Muscle stabilization strategies in people with medial knee osteoarthritis: The effect of instability
The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stabilit...
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| Published in | Journal of orthopaedic research Vol. 26; no. 9; pp. 1180 - 1185 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
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01.09.2008
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| Abstract | The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (n = 10) and OA Unstable (OAU) (n = 10) based on self‐reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self‐reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1180–1185, 2008 |
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| AbstractList | The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (
n
= 10) and OA Unstable (OAU) (
n
= 10) based on self-reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self-reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (n = 10) and OA Unstable (OAU) (n = 10) based on self‐reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self‐reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1180–1185, 2008 The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) ( n = 10) and OA Unstable (OAU) ( n = 10) based on self‐reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self‐reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:1180–1185, 2008 The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (n = 10) and OA Unstable (OAU) (n = 10) based on self-reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self-reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (n = 10) and OA Unstable (OAU) (n = 10) based on self-reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self-reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research.The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee stabilization strategies is unknown. This study investigated the influence of knee instability on muscle activation during walking when knee stability was challenged. Twenty people with medial knee OA participated and were grouped as OA Stable (OAS) (n = 10) and OA Unstable (OAU) (n = 10) based on self-reported knee instability during daily activities. Quadriceps strength, passive knee laxity, and varus alignment were assessed and related to knee instability and muscle cocontraction during walking when the support surface translated laterally. Few differences in knee joint kinematics between the groups were seen; however, there were pronounced differences in muscle activation. The OAU group used greater medial muscle cocontraction before, during, and following the lateral translation. Self-reported knee instability predicted medial muscle cocontraction, but medial laxity and limb alignment did not. The higher muscle cocontraction used by the OAU subjects appears to be an ineffective strategy to stabilize the knee. Instability and high cocontraction can be detrimental to joint integrity, and should be the focus of future research. |
| Author | Schmitt, Laura C. Rudolph, Katherine S. |
| AuthorAffiliation | 1 University of Cincinnati College of Medicine, Sports Medicine Biodynamics Center, Occupational Therapy and Physical Therapy Department, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229 2 Department of Physical Therapy and Program in Biomechanics and Movement Science, University of Delaware, 301 McKinly Lab, Newark, Delaware 19716 |
| AuthorAffiliation_xml | – name: 2 Department of Physical Therapy and Program in Biomechanics and Movement Science, University of Delaware, 301 McKinly Lab, Newark, Delaware 19716 – name: 1 University of Cincinnati College of Medicine, Sports Medicine Biodynamics Center, Occupational Therapy and Physical Therapy Department, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229 |
| Author_xml | – sequence: 1 givenname: Laura C. surname: Schmitt fullname: Schmitt, Laura C. organization: University of Cincinnati College of Medicine, Sports Medicine Biodynamics Center, Occupational Therapy and Physical Therapy Department, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229 – sequence: 2 givenname: Katherine S. surname: Rudolph fullname: Rudolph, Katherine S. email: krudo@udel.edu organization: Department of Physical Therapy and Program in Biomechanics and Movement Science, University of Delaware, 301 McKinly Lab, Newark, Delaware 19716 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18404657$$D View this record in MEDLINE/PubMed |
