School of Exercise Science, Australian Catholic University, Brisbane, Queensland 4014, Australia.
BMC Musculoskelet Disord. 2013 Nov 20;14:326. doi: 10.1186/1471-2474-14-326.
Self-reported knee joint instability compromises function in individuals with medial knee osteoarthritis and may be related to impaired joint mechanics. The purpose of this study was to evaluate the relationship between self-reported instability and the passive varus-valgus mechanical behaviour of the medial osteoarthritis knee.
Passive varus-valgus angular laxity and stiffness were assessed using a modified isokinetic dynamometer in 73 participants with medial tibiofemoral osteoarthritis. All participants self-reported the absence or presence of knee instability symptoms and the degree to which instability affected daily activity on a 6-point likert scale.
Forward linear regression modelling identified a significant inverse relationship between passive mid-range knee stiffness and symptoms of knee instability (r = 0.27; P < 0.05): reduced stiffness was indicative of more severe instability symptoms. Angular laxity and end-range stiffness were not related to instability symptoms (P > 0.05).
Conceivably, a stiffer passive system may contribute toward greater joint stability during functional activities. Importantly however, net joint stiffness is influenced by both active and passive stiffness, and thus the active neuromuscular system may compensate for reduced passive stiffness in order to maintain joint stability. Future work is merited to examine the role of active stiffness in symptomatic joint stability.
膝关节不稳的自我报告影响了内侧膝关节骨关节炎患者的功能,可能与关节力学受损有关。本研究旨在评估内侧膝关节骨关节炎患者自我报告的不稳定与膝关节被动内翻-外翻力学行为之间的关系。
使用改良等速测力仪评估 73 例内侧胫股关节炎患者的被动内翻-外翻角度松弛度和刚度。所有参与者均采用 6 分制 Likert 量表自我报告膝关节不稳定症状的有无以及不稳定对日常活动的影响程度。
向前线性回归模型确定了膝关节被动中程刚度与膝关节不稳定症状之间存在显著的负相关关系(r = 0.27;P < 0.05):刚度降低表明不稳定症状更严重。角度松弛度和终末刚度与不稳定症状无关(P > 0.05)。
可以认为,更僵硬的被动系统可能有助于在功能活动中提高关节稳定性。然而,重要的是,关节总刚度受到主动和被动刚度的影响,因此主动神经肌肉系统可能会补偿被动刚度的降低以维持关节稳定性。未来的工作值得研究主动刚度在关节稳定性中的作用。