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Sensori-motor adaptation to knee osteoarthritis during stepping-down before and after total knee replacement.

Mouchnino L, Gueguen N, Blanchard C, Boulay C, Gimet G, Viton JM, Franceschi JP, Delarque A - BMC Musculoskelet Disord (2005)

Bottom Line: This strategy could be aimed at shortening the duration-time supporting on the painful limb.However no such compensatory response was observed.The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

View Article: PubMed Central - HTML - PubMed

Affiliation: Laboratory of Movement and Perception, Faculty of Sport Sciences, 163 av. de Luminy, 13288 Marseille cedex 9, France. mouchnino@laps.univ-mrs.fr

ABSTRACT

Background: Stepping-down is preceded by a shift of the center of mass towards the supporting side and forward. The ability to control both balance and lower limb movement was investigated in knee osteoarthritis patients before and after surgery. It was hypothesized that pain rather than knee joint mobility affects the coordination between balance and movement control.

Methods: The experiment was performed with 25 adult individuals. Eleven were osteoarthritic patients with damage restricted to one lower limb (8 right leg and 3 left leg). Subjects were recruited within two weeks before total knee replacement by the same orthopedic surgeon using the same prosthesis and technics of surgery. Osteoarthritic patients were tested before total knee replacement (pre-surgery session) and then, 9 of the 11 patients were tested one year after the surgery when re-educative training was completed (post-surgery session). 14 adult individuals (men: n = 7 and women: n = 7) were tested as the control group.

Results: The way in which the center of mass shift forward and toward the supporting side is initiated (timing and amplitude) did not vary within patients before and after surgery. In addition knee joint range of motion of the leading leg remained close to normal before and after surgery. However, the relative timing between both postural and movement phases was modified for the osteoarthritis supporting leg (unusual strategy for stepping-down) before surgery. The "coordinated" control of balance and movement turned to be a "sequential" mode of control; once the body weight transfer has been completed, the movement onset is triggered. This strategy could be aimed at shortening the duration-time supporting on the painful limb. However no such compensatory response was observed.

Conclusion: The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

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Schema of the vertical ground reaction force recorded on the landing force platform. Weight acceptance was from the ground contact to the peak and was calculated in percentage relative to the body weight to normalize the data for all the subjects.
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Figure 3: Schema of the vertical ground reaction force recorded on the landing force platform. Weight acceptance was from the ground contact to the peak and was calculated in percentage relative to the body weight to normalize the data for all the subjects.

Mentions: The adaptation of the weight acceptance is illustrated in Fig. 3. The ground impact, defined as the maximal value of the vertical ground reaction force and normalized to the body weight, did not differ in patients before and after surgery [F(1,4) = 3.37; p = 0.14]. However, in patients landing on the sound leg (i.e. using the arthritis leg as the supporting leg) before surgery, the ground impact increased (142 % +/-36) [side-effect F(1,4) = 7.59; p = 0.05] compared to those landing on the arthritis leg (118 %+/-37) (Fig. 3). This result indicated a reduced breaking capacity of the supporting knee joint during the monopodal stance, which enhanced the forthcoming ground impact. After surgery, the ground impact decreased to a value close to that observed in the control group (p = 0.78) (Fig. 3).


Sensori-motor adaptation to knee osteoarthritis during stepping-down before and after total knee replacement.

Mouchnino L, Gueguen N, Blanchard C, Boulay C, Gimet G, Viton JM, Franceschi JP, Delarque A - BMC Musculoskelet Disord (2005)

Schema of the vertical ground reaction force recorded on the landing force platform. Weight acceptance was from the ground contact to the peak and was calculated in percentage relative to the body weight to normalize the data for all the subjects.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1131905&req=5

Figure 3: Schema of the vertical ground reaction force recorded on the landing force platform. Weight acceptance was from the ground contact to the peak and was calculated in percentage relative to the body weight to normalize the data for all the subjects.
Mentions: The adaptation of the weight acceptance is illustrated in Fig. 3. The ground impact, defined as the maximal value of the vertical ground reaction force and normalized to the body weight, did not differ in patients before and after surgery [F(1,4) = 3.37; p = 0.14]. However, in patients landing on the sound leg (i.e. using the arthritis leg as the supporting leg) before surgery, the ground impact increased (142 % +/-36) [side-effect F(1,4) = 7.59; p = 0.05] compared to those landing on the arthritis leg (118 %+/-37) (Fig. 3). This result indicated a reduced breaking capacity of the supporting knee joint during the monopodal stance, which enhanced the forthcoming ground impact. After surgery, the ground impact decreased to a value close to that observed in the control group (p = 0.78) (Fig. 3).

Bottom Line: This strategy could be aimed at shortening the duration-time supporting on the painful limb.However no such compensatory response was observed.The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

View Article: PubMed Central - HTML - PubMed

Affiliation: Laboratory of Movement and Perception, Faculty of Sport Sciences, 163 av. de Luminy, 13288 Marseille cedex 9, France. mouchnino@laps.univ-mrs.fr

ABSTRACT

Background: Stepping-down is preceded by a shift of the center of mass towards the supporting side and forward. The ability to control both balance and lower limb movement was investigated in knee osteoarthritis patients before and after surgery. It was hypothesized that pain rather than knee joint mobility affects the coordination between balance and movement control.

Methods: The experiment was performed with 25 adult individuals. Eleven were osteoarthritic patients with damage restricted to one lower limb (8 right leg and 3 left leg). Subjects were recruited within two weeks before total knee replacement by the same orthopedic surgeon using the same prosthesis and technics of surgery. Osteoarthritic patients were tested before total knee replacement (pre-surgery session) and then, 9 of the 11 patients were tested one year after the surgery when re-educative training was completed (post-surgery session). 14 adult individuals (men: n = 7 and women: n = 7) were tested as the control group.

Results: The way in which the center of mass shift forward and toward the supporting side is initiated (timing and amplitude) did not vary within patients before and after surgery. In addition knee joint range of motion of the leading leg remained close to normal before and after surgery. However, the relative timing between both postural and movement phases was modified for the osteoarthritis supporting leg (unusual strategy for stepping-down) before surgery. The "coordinated" control of balance and movement turned to be a "sequential" mode of control; once the body weight transfer has been completed, the movement onset is triggered. This strategy could be aimed at shortening the duration-time supporting on the painful limb. However no such compensatory response was observed.

Conclusion: The change in the strategy used when supporting on the arthritis and painful limb could result from the action of nociceptors that lead to increased proprioceptor thresholds, thus gating the proprioceptive inputs that may be the critical afferents in controlling the timing of the coordination between balance and movement initiation control.

Show MeSH
Related in: MedlinePlus