{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:29:41Z","timestamp":1792805381761,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Faculty of Allied Health Sciences, Thammasat University Research Fund","award":["2559"],"award-info":[{"award-number":["2559"]}],"id":[{"id":"https:\/\/ror.org\/002yp7f20","id-type":"ROR","asserted-by":"crossref"}]},{"award":["2559"],"award-info":[{"award-number":["2559"]}],"id":[{"id":"https:\/\/ror.org\/002yp7f20","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Thammasat University Research Unit in Health, Physical Performance, Movement, and Quality of Life for Longevity Society","id":[{"id":"https:\/\/ror.org\/002yp7f20","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/002yp7f20","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFMK"],"abstract":"<jats:p>Background: Knee osteoarthritis (KOA) is a major cause of pain, mobility limitation, and increased fall risk among older adults. Gait dysfunction, characterized by spatiotemporal and kinematic alterations, is a key functional consequence of KOA. While sagittal-plane gait deviations are well-established, multiplanar kinematic changes\u2014particularly in the frontal and transverse planes\u2014remain less clearly understood. This study aimed to compare three-dimensional gait characteristics between older adults with and without KOA. Methods: Ninety older adults (45 with KOA and 45 controls) completed gait assessments using a VICON\u2122 motion capture system. Participants walked at a self-selected speed along a straight walkway without turning movements during data collection. Spatiotemporal parameters and lower-limb joint kinematics (hip, knee, and ankle) were recorded during key gait phases: initial contact, mid-stance, toe-off, and mid-swing. Group comparisons were performed using independent t-tests with statistical significance set at p &lt; 0.05. Results: Compared with controls, participants with KOA demonstrated significantly slower gait velocity (p = 0.001), reduced cadence (p = 0.020), shorter stride length (p = 0.011), increased step time (p = 0.006), prolonged double support time (p = 0.009), and reduced single support time (p = 0.012). Kinematic analysis revealed greater knee adduction at initial contact (p = 0.001), reduced hip adduction (p = 0.002) and greater knee adduction (p = 0.003) during mid-stance, and increased ankle plantarflexion at toe-off (p = 0.004) in the KOA group. No significant between-group differences were observed during the mid-swing phase. Conclusions: Older adults with KOA exhibit distinct spatiotemporal and multiplanar kinematic gait alterations, particularly during weight-bearing phases. These changes may reflect adaptive gait patterns associated with joint dysfunction rather than definitive compensatory mechanisms. Three-dimensional gait analysis may provide valuable biomechanical insights to support early identification of mobility impairments and inform targeted rehabilitation planning in individuals with KOA.<\/jats:p>","DOI":"10.3390\/jfmk11020137","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:50:15Z","timestamp":1774533015000},"page":"137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Altered Spatiotemporal and Kinematic Gait in Patients with Knee Osteoarthritis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9286-7880","authenticated-orcid":false,"given":"Plaiwan","family":"Suttanon","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani 12121, Thailand"},{"name":"Thammasat University Research Unit in Health, Physical Performance, Movement and Quality of Life for Longevity Society, Thammasat University, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2583-0653","authenticated-orcid":false,"given":"Praewpun","family":"Saelee","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3045-157X","authenticated-orcid":false,"given":"Sudarat","family":"Apibantaweesakul","sequence":"additional","affiliation":[{"name":"Thammasat University Research Unit in Health, Physical Performance, Movement and Quality of Life for Longevity Society, Thammasat University, Pathum Thani 12121, Thailand"},{"name":"Department of Sports Science and Sports Development, Faculty of Allied Health Sciences, Thammasat University, Pathum Thani 12121, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e508","DOI":"10.1016\/S2665-9913(23)00163-7","article-title":"Global, regional, and national burden of osteoarthritis, 1990\u20132020 and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021","volume":"5","author":"Steinmetz","year":"2023","journal-title":"Lancet Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Chen, Y., Wang, Z., Xu, Z., and Chen, L. (2025). Rising tides of knee osteoarthritis: Global trends and regional disparities among middle-aged and elderly populations from 1990 to 2021 and its prediction to 2035. Front. Musculoskelet. Disord., 3.","DOI":"10.3389\/fmscd.2025.1619798"},{"key":"ref_3","unstructured":"World Health Organization (2025, October 15). Osteoarthritis: Key Facts. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/osteoarthritis#:~:text=Key%20facts,to%20continue%20to%20increase%20globally."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.joca.2012.09.012","article-title":"Osteoarthritis as a disease of mechanics","volume":"21","author":"Felson","year":"2013","journal-title":"Osteoarthr. Cartil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e32642","DOI":"10.1016\/j.heliyon.2024.e32642","article-title":"Biomechanical changes in lower extremity in individuals with knee osteoarthritis in the past decade: A scoping review","volume":"10","author":"Yang","year":"2024","journal-title":"Heliyon"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"32061","DOI":"10.1038\/s41598-025-17398-z","article-title":"Three-Dimensional gait biomechanics in patients with mild knee osteoarthritis","volume":"15","author":"Pan","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Pan, J., Xie, Z., Shen, H., Huang, Z., Zhang, X., and Liao, B. (2025). The effect of mild to moderate knee osteoarthritis on gait and three-dimensional biomechanical alterations. Front. Bioeng. Biotechnol., 13.","DOI":"10.3389\/fbioe.2025.1562936"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.gaitpost.2023.08.005","article-title":"Spatiotemporal and kinematic gait analysis in patients with knee osteoarthritis and femoral varus deformity","volume":"105","author":"Dai","year":"2023","journal-title":"Gait Posture"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.jbiomech.2007.10.016","article-title":"Gait and neuromuscular pattern changes are associated with differences in knee osteoarthritis severity levels","volume":"41","author":"Astephen","year":"2008","journal-title":"J. Biomech."