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Open Access 01-12-2021 | Knee Osteoarthritis | Research article

Hyperalgesia affects muscle activity and knee range of motion during a single-limb mini squat in individuals with knee osteoarthritis: a cross-sectional study

Authors: Jéssica Garcia Jorge, Ana Luiza Costa e Silva Cabral, Vanessa Martins Pereira Silva Moreira, Wallisen Tadashi Hattori, Valdeci Carlos Dionisio

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). This study aimed examine the clinical measures and hyperalgesia’s effect on muscle activity, knee range of motion (ROM) and postural control during the single-leg mini squat (SLMS) in individuals with KOA, determining the correlation between variables.

Methods

In this cross-sectional study, 60 individuals, 30 healthy (HG, 57.4 ± 6.86 years), and 30 with mild to moderate KOA (KOAG, 59.4 ± 5.46 years) were evaluated by the visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC), and the pressure pain threshold (PPT) in subcutaneous, myotomal, and sclerotomal structures. Muscle activity, knee ROM and postural control were assessed during a SLMS. The analyses were performed in the two phases of the SLMS. Phase 1 - during descending movement (eccentric contraction), Phase 2 - during ascending movement (concentric contraction). Analysis of covariance was applied for each variable separately, using weight as a co-variable. We used Spearman’s test for determining the correlation.

Results

There was no difference between groups for age, height, and postural control (p > 0.059), but KOAG presented the highest values for VAS and WOMAC (p = 0.000). In addition, EMG activity was higher in KOAG for gastrocnemius medialis and tibialis anterior muscles during phase 1 (p < 0.027), and for gastrocnemius medialis and gluteus medius muscles during phase 2 (p < 0.007), and reduced values for PPT and knee ROM (p = 0.000). Also, the correlations between PPT with muscle activity and postural control were moderate (rho< 0.482), while strong relationships were observed between some PPT points with VAS and WOMAC (rho> 0.507).

Conclusion

Hyperalgesia affects the functionality during a single-limb mini squat. There is an important correlation between hyperalgesia and muscle activity, postural control, and clinical measures in individuals with KOA.

Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73:1323–30. https://doi.org/10.1136/annrheumdis-2013-204763.CrossRef

Imamura M, Imamura ST, Kaziyama HHS, Targino RA, Hsing WT, de Souza LPM, et al. Impact of nervous system hyperalgesia on pain, disability, and quality of life in patients with knee osteoarthritis: a controlled analysis. Arthritis Rheum. 2008;59:1424–31. https://doi.org/10.1002/art.24120.CrossRefPubMed

Bushnell MC, Čeko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14:502–11. https://doi.org/10.1002/art.24120.CrossRefPubMedPubMedCentral

Rakel B, Vance C, Zimmerman MB, Petsas-Blodgett N, Amendola A, Sluka KA. Mechanical hyperalgesia and reduced quality of life occur in people with mild knee osteoarthritis pain. Clin J Pain. 2015;31:315–22. https://doi.org/10.1097/AJP.0000000000000116.CrossRefPubMed

Bevilaqua-Grossi D, Zanin M, Benedetti C, Florencio L, Oliveira A. Thermal and mechanical pain sensitization in patients with osteoarthritis of the knee. Physiother Theory Pract. 2019;35:139–47. https://doi.org/10.1080/09593985.2018.1441930.CrossRefPubMed

Graven-Nielsen T, Arendt-Nielsen L. Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat Rev Rheumatol. 2010;6:599–606. https://doi.org/10.1038/nrrheum.2010.107.CrossRefPubMed

Suokas AK, Walsh DA, McWilliams DF, Condon L, Moreton B, Wylde V, et al. Quantitative sensory testing in painful osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil. 2012;20:1075–85. https://doi.org/10.1016/j.joca.2012.06.009.CrossRef

Im HJ, Kim JS, Li X, Kotwal N, Sumner DR, Van Wijnen AJ, et al. Alteration of sensory neurons and spinal response to an experimental osteoarthritis pain model. Arthritis Rheum. 2010;62:2995–3005. https://doi.org/10.1002/art.27608.CrossRefPubMedPubMedCentral

Takacs J, Carpenter MG, Jayne Garland S, Hunt MA. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control. Aging Dis. 2013;4:84–99.PubMedPubMedCentral

10.

Marriott KA, Birmingham TB, Leitch KM, Pinto R, Giffin JR. Strong independent associations between gait biomechanics and pain in patients with knee osteoarthritis. J Biomech. 2019;94:123–9. https://doi.org/10.1016/j.jbiomech.2019.07.015.CrossRefPubMed

11.

