Background

Knee osteoarthritis accounts for more years of disability than all other forms of osteoarthritis combined. Gait kinetic and kinematic changes, in addition to reduced gait speed, are commonly observed. This study investigates whether core activation, which modifies lower extremity movement in young, active populations, can alter the gait and baseline core activation of those with knee osteoarthritis as compared to controls, and alter osteoarthritic knee pain.

Methods

Forty-four participants (22 controls and 22 with knee osteoarthritis) underwent biomechanical gait assessment, examining kinetic and kinematic variables, in addition to gait speed, with and without volitional transversus abdominis activation. Surface electromyography was used to measure baseline transversus abdominis activation under both conditions. Knee pain ratings were examined for those with knee osteoarthritis.

Findings

No significant biomechanical differences were observed within groups, or in the time/group interaction. Between-groups kinetic (time to first peak ground reaction force and amplitude of second peak ground reaction force) and gait speed differences were observed under both conditions. There were no differences in baseline electromyography activation between or within-groups, or within-group for self-reported pain for the osteoarthritic group.

Interpretation

Although previous studies have shown the benefit of core activation in correcting lower extremity movement patterns and kinetic loading in young, athletic populations, this study is the first to show this is not the case for persons with knee osteoarthritis. Future studies should examine the value of a progressive core stabilization program, of sufficient dose and mode, in correcting the observed gait differences in those with knee osteoarthritis.

Clinical Trial Registration Number: NCT03776981

中文翻译：

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在有或没有膝骨关节炎的患者中，腹横肌激活不会改变步态障碍

背景

膝关节骨关节炎比所有其他形式的骨关节炎加起来造成了更多的残疾。通常观察到步态动力学和运动学变化，除了步速降低之外。这项研究调查了核心激活是否可以改变膝关节骨关节炎患者的步态和基线核心激活，从而改变年轻人活跃人群的下肢运动，与对照组相比，其步态和基线核心激活是否发生改变，以及是否可以改变骨关节炎膝盖疼痛。

方法

44名参与者（22名对照者和22名膝部骨关节炎）进行了生物力学步态评估，除了步态速度外，还检查了有无横断性腹横肌激活的动力学和运动学变量。在两种情况下，表面肌电图均用于测量基线横断腹腔的激活。检查膝关节骨关节炎患者的膝关节疼痛等级。

发现

在组内或时间/组相互作用中未观察到明显的生物力学差异。在两个条件下均观察到组间动力学（到达第一峰值地面反作用力的时间和第二峰值地面反作用力的幅度）和步态速度差异。骨关节炎组的自我报告的疼痛之间或组内或组内基线肌电图激活无差异。

解释

尽管先前的研究表明核心激活在纠正年轻运动人群的下肢运动模式和运动负荷方面具有益处，但这项研究首次表明膝部骨关节炎患者并非如此。未来的研究应检查足够剂量和方式的渐进式核心稳定计划在纠正膝部骨关节炎患者步态差异方面的价值。

临床试验注册号：NCT03776981