Alterations in neuromuscular patterns between pre and one-year post-total knee arthroplasty
Alterations in neuromuscular patterns between pre and one-year post-total knee arthroplasty
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DOI：
10.1016/j.clinbiomech.2010.07.008
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发表时间：
2010-12-01
影响因子：
1.8
通讯作者：
Dunbar, Michael J.
中科院分区：
文献类型：
--
作者：
Hubley-Kozey, Cheryl L.;Hatfield, Gillian L.;Dunbar, Michael J.
背景：全膝关节置换术是治疗严重膝关节骨性关节炎的常用方法。目的评估关节置换手术对功能和关节负荷的影响，特别是考虑到接受这种干预的年轻人的增加。目的：比较全膝关节置换术前一周和术后一年水平步行时膝关节肌肉的神经肌肉激活模式。方法：对43例重症膝关节内侧室骨关节炎患者在全膝关节置换术前一周和术后一年的步行过程中，记录7块关节周围肌肉的表面肌电信号。主成分分析从肌电波形中提取模式，并为这些模式分配分数，并对测试时间之间以及肌群内内侧和外侧位置进行统计比较。发现：在手术后中晚期站立时，股四头肌和腿肌的总体激活幅度显著降低，活动减少。说明：总的来说，手术后的变化趋向于更典型的无症状模式。支持改善行走中的神经肌肉策略。考虑到严重的骨关节炎膝关节不会自然改善，在步态周期的特定阶段，神经肌肉特征的积极变化可以部分解释为机械环境的改变和手术干预后疼痛的减少。这些客观的发现与关节负荷环境直接相关，对评估手术技术、不同的假体和手术前的处理有价值。(C)2010 Elsevier Ltd.保留所有权利。
Background: Total knee arthroplasty is a common treatment for severe knee osteoarthritis. Objective measures are needed to evaluate the effect of arthroplasty surgery on function and joint loading, in particular given the rise in younger adults receiving this intervention. The objective was to compare neuromuscular activation patterns of the knee musculature during level walking one-week prior to and one-year following total knee arthroplasty.Methods: Surface electromyograms from seven periarticular muscles were recorded from 43 patients with severe medial compartment knee osteoarthritis during walking one-week prior to and one-year following total knee arthroplasty. Principal component analysis extracted patterns from the electromyographic waveforms and assigned scores for these patterns, which were statistically compared between test times and between medial and lateral sites within a muscle group.Findings: Significantly lower overall activation amplitudes were found for the quadriceps and hamstrings, with decreased activity during mid-late stance following surgery. Significant increases in gastrocnemius "activity were found late stance, along with altered waveform shapes.Interpretation: In general, the post-surgical changes moved toward more typical asymptomatic patterns. supporting improved neuromuscular strategies during walking. Given that improvements would not be expected to occur naturally in severe osteoarthritic knees the positive changes in neuromuscular characteristics during specific phases of the gait cycle can be explained in part by the altered mechanical environment and reduction in pain from the surgical intervention. These objective findings are directly relevant to the joint loading environment and can be valuable for evaluating surgical techniques, different prostheses and pre-post surgical management. (c) 2010 Elsevier Ltd. All rights reserved.