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• W2800532370 abstract "Purpose: Knee joint buckling, shifting or giving way is self-reported in 60–80% of individuals with knee osteoarthritis (OA) and these sensations are often felt during walking. Previous work has indicated individuals who self-report instabilities, demonstrate altered biomechanics during weight-bearing tasks. Altered mechanics may be a strategy to counteract sensations of instability, or, conversely these alterations may create an environment where instability is more likely. Either way, an interrelationship between the passive osteoligamentous, muscular and neural subsystems remain integral to joint function. The purpose of this investigation is to understand if kinematic, kinetic or muscle activation differences occur between individuals with knee OA who self-report stable versus unstable knees. Methods: Seventy-two participants with medial compartment moderate knee OA, defined using functional and radiographic criteria were recruited. Participants were grouped based on the Knee Outcome Survey instability score. Twenty participants reported having no instability (OA Stable [OAS], instability score = 5) and 21 participants reported instability that moderately to severely impacted their daily function (OA Unstable [OAU], instability score <3). The remaining subjects were excluded from analysis. Surface electromyograms (EMG) were acquired from quadriceps (VM, VL, RF), hamstrings (MH, LH) and gastrocnemius (MG, LG) using an AMT-8TM EMG measurement system (Bortec Inc.) Passive retro-reflective markers were place on bony landmarks and rigid segments using standardized procedures. Participants walked barefoot on a dual-belt, instrumented treadmill (R-Mill, Motekforce Link) at a self-selected walking speed, while marker motions (QualysisTM), muscle activations and ground reaction forces were recorded. Electromyograms were low-passed filtered and amplitude normalized to maximum voluntary contractions. Knee angles and net external moments were calculated. Principal component analysis was used to extract features of variability from EMG waveforms. Principal Pattern (PP) scores were calculated. Student’s t-test determined group differences for discrete biomechanical measures and Analysis of Variance models tested for PP-score main effects and interactions (alpha = 0.05). Post hoc testing was employed using Bonferonni procedures. Results: No group differences were identified in age, body mass index, walking velocity, knee extension or flexion strength. The OAU group demonstrated worse Knee Osteoarthritis Outcome Scores compared to the OAS group. Both OAS and OAU demonstrated similar knee motions during stance, and demonstrated no difference in peak adduction moment. The difference between peak flexion and extension moments was less in the OAU group compared to the OAS group (Figure 1A). Greater quadriceps (Figure 1B) and hamstring (Figure 1C) muscle activation (PP1-scores) during walking was also found in the OAU compared to the OAS group. No significant differences were identified in gastrocnemius muscle activation between groups. Similarly, no temporal features demonstrated statistical significance between the two groups.TableDemographics, walking velocity, self-reported survey scores and strength values for both groupsVariableOAU(KOS = 5)OAS(KOS < 3)n2120Age61(7)65(5)BMI29.2(4.4)27.6(4.6)Walking velocity1.02(0.12)1.09(0.13)KOOS-Symptoms54.3(10.87)*70.7(12.4)*KOOS-Pain58.6(18.4)*70.0(16.5)*KOOS-Activities of daily living58.4(21.1)*80.4(15.5)*KOOS-Quality of life36.6(14.0)*54.4(14.8)*Knee extension strength (Nm)100.2(43.6)119.4(32.8)Knee flexion strength (Nm)62.4(28.8)73.1(21.8) Open table in a new tab Conclusions: Individuals who self-reported knee joint instability also recounted more pain, symptoms, difficulties with daily activities and reduced quality of life. The OAU and OAS group demonstrate similar joint motions, indicating that both groups walk with similar kinematics. A less dynamic sagittal plane moment in the OAU group, provides evidence that in order to maintain kinematics, the OAU group may relying on compensations from other subsystems. An elevated contribution from the neuromuscular subsystem is demonstrated with higher PP1-scores for both the hamstrings and quadriceps in the OAU group. This elevated muscle activation, along with reduced sagittal plane moment dynamics suggests individuals who self-report sensations of instability maybe adopting a “stiffening” strategy to maintain stability during walking." @default.
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• W2800532370 date "2018-04-01" @default.
• W2800532370 modified "2023-09-26" @default.
• W2800532370 title "The impact of self-reported knee joint instability on walking mechanics in individuals with moderate knee osteoarthritis" @default.
• W2800532370 doi "https://doi.org/10.1016/j.joca.2018.02.726" @default.
• W2800532370 hasPublicationYear "2018" @default.
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