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Wu JZ, Herzog W, Epstein M. 2000. Joint contact mechanics in the early stages of osteoarthritis. Med Eng Phys 22: 1-12. Sharma L, Cahue S, Song J, et al. 2003. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum 48: 3359-3370. Irrgang JJ, Snyder-Mackler L, Wainner RS, et al. 1998. Development of a patient-reported measure of function of the knee. J Bone Joint Surg Am 80: 1132-1145. Kannus P, Jarvinen M, Kontiala H, et al. 1987. Occurrence of symptomatic knee osteoarthrosis in rural Finland: a prospective follow up study. Ann Rheum Dis 46: 804-808. Schmitt LC, Rudolph KS. 2007. Influences on knee movement strategies during walking in persons with medial knee osteoarthritis. Arthritis Rheum 57: 1018-1026. Herzog W, Adams M, Matyas J, et al. 1993. A preliminary study of hindlimb loading, morphology, and biochemistry of articular cartilage in the acl-deficient cat knee. Osteoarthritis Cartilage 1: 243-251. 2003; 138 1996; 19 1995; 13 2000; 22 2002; 10 1994; 25 2006 1999; 42 1998; 80 2000; 133 1992 1975; 116 2001; 45 1996; 35 1993; 1 2007; 57 1987; 46 1998; 37 2001; 60 1976; 58 2004; 51 1986; 83 2002; 20 2004; 19 2004; 12 2001; 9 2003; 48 1981 1990; 255 Hsu RW (e_1_2_1_24_2) 1990; 255 Schmitt L (e_1_2_1_20_2) 2006 Perry J (e_1_2_1_29_2) 1992 e_1_2_1_22_2 e_1_2_1_23_2 e_1_2_1_21_2 e_1_2_1_26_2 e_1_2_1_25_2 Delagi E (e_1_2_1_27_2) 1981 e_1_2_1_28_2 e_1_2_1_6_2 e_1_2_1_30_2 e_1_2_1_7_2 e_1_2_1_4_2 e_1_2_1_5_2 e_1_2_1_2_2 e_1_2_1_11_2 e_1_2_1_3_2 e_1_2_1_12_2 e_1_2_1_10_2 e_1_2_1_15_2 e_1_2_1_16_2 e_1_2_1_13_2 e_1_2_1_14_2 e_1_2_1_19_2 e_1_2_1_8_2 e_1_2_1_17_2 e_1_2_1_9_2 e_1_2_1_18_2 |
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Part 1: the disease and its risk factors publication-title: Ann Intern Med – volume: 20 start-page: 101 year: 2002 end-page: 107 article-title: The knee adduction moment during gait in subjects with knee osteoarthritis is more closely correlated with static alignment than radiographic disease severity, toe out angle and pain publication-title: J Orthop Res – year: 1981 – volume: 45 start-page: 331 year: 2001 end-page: 339 article-title: Modifiers of change in physical functioning in older adults with knee pain: the Observational Arthritis Study in Seniors (OASIS) publication-title: Arthritis Rheum – volume: 138 start-page: 613 year: 2003 end-page: 619 article-title: Quadriceps strength and osteoarthritis progression in malaligned and lax knees publication-title: Ann Intern Med – volume: 13 start-page: 473 year: 1995 end-page: 482 article-title: Mechanical behavior of articular cartilage in shear is altered by transection of the anterior cruciate ligament publication-title: J Orthop Res – volume: 25 start-page: 395 year: 1994 end-page: 403 article-title: Dynamics of knee malalignment publication-title: Orthop Clin North Am – volume: 12 start-page: 745 year: 2004 end-page: 751 article-title: Control of frontal plane knee laxity during gait in patients with medial compartment knee osteoarthritis publication-title: Osteoarthritis Cartilage – volume: 116 start-page: 585 year: 1975 end-page: 594 article-title: Compartmental evaluation of osteoarthritis of the knee. A comparative study of available diagnostic modalities publication-title: Radiology – volume: 19 start-page: 44 year: 2004 end-page: 49 article-title: Alterations in lower extremity movement and muscle activation patterns in individuals with knee osteoarthritis publication-title: Clin Biomech (Bristol, Avon) – volume: 80 start-page: 1132 year: 1998 end-page: 1145 article-title: Development of a patient‐reported measure of function of the knee publication-title: J Bone Joint Surg Am – year: 1992 – volume: 57 start-page: 1018 year: 2007 end-page: 1026 article-title: Influences on knee movement strategies during walking in persons with medial knee osteoarthritis publication-title: Arthritis Rheum – volume: 46 start-page: 804 year: 1987 end-page: 808 article-title: Occurrence of symptomatic knee osteoarthrosis in rural Finland: a prospective follow up study publication-title: Ann Rheum Dis – volume: 58 start-page: 594 year: 1976 end-page: 598 article-title: Collateral ligament laxity of the knee. Long‐term comparison between plateau fractures and normal publication-title: