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Muscular co-contraction is related to varus thrust in patients with knee osteoarthritis

  • Philippe C. Dixon
    Affiliations
    Bouvé College of Health Sciences, Northeastern University, Boston, USA

    Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, Montreal, Canada

    School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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  • Sharleen Gomes
    Affiliations
    Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, Montreal, Canada

    School of Physical and Occupational Therapy, McGill University, Montreal, Canada
    Search for articles by this author
  • Richard A. Preuss
    Affiliations
    Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, Montreal, Canada

    School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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  • Shawn M. Robbins
    Correspondence
    Corresponding author at: School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
    Affiliations
    Centre for Interdisciplinary Research in Rehabilitation, Constance Lethbridge Rehabilitation Centre, Montreal, Canada

    School of Physical and Occupational Therapy, McGill University, Montreal, Canada
    Search for articles by this author

      Highlights

      • Varus thrust and muscle co-contraction exists in patients with knee osteoarthritis.
      • These variables, measured during gait, have not been compared.
      • Quadriceps-hamstring co-contraction ratios were directly related to varus thrust.
      • Co-contraction during gait might stiffen the knee or it could be a reflex.

      Abstract

      Background

      Patients with knee osteoarthritis often present with varus thrust and muscular co-contraction during gait. It is unclear if these adaptations are related. The objective was to examine the relationship between muscle co-contraction and varus thrust during gait in patients with knee osteoarthritis and to determine if these relationships are modulated by disease severity or history of knee ligament rupture.

      Methods

      Participants (n = 42, 23 women, mean age 58 years) with knee osteoarthritis completed gait trials at self-selected speeds. Varus thrust was measured with an eight camera motion capture system sampled at 100 Hz. Co-contraction ratios were measured with surface electromyography sampled at 2000 Hz over the quadriceps, hamstrings, and gastrocnemius. Disease severity was measured on radiographs and history of anterior cruciate ligament rupture was confirmed on magnetic resonance imaging. Linear regression analyses examined the relationship between varus thrust and co-contraction ratios after controlling for radiographic disease severity and history of anterior cruciate ligament rupture.

      Findings

      Higher vastus lateralis–lateral hamstring (b = 0.081, P < 0.001; R2 = 0.353) and vastus medialis–medial hamstring (b = 0.063, P = 0.028; R2 = 0.168) co-contraction ratios were associated with greater varus thrust. Quadriceps-gastrocnemius co-contractions ratios were not related to varus thrust (P > 0.05). Radiographic disease severity or history of anterior cruciate ligament injury did not significantly contribute to regression models.

      Interpretation

      Greater quadriceps-hamstring co-contraction is associated with greater varus thrust in patients with knee osteoarthritis. Potential explanations include increased co-contraction may provide stability or there is a proprioceptive reflex that is independent of any stabilizing role. Research is needed to test these hypotheses.

      Keywords

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