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Seventy-six women completed the 6MWT under MoKA monitoring; pain intensity differed pre- versus post-test and was linked to walking distance and step count. 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\nMaciej Ku´s 1, Dagmara Wasiuk-Zowada 2, *, Katarzyna Herman 3, Jerzy Cholewi ´nski 3 and Andrzej Knapik 4  \nAcademic Editor: Christian Peham  \nReceived: 13 November 2025  \nRevised: 17 December 2025  \nAccepted: 22 December 2025  \nPublished: 25 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Doctoral School, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; [d201139@365.sum.edu.pl](d201139@365.sum.edu.pl)  \n2 Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland  \n3 Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-635 Katowice, Poland; [kherman@sum.edu.pl](kherman@sum.edu.pl) (K.H.); [jcholewinski@sum.edu.pl](jcholewinski@sum.edu.pl) (J.C.)  \n4 Department of Adapted Physical Activity and Sport, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland; [aknapik@sum.edu.pl](aknapik@sum.edu.pl)  \n* Correspondence: [dwasiuk@sum.edu.pl](dwasiuk@sum.edu.pl); Tel.: +48-32-208-87-12  \nAbstract  \nKnee osteoarthritis significantly reduces quality of life due to difficulties with locomotion. The objective assessment of gait parameters can provide guidance for developing therapeutic programs, and wearable sensors are becoming increasingly common for this purpose. The Movement Kinematics Analysis System (MoKA) utilizes the Inertial Measurement Unit, which enables gait analysis in non-laboratory settings. The aim of the study was to determine gait parameters in women scheduled for knee replacement immediately before surgery, along with determining the measurement reliability. Seventy-six women were enrolled in the study (research group n = 25; control group n = 51) . The participants completed the 6MWT with gait monitoring via the MoKA system. A comparison of pain intensity before and after the 6MWT revealed differences in p \u003C 0.001 . A comparison between the groups revealed differences in distance and step count. Pain intensity was negatively correlated with distance (R = −0.44) and the number of steps (R = −0.44), but did not affect the average length of steps (R = 0.05) . The overall consistency assessment (AC) demonstrated good internal consistency. The qualitative ICC assessment indicated moderate reliability for three measurements, good for one, and excellent for the remaining measurements. It can be assumed that the assessment of biomechanical gait parameters using a system equipped with an IMU meets the criteria for measurement reliability. The gait of women with KOA scheduled for total knee replacement surgery is flattened and slowed, which may provide guidance for the use of appropriate postoperative exercises to achieve appropriate gait biomechanics.  \nKeywords: knee osteoarthritis; 6MTW; IMU; gait analysis  \n1. Introduction  \nOsteoarthritis (OA) is a common musculoskeletal disorder with a global reach, which, together with its frequency, places a significant burden on healthcare systems [1–3] . Age is a significant factor influencing the occurrence of degenerative changes—it is estimated that it affects 35% of the population over 65 years of age with varying degrees of symptom severity [4,5] . OA is currently believed to be caused by a complex interaction of genetic,  \ncellular, biomechanical, and immunological factors that lead to a loss of physiological balance between the catabolic and anabolic processes occurring in joint cartilage and other joint components [6] . Some authors explicitly associate OA with a metabolic syndrome and demonstrate a similar course of the disease in terms of the presence of cytokines and factors characteristic of chr","cbCaiqTQVwOjoOZF","https://ap.wps.com/l/cbCaiqTQVwOjoOZF","pdf",768850,12,"English","# Abstract\n# Introduction\n## Knee osteoarthritis and disease burden\n## Risk factors and exercise therapy\n## Assessment methods and need for objective gait analysis","[{\"question\":\"What is the MoKA system used for in this study?\",\"answer\":\"MoKA is used to perform gait analysis using an inertial measurement unit, enabling assessment in non-laboratory settings during functional walking.\"},{\"question\":\"How were participants assessed in the study?\",\"answer\":\"Seventy-six women completed the 6MWT while their gait was monitored using the MoKA system, allowing comparisons of pain and gait parameters.\"},{\"question\":\"What did the reliability analyses show?\",\"answer\":\"Overall consistency (AC) indicated good internal consistency, while qualitative ICC results showed moderate reliability for three measurements, good for one, and excellent for the remaining measurements.\"}]","Gait Parameters of Women Before Knee Joint Arthritis - Analysis Using the MoKA System | PDF",1790766277]