Is modular control related to functional outcomes in individuals with knee osteoarthritis and following total knee arthroplasty?
Is modular control related to functional outcomes in individuals with knee osteoarthritis and following total knee arthroplasty?
复制标题
DOI：
10.1371/journal.pone.0267340
复制
发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Siston, Robert A.
中科院分区：
文献类型：
--
作者：
Koehn, Rebekah R.;Roelker, Sarah A.;Pan, Xueliang;Schmitt, Laura C.;Chaudhari, Ajit M. W.;Siston, Robert A.
接受全膝关节置换术（TKA）治疗膝关节骨性关节炎的个体通常会经历次优结果。对这些个体的神经肌肉控制策略的研究可能揭示导致这些功能缺陷的因素。这项初步研究的目的是确定TKA前后患者功能和模块化控制之间的关系。在手术前（n = 30）、手术后6个月（n = 26）和手术后24个月（n = 13）进行的≥5次地上行走试验中，收集了36名参与者（38个膝盖）tka受累肢体8块下肢肌肉的肌电图数据。肌肉模块估计使用非负矩阵分解。模块的数量由500个重新抽样试验确定。在手术前和手术后6个月，更多的模块与更好的基于性能和患者报告的功能相关。组织与健康、年龄匹配的对照组相似的参与者在手术后24个月的功能倾向于更好，尽管这些结果没有统计学意义。我们还观察到参与者的模块化控制策略的可塑性，100%的参与者在手术前和手术后24个月（10/10）表现出至少1个模块的模块数量和/或组织的变化。这项试点工作表明，TKA后的功能改善最初可能表现为步态期间招募的模块数量增加。功能的后续改进可能表现为改进的模块组织。这项研究首次对TKA手术前后的运动模块进行了表征，并证明了模块数量和组织在恢复过程中的变化，这可能与患者功能的变化有关。TKA后模块化控制的可塑性是一个关键的发现，以前没有文献记载，可能有助于通过新的康复方案预测或改善手术结果。
Individuals who undergo total knee arthroplasty (TKA) for treatment of knee osteoarthritis often experience suboptimal outcomes. Investigation of neuromuscular control strategies in these individuals may reveal factors that contribute to these functional deficits. The purpose of this pilot study was to determine the relationship between patient function and modular control during gait before and after TKA. Electromyography data from 36 participants (38 knees) were collected from 8 lower extremity muscles on the TKA-involved limb during ≥5 over-ground walking trials before (n = 30), 6-months after (n = 26), and 24-months after (n = 13) surgery. Muscle modules were estimated using non-negative matrix factorization. The number of modules was determined from 500 resampled trials. A higher number of modules was related to better performance-based and patient-reported function before and 6-months after surgery. Participants with organization similar to healthy, age-matched controls trended toward better function 24-months after surgery, though these results were not statistically significant. We also observed plasticity in the participants’ modular control strategies, with 100% of participants who were present before and 24-months after surgery (10/10) demonstrating changes in the number of modules and/or organization of at least 1 module. This pilot work suggests that functional improvements following TKA may initially present as increases in the number of modules recruited during gait. Subsequent improvements in function may present as improved module organization. This work is the first to characterize motor modules in TKA both before and after surgery and to demonstrate changes in the number and organization of modules over the time course of recovery, which may be related to changes in patient function. The plasticity of modular control following TKA is a key finding which has not been previously documented and may be useful in predicting or improving surgical outcomes through novel rehabilitation protocols.
登录
查看更多内容
影响因子：
2.8
作者：
Freisinger, Gregory M.;Hutter, Erin E.;Chaudhari, Ajit M. W.
通讯作者：
Chaudhari, Ajit M. W.
影响因子：
1.8
作者：
Hubley-Kozey, Cheryl L.;Hatfield, Gillian L.;Dunbar, Michael J.
通讯作者：
Dunbar, Michael J.
DOI：
10.1302/0301-620x.73b5.1894655
发表时间：
1991-09-01
影响因子：
--
作者：
JEFFERY, RS;MORRIS, RW;DENHAM, RA
通讯作者：
DENHAM, RA
DOI：
10.1016/j.apmr.2010.02.003
发表时间：
2010-06-01
影响因子：
4.3
作者：
Almeida, Gustavo J.;Schroeder, Carolyn A.;Piva, Sara R.
通讯作者：
Piva, Sara R.
影响因子：
5.5
作者：
Ivanenko, YP;Poppele, RE;Lacquaniti, F
通讯作者：
Lacquaniti, F