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1186\/s13075-023-03179-4","article-title":"Association of knee and hip osteoarthritis with the risk of falls and fractures: A systematic review and meta-analysis","volume":"25","author":"Zhang","year":"2023","journal-title":"Arthritis Res. Ther."},{"key":"ref_11","first-page":"281","article-title":"Risk Factors for Falls in People with Knee Osteoarthritis: Systematic Review","volume":"62","author":"Saelee","year":"2018","journal-title":"Vajira Med. J. J. Urban Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1589\/jpts.34.140","article-title":"Gait cycle time variability in patients with knee osteoarthritis and its possible associating factors","volume":"34","author":"Akimoto","year":"2022","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1002\/acr.22015","article-title":"Biomechanical deviations during level walking associated with knee osteoarthritis: A systematic review and meta-analysis","volume":"65","author":"Mills","year":"2013","journal-title":"Arthritis Care Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e36931","DOI":"10.1016\/j.heliyon.2024.e36931","article-title":"Comparison of Knee Biomechanical Characteristics during Gait between Patients with Knee Osteoarthritis and Healthy Individuals","volume":"10","author":"Zhang","year":"2024","journal-title":"Heliyon"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Agathos, C.P., Velisar, A., and Shanidze, N.M. (2023). A Comparison of walking behavior during the instrumented TUG and habitual gait. Sensors, 23.","DOI":"10.3390\/s23167261"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Cheng, L.-Y., Chien, Y.-C., Lin, T.-T., Lin, J.-Y., Cheng, H.-T., Chang, C.-W., Chen, S.-F., and Wang, F.-C. (2025). Assessment of gait and balance in elderly individuals with knee osteoarthritis using inertial measurement units. Sensors, 25.","DOI":"10.3390\/s25206288"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Gianzina, E., Yiannakopoulos, C.K., Kalinterakis, G., Delis, S., and Chronopoulos, E. (2025). Evaluation of the Timed Up and Go Test in patients with knee osteoarthritis using inertial sensors. Int. J. Transl. Med., 5.","DOI":"10.20944\/preprints202411.1360.v1"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1007\/s10067-007-0560-y","article-title":"Validation of a modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis","volume":"26","author":"Kuptniratsaikul","year":"2007","journal-title":"Clin. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.gaitpost.2009.05.020","article-title":"The gait profile score and movement analysis profile","volume":"30","author":"Baker","year":"2009","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/0141-1195(86)90098-7","article-title":"A Fortran package for generalized, cross-validatory spline smoothing and differentiation","volume":"8","author":"Woltring","year":"1986","journal-title":"Adv. Eng. Softw. (1978)"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Zieli\u0144ski, G. (Arch. Phys. Med. Rehabil., 2026). Getting to know pain effect sizes\u2014Guidelines for effect size and sample size in global pain research, Arch. Phys. Med. Rehabil., in press.","DOI":"10.1016\/j.apmr.2026.01.006"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1002\/acr.20248","article-title":"Individuals with severe knee osteoarthritis (OA) exhibit altered proximal walking mechanics compared with individuals with less severe OA and those without knee pain","volume":"62","author":"Hunt","year":"2010","journal-title":"Arthritis Care Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1053\/joca.2002.0797","article-title":"Increased knee joint loads during walking are present in subjects with knee osteoarthritis","volume":"10","author":"Baliunas","year":"2002","journal-title":"Osteoarthr. Cartil."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"110538","DOI":"10.1016\/j.jbiomech.2021.110538","article-title":"The effects of knee pain on knee contact force and external knee adduction moment in patients with knee osteoarthritis","volume":"123","author":"Yamagata","year":"2021","journal-title":"J. Biomech."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1002\/jor.20718","article-title":"Proximal gait adaptations in medial knee OA","volume":"27","author":"Briem","year":"2009","journal-title":"J. Orthop. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/S0268-0033(00)00007-3","article-title":"The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain","volume":"15","author":"Robon","year":"2000","journal-title":"Clin. Biomech."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mezghani, N., Mechmeche, I., Mitiche, A., Ouakrim, Y., and de Guise, J.A. (2018). An analysis of 3D knee kinematic data complexity in knee osteoarthritis and asymptomatic controls. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0202348"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jor.2023.12.011","article-title":"Gait variability and biomechanical distinctions in knee osteoarthritis: Insights from a 3D analysis in an adult elderly cohort","volume":"49","author":"Tanpure","year":"2024","journal-title":"J. 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