Transversus abdominis activation does not alter gait impairments in patients with and without knee osteoarthritis

Gait strategies for individuals with knee osteoarthritis when transitioning between floor and stair walking

Objective: Individuals with knee osteoarthritis are at higher risk for falls during transitions between floor and stair walking due to their reduced lower extremity function. However, the adjust gait characteristics of knee osteoarthritis subjects for dealing with stair transitions have not been explored. We aimed to investigate gait strategies in individuals with knee osteoarthritis compared to age-matched individuals without knee OA during the transition between walking on floor and stairs. Method: Gait of 30 individuals with knee osteoarthritis and 30 individuals without knee osteoarthritis during floor-to-stair and stair-to-floor walking transitions were accessed using a 3D motion capture system. Foot-tread clearance, and angles of lower extremity joints and trunk at Foot-tread clearance timepoint were analyzed by using biomechanical software (Visual 3D). Results: Compared with asymptomatic control group, the knee osteoarthritis group demonstrated no difference in vertical Foot-tread clearance and horizontal Foot-tread clearance during stair transitions. However, ankle dorsiflexion (p = 0.01) decreased, hip flexion (p = 0.02) and trunk lateral tilt (p = 0.02) increased in knee osteoarthritis group during the stair ascent transition. Moreover, trunk lateral tilt to the support side (p = 0.003) and pelvic rotation (p = 0.03) increased, while hip abduction of the swing leg (p = 0.03) decreased during the stair descent transition in individuals with knee osteoarthritis. Conclusion: Increased trunk lateral tilt and altered angle of hip may be a strategy utilized by individuals with knee OA to increase the foot clearance ability and compensate for the disease-related loss of lower extremity strength, range of motion, and balance. However, compensatory manifestations, such as the increased lateral tilt of the trunk and movement of the gravity center may enhance the risk of falls and result in more abnormal knee joint loading.

The Effect of Core Stabilization Training on Improving Gait and Self-Perceived Function in Patients with Knee Osteoarthritis: A Single-Arm Clinical Trial

The treatment of patients with knee osteoarthritis is typically focused on the involved lower extremity. There is a gap in the literature concerning the effectiveness of core stabilization training on the treatment of patients with knee osteoarthritis. This investigation aimed to determine whether core stabilization improved the gait and functional ability of patients with knee osteoarthritis. Eighteen participants with knee osteoarthritis completed the six-week core stabilization intervention. Participants completed the gait motion analysis and the Knee Injury and Osteoarthritis Outcome Score to assess self-perceived function, pre- and post-intervention. Gait speed improved (p = 0.006, d = 0.59), while the external knee adduction moment decreased (p = 0.034, d = −0.90). Moreover, self-reported function improved (p < 0.001, d = 1.26). The gait speed and external knee adduction moment changes met minimal detectable change thresholds, while gait speed also met the minimal clinically important difference. A six-week core stabilization program can thus improve gait speed and reduce the external knee adduction moment, which is tied to disease progression. Increased functional scores post-intervention indicate an important clinical improvement. Core stabilization training is a safe and potentially effective treatment option for this population.

Cortical activity, kinematics and trunk muscles activity response to pelvis movements during unstable sitting

BACKGROUND

Balance control is a leading component of human motor activities and its impairment is associated with an increased risk of falling, lower back pain due to impaired motor control mechanism. Prolonged sitting position at workplace is one of the risk factors of reduced postural control and lower back pain.

OBJECTIVE

To evaluate theta and alpha waves cortical activity, trunk muscles activity and kinematics in static sitting, dynamic sitting on different platforms: simple wobble board (WB) and wobble board on bearing surface (WBB).

METHODS

The kinematics of body segments, electromyography of five trunk muscles, electroencephalography of 32 scalp electrodes were measured during balance tasks in sitting position for 17 subjects with continuous seated position at workplace.

RESULTS

Cortical power on WBB1 increase in fronto - central (p< 0.05) region while on WBB2 increase in centro - parietal region (p< 0.05). WBB2 increase more muscles compared with WB2. The amplitude of movement of ASIS, Th10 can be seen lower on WBB compared with WB (p< 0.05).

CONCLUSIONS

The study shows that WBB can increase personalized sitting and improve trunk motor control during hours of prolonged sitting.