RESUMEN
OBJECTIVE: To determine the immediate effects of a varus unloader knee brace on lower-limb electromyographic activity in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. METHODS: Electromyographic data were recorded in 19 individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction during walking under three conditions: (i) no brace, (ii) unadjusted brace (no varus adjustment), and adjusted brace (varus adjustment). Variables of interest were statistically analyzed using repeated measures analysis of variance. RESULTS: There were no significant differences in muscle co-contraction between the three test conditions. The adjusted brace resulted in delayed offset of gluteus maximus (mean difference [95% CI]: 72ms [24, 119]), and earlier onset of gluteus medius (59ms [21, 97]) compared to no brace. The adjusted brace delayed onset of lateral gastrocnemius compared to no brace (53ms [28, 78]) and the unadjusted brace (39ms [7, 71]) and reduced average activation amplitude of gluteus maximus (-4mV [-6, -1]) and lateral gastrocnemius (-9mV [-16, -2]) compared to no brace. CONCLUSIONS: The unloader brace did not produce significant changes in muscle co-contraction in individuals with lateral knee osteoarthritis and valgus malalignment after anterior cruciate ligament reconstruction. Significant changes in gluteal and gastrocnemius muscle activation timing and amplitude were observed, however, it is not clear whether these changes are of clinical importance.
Asunto(s)
Reconstrucción del Ligamento Cruzado Anterior/métodos , Extremidad Inferior/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/fisiopatología , Osteoartritis de la Rodilla/fisiopatología , Tirantes , Humanos , Caminata/fisiologíaRESUMEN
OBJECTIVES: (i) To compare kinesiophobia, pain catastrophism and objective function between women with patellofemoral pain (PFP) and pain-free; (ii) to investigate the association of kinesiophobia and pain catastrophism with objetive function in women with PFP. DESIGN: Case-control. SETTING: Laboratory-based. PARTICIPANTS: Fifty-five women with PFP and forty pain-free women. MAIN OUTCOME MEASURES: Kinesiophobia and pain catastrophism were assessed using the Tampa Scale of Kinesiophobia and Pain Catastrophizing Scale, respectively. Forward step-down, single leg hop, and modified star balance tests were used to assess objective function. Independent t-tests were used for between-groups comparisons and Pearson correlation coefficients were used to investigate the association between the outcomes. RESULTS: Women with PFP had significantly worse kinesiophobia (pâ¯<â¯0.001; Effect size (ES)â¯=â¯1.16), pain catastrophism (pâ¯<â¯0.001; ESâ¯=â¯1.57), and poorer objective function (step-down, (pâ¯<â¯0.001; ESâ¯=â¯0.99); single-leg hop (pâ¯=â¯0.002; ESâ¯=â¯0.74); modified star balance (pâ¯<â¯0.001; ESâ¯=â¯0.66) than pain-free controls. Kinesiophobia and pain catastrophism were not correlated with objective function. CONCLUSION: Greater kinesiophobia, pain catastrophism and poorer objective function is evident in women with PFP, compared to pain-free controls. Kinesiophobia and pain catastrophism were not associated with objective function in women with PFP. Future research is necessary to understand how other physical and psychological factors might affect objective function.