Whether the presence of knee effusion in individuals with knee osteoarthritis (OA) affects periarticular neuromuscular control during gait and thus the joint loading environment is unknown. The purpose was to test the hypothesis that knee effusion presence alters periarticular neuromuscular patterns during gait in individuals with moderate knee OA. 40 patients with medial compartment knee OA participated after giving informed consent. Patients were assessed for the presence of effusion using a brush test and were assigned to the knee effusion (n=20) and no knee effusion (n=20) groups. Surface electrodes were placed in a bipolar configuration over the lateral and medial gastrocnemius, vastus lateralis and medialis, rectus femoris and the lateral and medial hamstrings of the affected limb. Five trials of self-selected walking were completed. Electromyograms (EMG) were collected using an AMT-8 EMG system (Bortec Inc.). An Optotrak motion capture system (Northern Digital Inc.) recorded leg motion. Euler rotations were used to derive knee angles. EMG waveforms were low-pass filtered and amplitude normalized to maximal effort voluntary isometric contractions. Quadriceps, gastrocnemius and hamstring strength was measured from torques produced against a Cybex dynamometer. Principal Component Analysis extracted the predominant waveform features and weighting scores were calculated for each measured waveform. Analysis of variance models test for main effects (group, muscle) and interactions (alpha = 0.05). Bonferonni post hoc testing was employed.Purpose
Method
Self-selected walking (Neutral), Toe out walking (10o>
self-selected, velocity +/− 0.1 m/s of self-selected) and Toe in walking (10o
a reduction in the overall knee adduction moment (captured by PC1), a reduction in the late stance magnitude of the knee adduction moment magnitude (captured by PC2 and PC3) and an increase in the early stance knee adduction moment magnitude (captured by PC2) (p<
0.05).
