Centre for Health Sciences Research, University of Salford, Salford, Manchester M6 6PU, UK.
Centre for Health Sciences Research, University of Salford, Salford, Manchester M6 6PU, UK; Al Baha University, Al Baha, Saudi Arabia.
Knee. 2021 Dec;33:216-225. doi: 10.1016/j.knee.2021.10.006. Epub 2021 Oct 27.
Previous research has demonstrated elevated activation of the knee flexor muscles in people with knee osteoarthritis. People with this condition have also been observed to walk with increased trunk flexion; this may alter biomechanical loading patterns and change muscle activation profiles. Therefore, the aim of this study was to understand the biomechanical effect of increasing trunk flexion during walking.
Kinetic and EMG data were collected from a sample of 20 people with knee osteoarthritis and a sample of 20 healthy matched controls during normal walking. Using a biofeedback protocol, participants were subsequently instructed to walk with a 5° increase in trunk flexion. Sagittal moments, muscle activations and co-contractions were then compared across a window in early stance with a two-way ANOVA test.
When trunk flexion was increased, there was a corresponding increase in activity of the medial and lateral hamstrings and gastrocnemius muscles as well as a rise in medial co-contraction. This effect was consistent across the two groups. The most pronounced effect was observed for semitendinosus, which showed a dramatic change in activation profile in the healthy group and a 127% increase in activation during early stance.
This is the first study to demonstrate that increased trunk flexion in people with knee osteoarthritis may explain, to some degree, the elevated knee flexor activity and medial co-contraction which is associated with this disease. These findings motivate further work to understand the therapeutic potential of interventions designed to improve postural alignment.
先前的研究表明，膝骨关节炎患者的膝关节屈肌活动增加。患有这种疾病的人也被观察到在行走时躯干前屈增加；这可能改变生物力学负荷模式并改变肌肉激活模式。因此，本研究旨在了解行走时增加躯干前屈对生物力学的影响。
从 20 名膝骨关节炎患者和 20 名健康匹配对照者的样本中收集了动力学和肌电图数据，在正常行走过程中。使用生物反馈协议，随后指示参与者在站立前期将躯干前屈增加 5°。然后使用双向 ANOVA 检验比较了矢状面力矩、肌肉激活和共同收缩在窗口中的表现。
当躯干前屈增加时，内侧和外侧半腱肌和腓肠肌以及内侧共同收缩的活动相应增加。这种影响在两组中都是一致的。最明显的影响发生在半腱肌上，它在健康组中的激活模式发生了巨大变化，在站立前期的激活增加了 127%。
这是第一项研究表明，膝骨关节炎患者的躯干前屈增加可能在一定程度上解释了与这种疾病相关的膝关节屈肌活动和内侧共同收缩增加。这些发现促使进一步研究旨在了解旨在改善姿势对齐的干预措施的治疗潜力。