J Bone Joint Surg Am – volume: 42 start-page: 861 year: 1999 end-page: 870 article-title: Laxity in healthy and osteoarthritic knees publication-title: Arthritis Rheum – volume: 22 start-page: 1 year: 2000 end-page: 12 article-title: Joint contact mechanics in the early stages of osteoarthritis publication-title: Med Eng Phys – volume: 10 start-page: 573 year: 2002 end-page: 579 article-title: Increased knee joint loads during walking are present in subjects with knee osteoarthritis publication-title: Osteoarthritis Cartilage – volume: 35 start-page: 560 year: 1996 end-page: 563 article-title: Knee laxity in patients with osteoarthritis and rheumatoid arthritis publication-title: Br J Rheumatol – volume: 51 start-page: 941 year: 2004 end-page: 946 article-title: Reports of joint instability in knee osteoarthritis: its prevalence and relationship to physical function publication-title: Arthritis Rheum – year: 2006 – volume: 19 start-page: 861 year: 1996 end-page: 869 article-title: Quantitation of central activation failure during maximal voluntary contractions in humans publication-title: Muscle Nerve – volume: 37 start-page: 1181 year: 1998 end-page: 1187 article-title: Improvements in quadriceps sensorimotor function and disability of patients with knee osteoarthritis following a clinically practicable exercise regime publication-title: Br J Rheumatol – volume: 60 start-page: 1040 year: 2001 end-page: 1045 article-title: The burden of musculoskeletal diseases in the general population of Spain: results from a national survey publication-title: Ann Rheum Dis – volume: 1 start-page: 243 year: 1993 end-page: 251 article-title: A preliminary study of hindlimb loading, morphology, and biochemistry of articular cartilage in the acl‐deficient cat knee publication-title: Osteoarthritis Cartilage – volume: 9 start-page: 62 year: 2001 end-page: 71 article-title: Dynamic stability in the anterior cruciate ligament deficient knee publication-title: Knee Surg Sports Traumatol Arthrosc – volume: 48 start-page: 3359 year: 2003 end-page: 3370 article-title: Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors publication-title: Arthritis Rheum – volume: 83 start-page: 2879 year: 1986 end-page: 2883 article-title: Contact pressures in the human hip joint measured in vivo publication-title: Proc Natl Acad Sci USA – ident: e_1_2_1_14_2 doi: 10.1093/rheumatology/35.6.560 – ident: e_1_2_1_6_2 doi: 10.1016/S0030-5898(20)31924-6 – ident: e_1_2_1_12_2 doi: 10.7326/0003-4819-138-8-200304150-00006 – ident: e_1_2_1_7_2 doi: 10.1053/joca.2002.0797 – ident: e_1_2_1_17_2 doi: 10.1002/art.22889 – ident: e_1_2_1_22_2 doi: 10.1002/jor.1100130402 – ident: e_1_2_1_28_2 doi: 10.1007/s001670000166 – volume-title: Knee stabilization and medial knee osteoarthritis. In: Biomechanics and movement science program year: 2006 ident: e_1_2_1_20_2 – ident: e_1_2_1_25_2 doi: 10.2106/00004623-197658050-00002 – volume: 255 start-page: 215 year: 1990 ident: e_1_2_1_24_2 article-title: Normal axial alignment of the lower extremity and load‐bearing distribution at the knee publication-title: Clin Orthop – ident: e_1_2_1_26_2 doi: 10.1002/(SICI)1097-4598(199607)19:7<861::AID-MUS8>3.0.CO;2-7 – ident: e_1_2_1_30_2 doi: 10.1016/S1350-4533(00)00012-6 – ident: e_1_2_1_13_2 doi: 10.1002/1529-0131(199905)42:5<861::AID-ANR4>3.0.CO;2-N – ident: e_1_2_1_23_2 doi: 10.2106/00004623-199808000-00006 – ident: e_1_2_1_10_2 doi: 10.1002/art.11420 – ident: e_1_2_1_15_2 doi: 10.1016/j.clinbiomech.2003.08.007 – volume-title: Gait analysis. 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| Snippet | The sensation of knee instability (shifting, buckling. and giving way) is common in people with medial knee osteoarthritis (OA). Its influence on knee... |
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| SubjectTerms | Adult Aged Electromyography Female Humans instability Joint Instability - complications Joint Instability - diagnosis Joint Instability - physiopathology knee Male Middle Aged muscle activity Muscle Contraction Muscle Strength osteoarthritis Osteoarthritis, Knee - complications Osteoarthritis, Knee - physiopathology Quadriceps Muscle - physiology Range of Motion, Articular walking Walking - physiology |
| Title | Muscle stabilization strategies in people with medial knee osteoarthritis: The effect of instability |
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