Sanchez-Ramirez DC, Van Der Leeden M, Knol DL, Van Der Esch M, Roorda LD, Verschueren S, et al. Association of postural control with muscle strength, proprioception, self-reported knee instability and activity limitations in patients with knee osteoarthritis. J Rehabil Med. 2013;45:192–7. https://doi.org/10.2340/16501977-1087.CrossRefPubMed

12.

Petrella M, Gramani-Say K, Serrão PRMS, Lessi GC, Barela JA, Carvalho RP, et al. Measuring postural control during mini-squat posture in men with early knee osteoarthritis. Hum Mov Sci. 2017;52:108–16. https://doi.org/10.1016/j.humov.2017.01.011.CrossRefPubMed

13.

Demirbüken O, Özyürek S, Angln S. The immediate effect of patellar tendon strap on weight-bearing asymmetry during squatting in patients with unilateral knee osteoarthritis: a pilot study. Prosthetics Orthot Int. 2016;40:682–8. https://doi.org/10.1177/0309364615612251.CrossRef

14.

Sanchez-Ramirez DC, Malfait B, Baert I, van der Leeden M, van Dieën J, Lems WF, et al. Biomechanical and neuromuscular adaptations during the landing phase of a stepping-down task in patients with early or established knee osteoarthritis. Knee. 2016;23:367–75. https://doi.org/10.1016/j.knee.2016.02.002.CrossRefPubMed

15.

Asay JL, Mündermann A, Andriacchi TP. Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis. J Orthop Res. 2009;27:325–9. https://doi.org/10.1002/jor.20751.CrossRefPubMed

16.

Comfort P, Jones PA, Smith LC, Herrington L. Joint kinetics and kinematics during common lower limb rehabilitation exercises. J Athl Train. 2015;50:1011–8. https://doi.org/10.4085/1062-6050-50.9.05.CrossRefPubMedPubMedCentral

17.

Khuu A, Foch E, Lewis CL. Not all single leg squats are equal: a biomechanical comparison of three variations. Int J Sports Phys Ther. 2016;11:201–11.PubMedPubMedCentral

18.

Hunt MA, McManus FJ, Hinman RS, Bennell KL. Predictors of single-leg standing balance in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010;62:496–500. https://doi.org/10.1002/acr.20046.CrossRef

19.

Arendt-Nielsen L, Graven-Nielsen T. Muscle pain: sensory implications and interaction with motor control. Clin J Pain. 2008;24:291–8. https://doi.org/10.1097/AJP.0b013e31815b608f.CrossRefPubMed

20.

Zale EL, Ditre JW. Pain-related fear, disability, and the fear-avoidance model of chronic pain. Curr Opin Psychol. 2015;5:24–30. https://doi.org/10.1016/j.copsyc.2015.03.014.CrossRefPubMedPubMedCentral

21.

Brenneman EC, Kuntz AB, Wiebenga EG, Maly MR. Does pain relate with activation of quadriceps and hamstrings muscles during strengthening exercise in people with knee osteoarthritis? Springerplus. 2016;5:463. https://doi.org/10.1186/s40064-016-2048-1.CrossRefPubMedPubMedCentral

22.

Park HJ, Ko S, Hong HM, Ok E, Lee JI. Factors related to standing balance in patients with knee osteoarthritis. Ann Rehabil Med. 2013;37:373–8. https://doi.org/10.5535/arm.2013.37.3.373.CrossRefPubMedPubMedCentral

23.

Henry R, Cahill CM, Wood G, Hroch J, Wilson R, Cupido T, et al. Myofascial pain in patients waitlisted for total knee arthroplasty. Pain Res Manag. 2012;17:321–7. https://doi.org/10.1155/2012/547183.CrossRefPubMedPubMedCentral

24.

Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29:1039–49. https://doi.org/10.1002/art.1780290816.CrossRef

25.

Moreira VMPS, Barboza SD, Oliveira JB, Pereira JM, Dionisio VC. Secondary hyperalgesia occurs regardless of unilateral or bilateral knee osteoarthritis involvement in individuals with mild or moderate level. Rev Bras Reumatol. 2017;57. https://doi.org/10.1016/j.rbre.2016.03.014.

26.

Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol. 2000;10:361–74. https://doi.org/10.1016/s1050-6411(00)00027-4.CrossRef

27.

de Oliveira DC, Barboza SD, da Costa FD, Cabral MP, Silva VM, Dionisio VC. Can pain influence the proprioception and the motor behavior in subjects with mild and moderate knee osteoarthritis? BMC Musculoskelet Disord. 2014;15:321. https://doi.org/10.1186/1471-2474-15-321.CrossRefPubMedPubMedCentral

28.

Sørensen RR, Jørgensen MG, Rasmussen S, Skou ST. Impaired postural balance in the morning in patients with knee osteoarthritis. Gait Posture. 2014;39:1040–4. https://doi.org/10.1016/j.gaitpost.2014.01.002.CrossRefPubMed

29.

