Charlton Jesse M, Hatfield Gillian L, Guenette Jordan A, Hunt Michael A
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada; Department of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada.
J Biomech. 2018 Jul 25;76:112-118. doi: 10.1016/j.jbiomech.2018.05.041. Epub 2018 Jun 18.
Toe-in and toe-out gait modification has received attention lately as a promising treatment for knee osteoarthritis due to its potential to improve knee joint loading and pain. However, the neuromuscular patterns associated with these walking styles are not well known, a factor that may influence knee joint load itself. Our aim was to conduct a thorough examination of the neuromuscular patterns associated with toe-in and toe-out walking in people with knee osteoarthritis. Fifteen participants were instructed to walk in four different foot rotations: 10° toe-in, 0°, as well as 10° and 20° toe-out. Nine surface electrodes were placed over lower extremity muscles and a variety of muscle activation parameters were examined. Peak and average medial hamstrings muscle activation was increased (p = 0.001, p < 0.001) during toe-in walking compared to toe-out walking. As well, average lateral gastrocnemius muscle activation was higher (p = 0.001) during toe-in walking compared to 20° toe-out. Medial thigh muscle co-contraction was higher (p = 0.003) during toe-in walking compared to all other conditions, and medial to lateral gastrocnemius activation ratio was lower (p = 0.032) during toe-in walking. These findings suggest potential overall increased joint loading with toe-in walking as a result of muscle co-contraction. Long-term assessment of these strategies is warranted.
内八字和外八字步态调整近来备受关注，因其有望改善膝关节负荷和疼痛，从而成为治疗膝关节骨关节炎的一种方法。然而，与这些行走方式相关的神经肌肉模式尚不为人所知，而这一因素可能会影响膝关节负荷本身。我们的目的是全面检查膝关节骨关节炎患者内八字和外八字行走时的神经肌肉模式。15名参与者被要求以四种不同的足部旋转方式行走：内旋10°、中立位、外旋10°和外旋20°。在下肢肌肉上放置了9个表面电极，并检测了各种肌肉激活参数。与外八字行走相比，内八字行走时半腱肌内侧的峰值和平均肌肉激活增加（p = 0.001，p < 0.001）。同样，与外旋20°行走相比，内八字行走时腓肠肌外侧的平均肌肉激活更高（p = 0.001）。与所有其他情况相比，内八字行走时大腿内侧肌肉的共同收缩更高（p = 0.003），且内八字行走时腓肠肌内侧与外侧的激活比率更低（p = 0.032）。这些发现表明，由于肌肉共同收缩，内八字行走可能会导致关节负荷总体增加。有必要对这些策略进行长期评估。
