Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

H.R. FallahYakhdani, H. Abbasi Bafghi, O.G. Meijer, S.M. Bruijn, N. van den Dikkenberg, M-G. Benedetti, J.H. van Dieen

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and co-contraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Pre-operatively, multivariate regressions on co-contraction time were used to identify determinants of co-contraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of co-contraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability. © 2011 Elsevier Ltd. All rights reserved.
    Original languageEnglish
    Pages (from-to)485-494
    JournalClinical Biomechanics
    Volume27
    DOIs
    Publication statusPublished - 2012

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    Knee Osteoarthritis
    Arthroplasty
    Walking
    Biomechanical Phenomena
    Leg
    Knee
    Accidental Falls
    Muscles
    Knee Replacement Arthroplasties
    Contracts

    Cite this

    FallahYakhdani, H.R. ; Abbasi Bafghi, H. ; Meijer, O.G. ; Bruijn, S.M. ; van den Dikkenberg, N. ; Benedetti, M-G. ; van Dieen, J.H. / Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis. In: Clinical Biomechanics. 2012 ; Vol. 27. pp. 485-494.
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    title = "Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis",
    abstract = "Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and co-contraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Pre-operatively, multivariate regressions on co-contraction time were used to identify determinants of co-contraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of co-contraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability. {\circledC} 2011 Elsevier Ltd. All rights reserved.",
    author = "H.R. FallahYakhdani and {Abbasi Bafghi}, H. and O.G. Meijer and S.M. Bruijn and {van den Dikkenberg}, N. and M-G. Benedetti and {van Dieen}, J.H.",
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    Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis. / FallahYakhdani, H.R.; Abbasi Bafghi, H.; Meijer, O.G.; Bruijn, S.M.; van den Dikkenberg, N.; Benedetti, M-G.; van Dieen, J.H.

    In: Clinical Biomechanics, Vol. 27, 2012, p. 485-494.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

    AU - FallahYakhdani, H.R.

    AU - Abbasi Bafghi, H.

    AU - Meijer, O.G.

    AU - Bruijn, S.M.

    AU - van den Dikkenberg, N.

    AU - Benedetti, M-G.

    AU - van Dieen, J.H.

    PY - 2012

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    N2 - Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and co-contraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Pre-operatively, multivariate regressions on co-contraction time were used to identify determinants of co-contraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of co-contraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability. © 2011 Elsevier Ltd. All rights reserved.

    AB - Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and co-contraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Pre-operatively, multivariate regressions on co-contraction time were used to identify determinants of co-contraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of co-contraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability. © 2011 Elsevier Ltd. All rights reserved.

    U2 - 10.1016/j.clinbiomech.2011.11.006

    DO - 10.1016/j.clinbiomech.2011.11.006

    M3 - Article

    VL - 27

    SP - 485

    EP - 494

    JO - Clinical Biomechanics

    JF - Clinical Biomechanics

    SN - 0268-0033

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