Shanahan Camille J, Wrigley Tim V, Farrell Michael J, Bennell Kim L, Hodges Paul W
University of Melbourne, Department of Physiotherapy, Australia; The Florey Institute of Neuroscience and Mental Health, Australia.
University of Melbourne, Department of Physiotherapy, Australia.
Hum Mov Sci. 2015 Jun;41:103-13. doi: 10.1016/j.humov.2015.02.008. Epub 2015 Mar 18.
The mechanisms for proprioceptive changes associated with knee osteoarthritis (OA) remain elusive. Observations of proprioceptive changes in both affected knees and other joints imply more generalized mechanisms for proprioceptive impairment. However, evidence for a generalized effect remains controversial. This study examined whether joint repositioning proprioceptive deficits are localized to the diseased joint (knee) or generalized across other joints (elbow and ankle) in people with knee OA. Thirty individuals with right knee OA (17 female, 66±7 [mean±SD] years) of moderate/severe radiographic disease severity and 30 healthy asymptomatic controls of comparable age (17 female, 65±8years) performed active joint repositioning tests of the knee, ankle and elbow in randomised order in supine. Participants with knee OA had a larger relative error for joint repositioning of the knee than the controls (OA: 2.7±2.1°, control: 1.6±1.7°, p=.03). Relative error did not differ between groups for the ankle (OA: 2.2±2.5°, control: 1.9±1.3°, p=.50) or elbow (OA: 2.5±3.3°, control: 2.9±2.8°, p=.58). These results are consistent with a mechanism for proprioceptive change that is localized to the knee joint. This could be mediated by problems with mechanoreceptors, processing/relay of somatosensory input to higher centers, or joint-specific interference with cognitive processes by pain.
与膝关节骨关节炎(OA)相关的本体感觉变化机制仍不清楚。对患侧膝关节和其他关节本体感觉变化的观察表明,本体感觉受损存在更普遍的机制。然而,关于普遍效应的证据仍存在争议。本研究调查了膝关节OA患者的关节重新定位本体感觉缺陷是局限于患病关节(膝关节)还是在其他关节(肘关节和踝关节)中普遍存在。30名患有中度/重度影像学疾病严重程度的右膝OA患者(17名女性,66±7[平均值±标准差]岁)和30名年龄相仿的健康无症状对照者(17名女性,65±8岁)仰卧位,以随机顺序对膝关节、踝关节和肘关节进行主动关节重新定位测试。膝关节OA患者膝关节重新定位的相对误差大于对照组(OA组:2.7±2.1°,对照组:1.6±1.7°,p = 0.03)。踝关节(OA组:2.2±2.5°,对照组:1.9±1.3°,p = 0.50)和肘关节(OA组:2.5±3.3°,对照组:2.9±2.8°,p = 0.58)的相对误差在两组之间没有差异。这些结果与本体感觉变化机制局限于膝关节一致。这可能是由机械感受器问题、体感输入向高级中枢的处理/传递问题或疼痛对认知过程的关节特异性干扰介导的。