Schober P, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126:1763–8. https://doi.org/10.1213/ANE.0000000000002864.CrossRefPubMed

30.

Moss P, Knight E, Wright A. Subjects with knee osteoarthritis exhibit widespread hyperalgesia to pressure and cold. PLoS One. 2016;11. https://doi.org/10.1371/journal.pone.0147526.

31.

Pelletier R, Higgins J, Bourbonnais D. Is neuroplasticity in the central nervous system the missing link to our understanding of chronic musculoskeletal disorders? BMC Musculoskelet Disord. 2015;16. https://doi.org/10.1186/s12891-015-0480-y.

32.

Baliki MN, Chialvo DR, Geha PY, Levy RM, Harden RN, Parrish TB, et al. Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci. 2006;26:12165–73. https://doi.org/10.1523/JNEUROSCI.3576-06.2006.CrossRefPubMedPubMedCentral

33.

Ahmad AH, Zakaria R. Pain in times of stress. Malays J Med Sci. 2015;22(Spec Issue):52–61.PubMedPubMedCentral

34.

Tarragó MDGL, Deitos A, Brietzke AP, Vercelino R, Torres ILS, Fregni F, et al. Descending control of nociceptive processing in knee osteoarthritis is associated with intracortical disinhibition. Medicine. 2016;95. https://doi.org/10.1097/MD.0000000000003353.

35.

Dionisio VC, Almeida GL, Duarte M, Hirata RP. Kinematic, kinetic and EMG patterns during downward squatting. J Electromyogr Kinesiol. 2008;18:134–43. https://doi.org/10.1016/j.jelekin.2006.07.010.CrossRefPubMed

36.

Hase K, Sako M, Ushiba J, Chino N. Motor strategies for initiating downward-oriented movements during standing in adults. Exp Brain Res. 2004;158:18–27. https://doi.org/10.1007/s00221-004-1875-4.CrossRefPubMed

37.

Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. PM R. 2012;4(5 SUPPL). https://doi.org/10.1016/j.pmrj.2012.01.019.

38.

Hodges PW, van den Hoorn W, Wrigley TV, Hinman RS, Bowles KA, Cicuttini F, et al. Increased duration of co-contraction of medial knee muscles is associated with greater progression of knee osteoarthritis. Man Ther. 2016;21:151–8. https://doi.org/10.1016/j.math.2015.07.004.CrossRefPubMed

39.

Hubley-Kozey CL, Hill NA, Rutherford DJ, Dunbar MJ, Stanish WD. Coactivation differences in lower limb muscles between asymptomatic controls and those with varying degrees of knee osteoarthritis during walking. Clin Biomech. 2009;24:407–14. https://doi.org/10.1016/j.clinbiomech.2009.02.005.CrossRef

40.

Bouchouras G, Patsika G, Hatzitaki V, Kellis E. Kinematics and knee muscle activation during sit-to-stand movement in women with knee osteoarthritis. Clin Biomech. 2015;30:599–607. https://doi.org/10.1016/j.clinbiomech.2015.03.025.CrossRef

41.

Frey-Law LA, Avin KG. Muscle coactivation: a generalized or localized motor control strategy? Muscle Nerve. 2013;48:578–85. https://doi.org/10.1002/mus.23801.CrossRefPubMedPubMedCentral

42.

Childs JD, Sparto PJ, Fitzgerald GK, Bizzini M, Irrgang JJ. Alterations in lower extremity movement and muscle activation patterns in individuals with knee osteoarthritis. Clin Biomech. 2004;19:44–9. https://doi.org/10.1016/j.clinbiomech.2003.08.007.CrossRef

43.

Turcot K, Armand S, Fritschy D, Hoffmeyer P, Suvà D. Sit-to-stand alterations in advanced knee osteoarthritis. Gait Posture. 2012;36:68–72. https://doi.org/10.1016/j.gaitpost.2012.01.005.CrossRefPubMed

44.

Felson DT, Gross KD, Nevitt MC, Ph D, Yang M, Lane NE, et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Rheum. 2009;61:1070–6. https://doi.org/10.1002/art.24606.CrossRefPubMedPubMedCentral

Title: Hyperalgesia affects muscle activity and knee range of motion during a single-limb mini squat in individuals with knee osteoarthritis: a cross-sectional study
Authors: Jéssica Garcia Jorge
Ana Luiza Costa e Silva Cabral
Vanessa Martins Pereira Silva Moreira
Wallisen Tadashi Hattori
Valdeci Carlos Dionisio
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Knee Osteoarthritis
Electromyographic
Knee Osteoarthritis
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-03947-w

ACC 2024 Congress

Springer Medicine

Hyperalgesia affects muscle activity and knee range of motion during a single-limb mini squat in individuals with knee osteoarthritis: a cross-sectional study

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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