Asymmetries and relationships between muscle strength, proprioception, biomechanics, and postural stability in patients with unilateral knee osteoarthritis

Zeng, Ziquan; Shan, Jiaxin; Zhang, Yilong; Wang, Yi; Li, Congcong; Li, Junyi; Chen, Weijian; Ye, Zixuan; Ye, Xiangling; Chen, Zehua; Wu, Zugui; Zhao, Chuan-Xi; Xu, Xuemeng

doi:10.3389/fbioe.2022.922832

Cited by 9 publications

(11 citation statements)

References 79 publications

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“…Previous studies also showed sagittal plane biomechanics, rather than the knee adduction moment, appear to be more relevant in ACLR patients. 31 The Strengths and Limitations of this Study Our study revealed that the ACLR knees face a more challenging knee kinematics environment during fast walking. Furthermore, this finding may provide a practical method for researchers and clinicians to identify gait asymmetries of ACLR patients in fast walking status.…”

Section: Coronal Planementioning

confidence: 84%

“…We only found significant differences in the ROM of adduction and abduction during normal and slow walking speeds. Previous studies also showed sagittal plane biomechanics, rather than the knee adduction moment, appear to be more relevant in ACLR patients 31 …”

Section: Discussionmentioning

confidence: 96%

“…It has been reported that such gait asymmetry may increase the risk of KOA or reinjuries. 31,33 Author Contributions H uahao Lai: Writing, methodology. Xiaoling Chen: Writing, investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, we found that more feelings of discomfort and walking kinematic asymmetries of ACLR patients were found in fast walking. It has been reported that such gait asymmetry may increase the risk of KOA or reinjuries 31,33 …”

Section: Discussionmentioning

confidence: 99%

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Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?

Lai,

Chen,

Huang

et al. 2024

Orthopaedic Surgery

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ObjectiveKnee kinematic asymmetries after anterior cruciate ligament reconstruction (ACLR) are correlated with poor clinical outcomes, such as the progression of knee cartilage degenerations or reinjuries. Fast walking in patients with knee conditions may exacerbate knee kinematic asymmetries, but its impact on ACLR patients is uncertain. The aim of this study is to investigate if fast walking induces more knee kinematic asymmetries in unilateral ACLR patients.MethodsThis cross‐sectional study enrolled 55 patients with unilateral ACLR from January 2020 to July 2022. There were 48 males and seven females with an average age of 30.6 ± 6.4 years. Knee kinematic data were collected at three walking speeds: self‐selected, fast (150% normal), and slow (50% normal). A 3D knee kinematic analysis system measured the data, and self‐reported outcomes assessed comfort levels during walking. We used SPM1D for two‐way repeated ANOVA and posthoc paired t‐tests to analyze kinematic differences in groups.ResultsIn fast walking, ACLR knees exhibited more transverse kinematic asymmetries than intact knees, including greater external rotation angle (1.8°, 38%–43%; gait cycle [GC], p < 0.05 & 1.8–2.7°, 50%–61% GC, p < 0.05) and increased proximal tibial translation (2.1–2.5 mm, 2%–6% GC, p < 0.05 & 2.5–3.2 mm, 92%–96% GC, p < 0.05). Additionally, ACLR knees showed greater posterior tibial translation than intact knees (3.6–3.7 mm, 7%–8% GC, p < 0.05) during fast walking. No posterior tibial translation asymmetries were observed in slow walking compared to normal walking levels. ACLR knees have the most comfortable feelings in slow walking speed, and the most uncomfortable feelings in fast walking speed levels (29%).ConclusionsFast walking induces additional external tibial rotation and proximal and posterior tibial translation asymmetries in ACLR patients. This raises concerns about long‐term safety and health during fast walking. Fast walking, not self‐selected speed, is beneficial for identifying postoperative gait asymmetries in ACLR patients.

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Section: Coronal Planementioning

confidence: 84%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?

