Knee osteoarthritis alters peri-articular knee muscle strategies during gait.
Knee osteoarthritis alters peri-articular knee muscle strategies during gait.
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DOI：
10.1371/journal.pone.0262798
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Whatling GM
中科院分区：
文献类型：
--
作者：
Ghazwan A;Wilson C;Holt CA;Whatling GM
肌肉的主要作用是移动和控制关节。因此，重要的是要了解退行性关节疾病如何改变这种作用，从而对机械关节负荷产生影响。肌肉控制策略可以根据力量和协调而变化，这反过来又会影响关节控制和负荷。本研究的目的是研究三个受试者组的神经肌肉控制机制和关节生物力学的变化，包括：单髁膝关节骨关节炎（OA），已收载用于胫骨高位截骨术（HTO前，n = 10）;多髁膝关节OA，已收载用于全膝关节置换术（TKR前，n = 9）和非病理性膝关节（NP，n = 11）。下肢运动学和肌电图（EMG）数据的受试者走在自选的速度，输入到肌电驱动的肌肉骨骼膝关节模型，其缩放和校准到每个人估计肌肉力量。与NP相比，HTO前和TKR前的腓肠肌峰值肌力分别降低了30%和18%，HTO前的腘绳肌峰值肌力估计值增加了25%。较高的股四头肌和腘绳肌力量表明，与腓肠肌的共同收缩可能导致较高的关节接触力。结合由于高的膝关节外收力矩而导致的过度负荷，这可能会加剧关节破坏。增加的外侧肌肉共收缩反映了从NP到单室OA（前HTO）的进展。TKR前患者采用与HTO前患者不同的步态模式。内侧肌肉共激活增加可能会区分单室或多室OA。
The primary role of muscles is to move, and control joints. It is therefore important to understand how degenerative joint disease changes this role with the resulting effect on mechanical joint loading. Muscular control strategies can vary depending on strength and coordination which in turn influences joint control and loading. The purpose of this study was to investigate the variation in neuromuscular control mechanisms and joint biomechanics for three subject groups including those with: uni-compartmental knee osteoarthritis (OA), listed for high tibial osteotomy surgery (pre-HTO, n = 10); multi-compartmental knee OA listed for total knee replacement (pre-TKR, n = 9), and non-pathological knees (NP, n = 11). Lower limb kinematics and electromyography (EMG) data for subjects walking at self-selected speed, were input to an EMG-driven musculoskeletal knee model which was scaled and calibrated to each individual to estimate muscle forces. Compared to NP, the peak gastrocnemius muscle force reduced by 30% and 18% for pre-HTO and pre-TKR respectively, and the peak force estimated for hamstring muscle increased by 25% for pre-HTO. Higher quadriceps and hamstring forces suggest that co-contraction with the gastrocnemius could lead to higher joint contact forces. Combined with the excessive loading due to a high external knee adduction moment this may exacerbate joint destruction. An increased lateral muscle co-contraction reflects the progression from NP to uni-compartmental OA (pre-HTO). Pre-TKR patients adopt a different gait pattern to pre-HTO patients. Increased medial muscle co-activation could potentially differentiate between uni- or multi-compartmental OA.
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影响因子：
2.8
作者：
Kumar, Deepak;Rudolph, Katherine S.;Manal, Kurt T.
通讯作者：
Manal, Kurt T.
影响因子：
3.7
作者：
Ghazwan A;Forrest SM;Holt CA;Whatling GM
通讯作者：
Whatling GM
影响因子：
2.5
作者：
Hermens, HJ;Freriks, B;Rau, G
通讯作者：
Rau, G
影响因子：
1.8
作者：
Hubley-Kozey, Cheryl L.;Hill, Nicholas A.;Stanish, William D.
通讯作者：
Stanish, William D.
影响因子：
1.1
作者：
Gage, JR;Novacheck, TF
通讯作者：
Novacheck, TF