Abstract
We performed physical therapy for a patient with osteoarthritis of the knee accompanied by lumbar spondylosis. This patient had extension limitation of the knee joint and pain in the lower left back as well as in the inside of left knee joint while walking. The patient's problem while walking was caused by lateral thrust, which in turn was causing lateral bending of the trunk towards the stance side during the phase from left heel contact to mid-stance. Moreover, increasing the workload of the lower back muscles reduced the extension movement of the knee joint during the phase from left mid-stance to toe-off. Therefore, we considered that extension limitation of the knee joint has marked effects on trunk alignment while walking. The patient was asked to perform weight-shifting and stepping exercises because we believe that physical therapy brings about an improvement in the extension movement of the knee joint and alleviate the pain in the lower back and knee joint. After 2 weeks of physical therapy, this patient's lateral thrust improved during the phase from left heel contact to mid-stance. Furthermore, the extension movement of the knee joint improved, thereby reducing the work load of lower back muscles during the phase from left mid-stance to toe-off. The patient was able to walk without any pain in the lower back and knee joint because she was made to perform weight-shifting and stepping exercises in order to achieve trunk alignment as well as to correct the extension limitation of the knee joint and restore its function by facilitation of the quadriceps femoris. It is important to take into account the relationship between the knee joint and trunk alignment when attempting to correct the gait of a patient with osteoarthritis of the knee.
