Fu Shengxing, Duan Tingjin, Hou Meijin, Yang Fengjiao, Chai Yatai, Chen Yongkang, Liu Benke, Ma Ye, Liu Anmin, Wang Xiangbin, Chen Lidian
National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fuzhou, China.
Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Hum Neurosci. 2021 Nov 3;15:760960. doi: 10.3389/fnhum.2021.760960. eCollection 2021.
Stand-to-sit task is an important daily function, but there is a lack of research evidence on whether knee osteoarthritis (knee OA) affects the postural balance during the task. This study aimed to compare individuals with knee OA and asymptomatic controls in postural balance and identify kinematic and lower extremity muscle activity characteristics in individuals with knee OA during the stand-to-sit task. In total, 30 individuals with knee OA and 30 age-matched asymptomatic controls performed the 30-s Chair Stand Test (30sCST) at self-selected speeds. Motion analysis data and surface electromyography (sEMG) were collected while participants performed the 30sCST. To quantify postural balance, the displacement of the center of mass (CoM) and the peak instantaneous velocity of the CoM were calculated. The kinematic data included forward lean angles of the trunk and pelvic, range of motion (RoM) of the hip, knee, and ankle joints in the sagittal plane. The averaged activation levels of gluteus maximus, vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), tibialis anterior (TA), and medial head of gastrocnemius muscles were indicated by the normalized root mean square amplitudes. Compared with the asymptomatic control group, the knee OA group prolonged the duration of the stand-to-sit task, demonstrated significantly larger CoM displacement and peak instantaneous CoM velocity in the anterior-posterior direction, reduced ankle dorsiflexion RoM, greater anterior pelvic tilt RoM, and lower quadriceps femoris and muscles activation level coupled with higher BF muscle activation level during the stand-to-sit task. This study indicates that individuals with knee OA adopt greater pelvic forward lean RoM and higher BF muscle activation level during the stand-to-sit task. However, these individuals exist greater CoM excursion in the anterior-posterior direction and take more time to complete the task. This daily functional activity should be added to the rehabilitation goals for individuals with knee OA. The knee OA group performs reduced ankle dorsiflexion RoM, quadriceps femoris, and TA activation deficit. In the future, the rehabilitation programs targeting these impairments could be beneficial for restoring the functional transfer in individuals with knee OA.
从站立到坐下的动作是一项重要的日常功能,但关于膝骨关节炎(膝OA)是否会影响该动作过程中的姿势平衡,目前缺乏研究证据。本研究旨在比较膝OA患者和无症状对照组在姿势平衡方面的差异,并确定膝OA患者在从站立到坐下动作过程中的运动学和下肢肌肉活动特征。总共30名膝OA患者和30名年龄匹配的无症状对照组以自我选择的速度进行了30秒椅子站立测试(30sCST)。在参与者进行30sCST时收集运动分析数据和表面肌电图(sEMG)。为了量化姿势平衡,计算了质心(CoM)的位移和CoM的峰值瞬时速度。运动学数据包括躯干和骨盆的前倾角度、矢状面内髋、膝和踝关节的活动范围(RoM)。通过归一化均方根幅值表示臀大肌、股外侧肌、股内侧肌、股直肌、股二头肌(BF)、胫前肌(TA)和腓肠肌内侧头肌肉的平均激活水平。与无症状对照组相比,膝OA组从站立到坐下动作的持续时间延长,在前后方向上表现出明显更大的CoM位移和CoM峰值瞬时速度,踝关节背屈RoM减小,骨盆前倾RoM增大,股四头肌和肌肉激活水平降低,同时在从站立到坐下动作过程中BF肌肉激活水平升高。本研究表明,膝OA患者在从站立到坐下动作过程中采用更大的骨盆前倾RoM和更高的BF肌肉激活水平。然而,这些个体在前后方向上存在更大的CoM偏移,并且完成任务需要更多时间。这项日常功能活动应纳入膝OA患者的康复目标。膝OA组踝关节背屈RoM减小,股四头肌和TA激活不足。未来,针对这些损伤的康复计划可能有助于恢复膝OA患者的功能转移。