Objective: Stand-to-sit task is an important daily function, but there is a lack of research evidence on whether knee osteoarthritis (knee OA) affects the postural balance during the task. This study aimed to compare individuals with knee OA and asymptomatic controls in postural balance and identify kinematic and lower extremity muscle activity characteristics in individuals with knee OA during the stand-to-sit task.Methods: In total, 30 individuals with knee OA and 30 age-matched asymptomatic controls performed the 30-s Chair Stand Test (30sCST) at self-selected speeds. Motion analysis data and surface electromyography (sEMG) were collected while participants performed the 30sCST. To quantify postural balance, the displacement of the center of mass (CoM) and the peak instantaneous velocity of the CoM were calculated. The kinematic data included forward lean angles of the trunk and pelvic, range of motion (RoM) of the hip, knee, and ankle joints in the sagittal plane. The averaged activation levels of gluteus maximus, vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), tibialis anterior (TA), and medial head of gastrocnemius muscles were indicated by the normalized root mean square amplitudes.Results: Compared with the asymptomatic control group, the knee OA group prolonged the duration of the stand-to-sit task, demonstrated significantly larger CoM displacement and peak instantaneous CoM velocity in the anterior-posterior direction, reduced ankle dorsiflexion RoM, greater anterior pelvic tilt RoM, and lower quadriceps femoris and muscles activation level coupled with higher BF muscle activation level during the stand-to-sit task.Conclusion: This study indicates that individuals with knee OA adopt greater pelvic forward lean RoM and higher BF muscle activation level during the stand-to-sit task. However, these individuals exist greater CoM excursion in the anterior-posterior direction and take more time to complete the task. This daily functional activity should be added to the rehabilitation goals for individuals with knee OA. The knee OA group performs reduced ankle dorsiflexion RoM, quadriceps femoris, and TA activation deficit. In the future, the rehabilitation programs targeting these impairments could be beneficial for restoring the functional transfer in individuals with knee OA.
Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs.Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D).Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion (p = 0.01) decreased, hip flexion (p = 0.02) and trunk lateral tilt (p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side (p = 0.003) and pelvic rotation (p = 0.03) increased, while hip abduction of the swing leg (p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis.Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.
Background Kinesiophobia is an excessive and misunderstood feeling in the osteoarthritis (OA) population, processing acute to subacute diseases and delaying functional recovery. The purpose of this study was to synthesize evidence from randomized controlled trials (RCTs) to evaluate the effectiveness of rehabilitation interventions to reduce kinesiophobia and pain intensity in individuals with OA. Methods A systematic search in 5 electronic databases (PubMed, Web of Science, Cochrane Library, Embase, and CNKI) was performed to identify RCTs comparing rehabilitation interventions with control interventions in OA. It was reported that changes in kinesiophobia and pain intensity were assessed as standardized mean difference (SMD) if outcomes were on the distinct scales with 95% confidence intervals (95% CI). If heterogeneity (I2 > 50%) of the pooled effect is detected, subgroup analysis and sensitivity analysis would be necessary to evaluate the source of heterogeneity and eliminate it. Two independent reviewers assessed methodological quality using the Cochrane Collaboration Risk of Bias Tool. The GRADEpro GDT was used to illustrate the quality of evidence. Results Twelve trials with 830 participants met eligibility criteria and were included in this review. The results demonstrate statistical significant difference favored kinesiophobia concerning the rehabilitation interventions [SMD difference: -0.55 (95% CI, -0.86 to -0.24)], physiotherapy [SMD difference: -0.36 (95% CI, -0.65 to -0.08)], psychotherapy [SMD difference: -1.42 (95% CI, -2.05 to -0.79)]. Also display difference for pain intensity was observed in rehabilitation interventions [SMD difference: -0.22 (95% CI, -0.37 to -0.07)], physiotherapy [SMD difference: -0.29 (95% CI: -0.45 to -0.13)], psychotherapy [SMD difference: -2.45 (95% CI, -3.61 to -1.30)]. Five studies reported adverse effects (n = 57), and only one participant suffered a severe adverse event. Conclusion Concerning OA, rehabilitation interventions were statistically effective for reducing kinesiophobia and pain intensity compared to control interventions. Overall, the degree of evidence was low to moderate.
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