Lai,

Chen,

Huang

et al. 2024

Orthopaedic Surgery

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“…This idea is not simplistic and will involve careful analysis if the goal is to avert possible knee extensor muscle weaknesses from increasing the risk of developing or perpetuating knee osteoarthritis in both men and women [36][37][38][39]. Why this weakness tends to be asymmetrical from side to side in unilateral cases, and the specific influence of proprioception changes, stability deficits, joint range of motion factors, intra-articular sensory neurons, pain and associated muscle compensatory responses, and joint biomechanics, along with muscle cross sectional area ratio measures and their independent or collective presence appear to impact on the severity of osteoarthritis-related morphological changes at the knee should also not be overlooked [31,[40][41][42][43]. Indeed, careful analyses have revealed that quadriceps muscle weakness is found to be consistently associated with the measure of patella alta and bone marrow lesions in patella femoral knee osteoarthritis cases DOI: https://doi.org/10.46889/JOSR.2022.3307 [44].…”

Section: Key Findingsmentioning

confidence: 99%

Quadriceps Muscle Mechanics and Knee Osteoarthritis - A 2022 Update

Marks¹

2022

JOSR

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Background: Knee joint osteoarthritis is a highly disabling disease with no distinct cause that persists unabated despite decades of research. Among the various possible causes and factors that influence the progression of the disease other than age and trauma may be various forms of muscle dysfunction, especially among the key knee extensor muscle group known as the quadriceps femoris. Aim: This narrative review strove to examine some pertinent past and recent 2022 research highlights in this respect and to offer possible research recommendations in this regard. Methods: To achieve the review aims, the PUBMED data base and others housing reports aligned with this topic was searched using the key words knee osteoarthritis and quadriceps/knee extensor muscles. Pertinent 2022 and related data were carefully examined and the study researchers’ approaches, conclusions, and recommendations were duly recorded. Results: Many diverse studies within the desired topical theme prevail, rendering it challenging to discern or extract any meaningful trend or conceptuality sound deterministic theory of causation or pathogenic osteoarthritis insights. Even in the realm where multiple publications are available on a single theme, conclusions and design approaches remain inconsistent and of possible moderate quality at best. Conclusion: Efforts to examine and intervene to avert one or more manifestations of quadriceps muscle dysfunction may prove to be highly important in the realm of favorably influencing or minimizing excess osteoarthritis knee joint dysfunction, regardless of whether knee extensor muscle dysfunction is a reactive, rather than a causative factor, but requires a more profound evidence base.

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Analysis of Postural Control in Patients Diagnosed with Unilateral Knee Osteoarthrosis and Its Relationship with the Risk of Falls

de Freitas,

Vieira

et al. 2023

Advances in Orthopedics

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Introduction. Knee osteoarthrosis, whether subtle or marked, appears to alter the stability and performance of the knee joint in activities of daily living that prevent the maintenance of bipedal posture. However, there is still a gap in the literature as to how knee osteoarthritis can affect static balance. Objective. To analyze the performance of postural control in elderly diagnosed with unilateral knee osteoarthrosis. Materials and Methods. 40 elderly people of both sexes participated in this study, divided into two groups containing 20 elderly each. Group 1 (G1) consists of elderly patients who have received a diagnosis of unilateral knee osteoarthritis. Despite undergoing conservative treatment, their condition has shown insufficient improvement, leading to a clinical recommendation for total knee arthroplasty (TKA). The G2 group was made up of 20 elderly with an average age of 71.09 years, considered active, who do not have a diagnosis of osteoarthritis in the knee joint and practice physical activity. With the aid of a Baroscan pressure platform, the center of pressure (COP) displacement in the anteroposterior (COPAP) direction and mediolateral direction (COPML) and the area of center of pressure displacement were evaluated during bipedal postural control with eyes open and eyes closed. Results. During postural control with eyes open and eyes closed, the G1 group showed greater displacement of the COP in the anteroposterior direction—COPAP ( p = 0.007 )—and mediolateral direction—COPML ( p = 0.033 )—when compared to the G2 group. As for the area of displacement of the COP, group G1 presented a larger area of displacement ( p = 0.002 ) than group G2 during bipedal postural control with open eyes. For the condition with eyes closed, both groups showed similar behaviors, which resulted in no present statistically significant differences. Conclusion. The results suggest that unilateral knee osteoarthritis influences bipedal postural control and activities of daily living that require this static balance, since information from the somatosensory system is reduced, resulting in stability of tasks that require body control and promoting the risk of falls. From a clinical perspective, the results suggest that the assessment of bipedal postural control can assist orthopedic physicians in assessing joint stability in patients with unilateral knee osteoarthrosis.

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Asymmetries and relationships between muscle strength, proprioception, biomechanics, and postural stability in patients with unilateral knee osteoarthritis

Cited by 9 publications

References 79 publications

Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?

Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?

Quadriceps Muscle Mechanics and Knee Osteoarthritis - A 2022 Update

Analysis of Postural Control in Patients Diagnosed with Unilateral Knee Osteoarthrosis and Its Relationship with the Risk of Falls

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