gait symmetry, gait velocity and self-reported function following total hip replacement","volume":"43","author":"Helbostad","year":"2011","journal-title":"J. Rehabil. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"291-B7","DOI":"10.2519\/jospt.2014.4634","article-title":"Spatial-temporal gait characteristics in individuals with hip osteoarthritis: A systematic literature review and meta-analysis","volume":"44","author":"Constantinou","year":"2014","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_20","first-page":"Cr159","article-title":"Changes in gait parameters in total hip arthroplasty patients before and after surgery","volume":"14","author":"Cichy","year":"2008","journal-title":"Med. Sci. Monit."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S0268-0033(02)00024-4","article-title":"Temporal gait analysis of hip osteoarthritic patients operated with cementless hip replacement","volume":"17","author":"Kyriazis","year":"2002","journal-title":"Clin. Biomech."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.clinbiomech.2010.05.003","article-title":"Gait asymmetry following an anterior and anterolateral approach to total hip arthroplasty","volume":"25","author":"Lugade","year":"2010","journal-title":"Clin. Biomech."},{"key":"ref_23","first-page":"167","article-title":"Clinical study on arthroplasties for osteoarthritic hip by quantitative gait analysis. Comparison between total hip arthroplasty and bipolar endoprosthetic arthroplasty","volume":"8","author":"Isobe","year":"1998","journal-title":"Biomed. Mater. Eng."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/09593980500213035","article-title":"Overground and walkway ambulation with unilateral hip osteoarthritis: Comparison of step length asymmetries and reproducibility of treadmill mounted force plate readings","volume":"22","author":"Vogt","year":"2006","journal-title":"Physiother. Theory Pract."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S67","DOI":"10.1016\/S1063-4584(10)60162-8","article-title":"Gait alterations and their association with radiographic severity and pain in unilateral hip osteoarthritis","volume":"18","author":"Shakoor","year":"2010","journal-title":"Osteoarthr. Cartil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/j.gaitpost.2013.09.010","article-title":"Weight-bearing asymmetries during sit-to-stand in patients with mild-to-moderate hip osteoarthritis","volume":"39","author":"Eitzen","year":"2014","journal-title":"Gait Posture"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1002\/jor.22127","article-title":"Lower-limb joint mechanics after total hip arthroplasty during sitting and standing tasks","volume":"30","author":"Lamontagne","year":"2012","journal-title":"J. Orthop. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2027","DOI":"10.1016\/j.arth.2015.05.024","article-title":"Sit-to-stand biomechanics before and after total hip arthroplasty","volume":"30","author":"Abujaber","year":"2015","journal-title":"J. Arthroplast."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Loureiro, A., Constantinou, M., Beck, B., Barrett, R.S., and Diamond, L.E. (2019). A 12-month prospective exploratory study of muscle and fat characteristics in individuals with mild-to-moderate hip osteoarthritis. BMC Musculoskelet. Disord., 20.","DOI":"10.1186\/s12891-019-2668-z"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Loureiro, A., Constantinou, M., Diamond, L.E., Beck, B., and Barrett, R. (2018). Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits. BMC Musculoskelet. Disord., 19.","DOI":"10.1186\/s12891-018-2230-4"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.gaitpost.2017.01.017","article-title":"Hip joint mechanics during walking in individuals with mild-to-moderate hip osteoarthritis","volume":"53","author":"Constantinou","year":"2017","journal-title":"Gait Posture"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.gaitpost.2019.05.008","article-title":"Individuals with mild-to-moderate hip osteoarthritis exhibit altered pelvis and hip kinematics during sit-to-stand","volume":"71","author":"Higgs","year":"2019","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1259\/bjr\/61371891","article-title":"A morphological index for assessing hip osteoarthritis severity from radiographic images","volume":"81","author":"Boniatis","year":"2008","journal-title":"Brit. J. Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1136\/ard.16.4.494","article-title":"Radiological assessment of osteo-arthrosis","volume":"16","author":"Kellgren","year":"1957","journal-title":"Ann. Rheum. