Alterations in lower extremity movement and muscle activation patterns in individuals with knee osteoarthritis

Childs, John D.; Sparto, Patrick J.; Fitzgerald, G. Kelley; Bizzini, Mario; Irrgang, James J.

doi:10.1016/j.clinbiomech.2003.08.007

Cited by 298 publications

(322 citation statements)

References 8 publications

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“…These results suggest that muscle strength is required for successful joint stabilization and maintenance of physical functioning. A large body of literature exists demonstrating altered walking patterns (e.g., higher quadriceps and hamstrings activation and less knee excursion) in knee OA patients (3,(5)(6)(7)(8)(9)(10)(11)(12)(13), presumably as a strategy to stabilize the knee joint despite impairments in proprioceptive accuracy and laxity. These altered walking patterns further suggest a key role of the muscles in maintaining knee stability.…”

Section: Knoop Et Almentioning

confidence: 99%

“…Knee OA patients reporting knee instability have more severe activity limitations (2,4) than knee OA patients without this sensation. Self-reported knee instability has been linked to higher pain levels (1), higher rates of falling (1), and altered walking patterns (3,(5)(6)(7)(8)(9)(10)(11)(12)(13), and has been suggested to be a cause of knee OA onset and progression (7,13). Causes of knee instability are still unknown and need to be identified.…”

Section: Introductionmentioning

confidence: 99%

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Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Knoop¹,

Leeden²,

Esch³

et al. 2011

Arthritis Care & Research

106

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Objective. To determine whether muscle strength, proprioceptive accuracy, and laxity are associated with self-reported knee instability in a large cohort of knee osteoarthritis (OA) patients, and to investigate whether muscle strength may compensate for impairment in proprioceptive accuracy or laxity, in order to maintain knee stability. Methods. Data from 283 knee OA patients from the Amsterdam Osteoarthritis cohort were used. Univariable and multivariable logistic regression analyses were performed to assess the association between muscle strength, proprioceptive accuracy (motion sense), frontal plane varus-valgus laxity, and self-reported knee instability. Additionally, effect modification between muscle strength and proprioceptive accuracy and between muscle strength and laxity was determined. Results. Self-reported knee instability was present in 67% of the knee OA patients and mainly occurred during walking. Lower muscle strength was significantly associated with the presence of self-reported knee instability, even after adjusting for relevant confounding. Impaired proprioceptive accuracy and high laxity were not associated with self-reported knee instability. No effect modification between muscle strength and proprioceptive accuracy or laxity was found. Conclusion. Lower muscle strength is strongly associated with self-reported knee instability in knee OA patients, while impairments in proprioceptive accuracy and laxity are not. A compensatory role of muscle strength for impaired proprioceptive accuracy or high laxity, in order to stabilize the knee, could not be demonstrated.

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Section: Knoop Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Knoop¹,

Leeden²,

Esch³

et al. 2011

Arthritis Care & Research

106

View full text Add to dashboard Cite

show abstract

“…Doorenbosch and Harlaar showed that there is increased cocontraction in patients with lesions of the anterior cruciate ligament as compared with healthy control subjects (2). Likewise, differences in muscle activity patterns, including significant increases in co-contraction, have been reported during walking in patients with OA of the knee when compared with age-and sex-matched controls (3,4). We believe that Lewek et al rightly conclude that antagonist muscle co-contraction is used to stabilize the knee joint in the absence of adequate stabilization by the passive restraint system (ligaments and capsule) of the knee.…”

Section: To the Editormentioning

confidence: 73%

The pros and cons of muscle co‐contraction in osteoarthritis of the knee: Comment on the article by Lewek et al

Steultjens¹,

Dekker²

2006

Arthritis & Rheumatism

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“…Since one of the important biomechanical functions of the knee is to act as a shock absorber during the loading phase (0 -12% of gait cycle) by controlling knee flexion, the early stance knee ROM measure provides information about any restriction in the knee flexion motion (30). Knee flexion/ extension impulse was calculated as the cumulative magnitude of the time-integral external knee flexion and extension moments (normalized to % of body weight ϫ height) throughout the stance phase (i.e., the total area under the curve, as indicated in Figure 2) (20). Several studies have used the knee impulse previously as a useful gait parameter (31,32).…”

Section: Significance and Innovationsmentioning

confidence: 99%

“…Altered gait pattern is often observed in people with knee OA (20,21). Pain associated with knee OA has been thought to result in gait modification as an attempt to reduce the load on the affected joint, with studies reporting changes in joint loading as a response to pain relief (22)(23)(24), or pain induction in experimental trials (25,26).…”

Section: Introductionmentioning

confidence: 99%

Association between skeletal muscle inflammatory markers and walking pattern in people with knee osteoarthritis

Levinger

Caldow

Feller

et al. 2011

Arthritis Care & Research

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Objective. Patients with knee osteoarthritis (OA) are characterized by increased muscle inflammation and altered gait. We investigated the association between proinflammatory mediators in the vastus lateralis and physical function and gait in patients with knee OA. Methods. Nineteen patients with knee OA underwent gait analysis, assessment of self-reported pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and a muscle biopsy that was taken during their knee replacement surgery. Muscle was analyzed for cellular protein inflammatory mediators, interleukin-6, monocyte chemotactic protein 1 (MCP-1), p65 NF-B, signal transducer and activator of transcription 3 (STAT-3), and JNK-1. Sagittal plane knee function, including early stance knee range of motion (ROM) and knee sagittal plane impulse, was measured using a motion analysis system. Pearson's correlation was used to assess relationships between selected variables. Results. Significant positive correlations were found between MCP-1 and self-perceived stiffness, physical function, and the total WOMAC score (P < 0.05). MCP-1 was also negatively correlated with early stance knee ROM (r ‫؍‬ ؊0.52, P ‫؍‬ 0.023). Reduced velocity was associated with elevated levels of p65 NF-B and STAT-3 (P < 0.05). Knee sagittal plane impulse was negatively correlated with JNK-1 (P ‫؍‬ 0.02), indicating reduction in knee impulse with an increased level of JNK-1. Conclusion. Increased levels of several proinflammatory mediators were correlated with altered knee function during walking as well as greater physical disability and slower gait velocity. Identification of the cellular and molecular mechanisms associated with muscle inflammation is important to better understand the underlying mechanism responsible for altered gait and function in patients with knee OA.

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Alterations in lower extremity movement and muscle activation patterns in individuals with knee osteoarthritis

Cited by 298 publications

References 8 publications

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

The pros and cons of muscle co‐contraction in osteoarthritis of the knee: Comment on the article by Lewek et al

Association between skeletal muscle inflammatory markers and walking pattern in people with knee osteoarthritis

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