J.L. Astephen Wilson

The association between knee joint biomechanics and neuromuscular control and moderate knee osteoarthritis radiographic and pain severity

OBJECTIVE The objective of this study was to determine the association between biomechanical and neuromuscular factors of clinically diagnosed mild to moderate knee osteoarthritis (OA) with radiographic severity and pain severity separately. METHOD Three-dimensional gait analysis and electromyography were performed on a group of 40 participants with clinically diagnosed mild to moderate medial knee OA. Associations between radiographic severity, defined using a visual analog radiographic score, and pain severity, defined with the pain subscale of the WOMAC osteoarthritis index, with knee joint kinematics and kinetics, electromyography patterns of periarticular knee muscles, BMI and gait speed were determined with correlation analyses. Multiple linear regression analyses of radiographic and pain severity were also explored. RESULTS Statistically significant correlations between radiographic severity and the overall magnitude of the knee adduction moment during stance (r²=21.4%, P=0.003) and the magnitude of the knee flexion angle during the gait cycle (r²=11.4%, P=0.03) were found. Significant correlations between pain and gait speed (r²=28.2%, P<0.0001), the activation patterns of the lateral gastrocnemius (r²=16.6%, P=0.009) and the medial hamstring (r²=10.3%, P=0.04) during gait were found. The combination of the magnitude of the knee adduction moment during stance and BMI explained a significant portion of the variability in radiographic severity (R(2)=27.1%, P<0.0001). No multivariate model explained pain severity better than gait speed alone. CONCLUSIONS This study suggests that some knee joint biomechanical variables are associated with structural knee OA severity measured from radiographs in clinically diagnosed mild to moderate levels of disease, but that pain severity is only reflected in gait speed and neuromuscular activation patterns. A combination of the knee adduction moment and BMI better explained structural knee OA severity than any individual factor alone.

Obesity is associated with prolonged activity of the quadriceps and gastrocnemii during gait

PURPOSE To examine the effect of obesity and its potential interaction with knee OA presence on the electromyography patterns of the major knee joint periarticular muscles during walking. SCOPE One hundred and eighteen asymptomatic adults and 177 adults with moderate knee osteoarthritis were subdivided into categories of healthy weight (n = 77; 20 kg/m(2) < BMI < 25 kg/m(2)), overweight (n = 117; 25 kg/m(2) ⩽ BMI < 30 kg/m(2)), and obese (n = 101; BMI ⩾ 30 kg/m(2) based on their body mass index (BMI). All individuals underwent a three-dimensional gait analysis. Surface electromyograms from the lateral and medial gastrocnemii, lateral and medial hamstrings, vastus lateralis, vastus medialis, and rectus femoris were recorded during self-selected speed walking. Principal component analysis was used to extract major features of amplitude and temporal pattern variability from the electromyograms of each muscle group (gastrocnemii, quadriceps, hamstrings separately). Analysis of variance models tested for main BMI category effects and interaction effects for these features (α = 0.05). Statistically significant BMI category (i.e. obesity) effects were found for features that described more prolonged activations of the gastrocnemii and quadriceps muscles during the stance phase of gait with obesity (P < 0.05). CONCLUSIONS Obesity was associated with prolonged activation of quadriceps and gastrocnemii, which can result in prolonged knee joint contact loading, and thereby may contribute to the predisposition of knee OA development and progression in obese individuals.

Effect on Oxygen Cost of Transport from 8-Weeks of Progressive Training with Barefoot Running.

Popular interest in barefoot running has emerged as a result of its alleged performance and injury prevention benefits. Oxygen cost of transport (COT) improvements from barefoot running, however, remains equivocal. The aim of this study was to determine the influence of an 8-week progressive barefoot training program on COT and associated spatiotemporal variables. 15 male runners participated in this study. Variables such as oxygen uptake, biomechanical and spatiotemporal characteristics of gait, including ground contact (GC) and swing time; stride length and frequency and ankle plantar-dorsiflexion were measured pre- and post-intervention. The COT did not differ between barefoot and shod running either pre- or post-training. Improved barefoot COT (p<0.05) but not shod was found between pre- and post-training. Biomechanical differences between barefoot and shod conditions persisted over the training period. A decrease in barefoot COT was associated with a decrease in GC time (p=0.003, r=0.688) and a small increase in stride frequency (p=0.030; r=0.569). Ground contact time and stride frequency, previously associated with COT, only partly contribute (32% - Stride frequency and 47% - GC time) to a decrease in COT after barefoot training. Thus other physiological and biomechanical variables must influence the improvement in COT after a barefoot training intervention.