Co-contraction in RA patients with a mobile bearing total knee prosthesis during a step-up task
It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotation...
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| Published in | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 16; no. 8; pp. 734 - 740 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer-Verlag
01.08.2008
John Wiley & Sons, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0942-2056 1433-7347 |
| DOI | 10.1007/s00167-008-0537-7 |
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| Abstract | It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (
n
= 5), a FB group (
n
= 4) and a control group (
n
= 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96° versus 88° (
P
= 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20–60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (
P
= 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training. |
|---|---|
| AbstractList | It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (
n
= 5), a FB group (
n
= 4) and a control group (
n
= 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96° versus 88° (
P
= 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20–60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (
P
= 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training. It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (n = 5), a FB group (n = 4) and a control group (n = 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96 degrees versus 88 degrees (P = 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20-60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (P = 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training.It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (n = 5), a FB group (n = 4) and a control group (n = 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96 degrees versus 88 degrees (P = 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20-60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (P = 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training. It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (n=5), a FB group (n=4) and a control group (n=8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96 degree versus 88 degree (P=0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20-60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (P=0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training. It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co‐contraction to stabilize the knee joint during a step‐up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step‐up task of a MB group ( n = 5), a FB group ( n = 4) and a control group ( n = 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step‐up task co‐contraction indices were determined from an EMG‐force model. Controls showed a higher active ROM during the step‐up task than the patient group, 96° versus 88° ( P = 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20–60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co‐contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co‐contraction during this interval ( P = 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co‐contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co‐contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co‐contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle‐coordination training. It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more co-contraction to stabilize the knee joint during a step-up task than RA patients with a fixed bearing total knee prosthesis (FB) where this rotational freedom is absent while having the same articular geometry. Surface EMG, kinematics and kinetics about the knee were recorded during a step-up task of a MB group (n = 5), a FB group (n = 4) and a control group (n = 8). Surface EMG levels of thigh muscles were calibrated to either knee flexion or extension moments by means of isokinetic contractions on a dynamometer. During the step-up task co-contraction indices were determined from an EMG-force model. Controls showed a higher active ROM during the step-up task than the patient group, 96 degrees versus 88 degrees (P = 0.007). In the control group higher average muscle extension, flexion and net moments during single limb support phase were observed than in the patient group. During the 20-60% interval of the single limb support, MB patients showed a significant higher level of flexor activity, resulting in a lower net joint moment, however co-contraction levels were not different. Compared to the control group arthroplasty patients showed a 40% higher level of co-contraction during this interval (P = 0.009). Control subjects used higher extension moments, resulting in a higher net joint moment. Visual analysis revealed a timing difference between the MB and FB group. The FB group seems to co-contract approximately 20% later compared to the MB group. RA patients after total knee arthroplasty show a lower net knee joint moment and a higher co-contraction than controls indicating avoidance of net joint load and an active stabilization of the knee joint. MB and FB patients showed no difference in co-contraction levels, although timing in FB is closer to controls than MB subjects. Since visual analysis revealed a timing difference between the MB and FB group, this may express compensation by coordination. Rehabilitation programs for RA patients should include besides muscle strength training, elements of muscle-coordination training. |
| Author | Velzeboer, Sanne Nelissen, Rob G. H. H. Valstar, Edward R. Doorenbosch, Caroline A. M. Harlaar, Jaap Garling, Eric H. Wolterbeek, Nienke |
| Author_xml | – sequence: 1 givenname: Eric H. surname: Garling fullname: Garling, Eric H. organization: Department of Orthopaedics, Leiden University Medical Center, Department of Radiology, Division of Image Processing, Leiden University Medical Center – sequence: 2 givenname: Nienke surname: Wolterbeek fullname: Wolterbeek, Nienke email: n.wolterbeek@lumc.nl organization: Department of Orthopaedics, Leiden University Medical Center – sequence: 3 givenname: Sanne surname: Velzeboer fullname: Velzeboer, Sanne organization: Department of Rehabilitation Medicine, VU University Medical Center – sequence: 4 givenname: Rob G. H. H. surname: Nelissen fullname: Nelissen, Rob G. H. H. organization: Department of Orthopaedics, Leiden University Medical Center – sequence: 5 givenname: Edward R. surname: Valstar fullname: Valstar, Edward R. organization: Department of Orthopaedics, Leiden University Medical Center, Department of Biomechanics, Faculty of Mechanical Engineering, Delft University of Technology – sequence: 6 givenname: Caroline A. M. surname: Doorenbosch fullname: Doorenbosch, Caroline A. M. organization: Department of Rehabilitation Medicine, VU University Medical Center – sequence: 7 givenname: Jaap surname: Harlaar fullname: Harlaar, Jaap organization: Department of Rehabilitation Medicine, VU University Medical Center |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/18478203$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_gaitpost_2013_03_004 crossref_primary_10_1016_j_knee_2013_08_002 crossref_primary_10_1016_j_clinbiomech_2019_05_004 crossref_primary_10_1186_s13018_020_1570_6 crossref_primary_10_1186_s13018_016_0423_9 crossref_primary_10_1016_j_jbiomech_2016_09_022 crossref_primary_10_2522_ptj_20140448 crossref_primary_10_1080_02640414_2016_1167231 crossref_primary_10_1002_jor_20941 crossref_primary_10_1016_j_gaitpost_2013_01_007 |
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| Keywords | Knee stability Co-contraction Total knee arthroplasty Mobile bearing knee Rheumatoid arthritis |
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| PublicationPlace_xml | – name: Berlin/Heidelberg – name: Germany – name: Hoboken |
| PublicationTitle | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
| PublicationTitleAbbrev | Knee Surg Sports Traumatol Arthr |
| PublicationTitleAlternate | Knee Surg Sports Traumatol Arthrosc |
| PublicationYear | 2008 |
| Publisher | Springer-Verlag John Wiley & Sons, Inc |
| Publisher_xml | – name: Springer-Verlag – name: John Wiley & Sons, Inc |
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| Snippet | It was hypothesized that rheumatoid arthritis (RA) patients with a total knee prosthesis that allows axial rotation of the bearing (MB) will show more... |
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| SubjectTerms | Adult Aged Aged, 80 and over Arthritis, Rheumatoid - physiopathology Arthritis, Rheumatoid - surgery Arthroplasty, Replacement, Knee Biomechanical Phenomena Case-Control Studies Design Electromyography Humans Joint Instability - physiopathology Joint replacement surgery Kinematics Knee Knee Prosthesis Medicine Medicine & Public Health Middle Aged Movement - physiology Muscle Contraction - physiology Muscle Strength Dynamometer Muscle, Skeletal - physiology Orthopedics Patients Polyethylene Prostheses Range of Motion, Articular - physiology Rheumatoid arthritis Rotation |
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| Title | Co-contraction in RA patients with a mobile bearing total knee prosthesis during a step-up task |
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