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1054\/arth.2001.23716","article-title":"The Harris hip score: Comparison of patient self-report with surgeon assessment","volume":"16","author":"Mahomed","year":"2001","journal-title":"J. Arthroplast."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1007\/s11999-016-4732-4","article-title":"Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis","volume":"474","author":"Kohn","year":"2016","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1016\/S0021-9290(03)00087-3","article-title":"Repeatability of gait data using a functional hip joint centre and a mean helical knee axis","volume":"36","author":"Besier","year":"2003","journal-title":"J. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s13029-015-0044-4","article-title":"MOtoNMS: A MATLAB toolbox to process motion data for neuromusculoskeletal modeling and simulation","volume":"10","author":"Mantoan","year":"2015","journal-title":"Source Code Biol. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1109\/TBME.2007.901024","article-title":"OpenSim: Open-source software to create and analyze dynamic simulations of movement","volume":"54","author":"Delp","year":"2007","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1016\/j.jbiomech.2010.03.008","article-title":"Generalized n-dimensional biomechanical field analysis using statistical parametric mapping","volume":"43","author":"Pataky","year":"2010","journal-title":"J. Biomech."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1093\/rheumatology\/39.9.955","article-title":"Range of joint motion and disability in patients with osteoarthritis of the knee or hip","volume":"39","author":"Steultjens","year":"2000","journal-title":"Rheumatology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/S0003-9993(95)80510-9","article-title":"Bilateral gait patterns in subjects fitted with a total hip prosthesis","volume":"76","author":"Loizeau","year":"1995","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1002\/acr.21806","article-title":"Muscle weakness in hip osteoarthritis: A systematic review","volume":"65","author":"Loureiro","year":"2013","journal-title":"Arthritis. Care Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.pain.2004.03.035","article-title":"Pain-related fear and daily functioning in patients with osteoarthritis","volume":"110","author":"Heuts","year":"2004","journal-title":"Pain"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1136\/ard.61.8.687","article-title":"Investigation of hip abductor activation in subjects with clinical unilateral hip osteoarthritis","volume":"61","author":"Sims","year":"2002","journal-title":"Ann. Rheum. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.clinbiomech.2019.05.007","article-title":"No difference in gait kinematics or kinetics between limbs in bilateral total hip replacement patients at long-term follow-up","volume":"67","author":"Gallagher","year":"2019","journal-title":"Clin. Biomech."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.bspc.2018.01.013","article-title":"Gait symmetry measures: A review of current and prospective methods","volume":"42","author":"Viteckova","year":"2018","journal-title":"Biomed. Signal Process. Control."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1475-925X-6-26","article-title":"Computation of the kinematics and the minimum peak joint moments of sit-to-stand movements","volume":"6","author":"Yoshioka","year":"2007","journal-title":"Biomed. Eng. Online"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Sanchez-Adams, J., Leddy, H.A., McNulty, A.L., O\u2019Conor, C.J., and Guilak, F. (2014). The mechanobiology of articular cartilage: Bearing the burden of osteoarthritis. Curr. Rheumatol. Rep., 16.","DOI":"10.1007\/s11926-014-0451-6"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.berh.2005.09.007","article-title":"Osteoarthritis: Epidemiology","volume":"20","author":"Arden","year":"2006","journal-title":"Best Pract. Res. Clin. Rheumatol."}],"container-title":["Symmetry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-8994\/13\/5\/768\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:54:52Z","timestamp":1760162092000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-8994\/13\/5\/768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,28]]},"references-count":50,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["sym13050768"],"URL":"https:\/\/doi.org\/10.3390\/sym13050768","relation":{},"ISSN":["2073-8994"],"issn-type":[{"type":"electronic","value":"2073-8994"}],"subject":[],"published":{"date-parts":[[2021,4,28]]}}}