Delayed Onset Time of Gluteus Medius Muscle and Frontal Mechanics of Trunk and Pelvis in Individuals with Medial Knee Osteoarthritis
Abstract
Objective: An increased strengthening of hip abductor muscles helps to improve pain and functional activity in medial knee osteoarthritis (OA). However, the mechanism analysis of the functional benefits is still incomplete. The objective was to compare the function of the gluteus medius (GMed) muscle, the contralateral pelvic drop, and ipsilateral trunk lean between the with and without knee OA groups.
Material and Methods: Twenty individuals participated in the study. Kinematics and kinetics were recorded during level walking using a 10-camera ViconTMNexus system and a force plate. GMed activity was recorded using a Delsys Trigno system. The data of 2 participants were excluded because they were incomplete. Finally, 18 data (9 knee OA and 9 asymptomatic) were reported. Independent T-test and the Mann-Whitney U test were used for statistical analysis.
Results: A delayed time of GMed muscle (32.73±30.42 ms) was significantly (p-value=0.006) exhibited in individuals with knee OA after foot contact. A lower knee injury and OA outcome score was noted in individuals with knee OA. No significant difference in manual muscle strength test, contralateral pelvic drop, lateral trunk lean, and average GMed muscle activity was observed between the groups.
Conclusion: A significant delay of GMed activation was noted in individuals with knee OA who had moderate severity in the current study, and it might be a sensitive indicator for the observation of neuromuscular deficits. In future studies, interventions aimed at improving the onset time of GMed should be investigated in individuals with knee OA in order to assess the clinical implications.
Keywords
Full Text:
PDFReferences
Vina ER, Kwoh CK. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol 2018;30:160-7.
Vincent KR, Conrad BP, Fregly BJ, Vincent HK. The pathophysiology of osteoarthritis: a mechanical perspective on the knee joint. PM R 2012;4(5Suppl):S3-9.
Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. eClinicalMedicine 2020;29-30:100587. doi: 10.1016/j.eclinm.2020.100587.
Wise B L, Niu J, Yang M, Lane NE, Harvey W, Felson DT, et al. Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans. Arthritis Care Res (Hoboken) 2012;64:847-52.
Linley HS, Sled EA, Culham EG, Deluzio KJ. A biomechanical analysis of trunk and pelvis motion during gait in subjects with knee osteoarthritis compared to control subjects. Clin Biomech (Bristol, Avon) 2010;25:1003-10. doi: 10.1016/j.clinbiomech.2010.07.012.
Chang A, Hayes K, Dunlop D, Song J, Hurwitz D, Cahue S, et al. Hip abduction moment and protection against medial tibiofemoral osteoarthritis progression. Arthritis Rheum 2005;52:3515-9.
Mündermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum 2005;52:2835-44. doi: 10.1002/art.21262.
Tanaka K, Miyashita K, Urabe Y, Ijiri T, Takemoto Y, Ishii Y, et al. Characteristics of trunk lean motion during walking in patients with symptomatic knee osteoarthritis. Knee 2008;15:134-8. doi: 10.1016/j.knee.2007.12.009
Bennell KL, Hunt MA, Wrigley TV, Ijiri T, Takemoto Y, Ishii Y, et al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthr Cartil 2010;18:621-8. doi: 10.1016/j.joca.2010.01.010.
Kean CO, Bennell KL, Wrigley TV, Hinman RS. Relationship between hip abductor strength and external hip and knee adduction moments in medial knee osteoarthritis. Clin Biomech (Bristol, Avon) 2015;30:226-30. doi: 10.1016/j.clinbiomech.2015.01.008.
Neptune RR, McGowan CP. Muscle contributions to frontal plane angular momentum during walking. J Biomech 2016;49:2975-81.
Ling SM, Conwit RA, Talbot L, Shermack M, Wood JE, Dredge EM, et al. Electromyographic patterns suggest changes in motor unit physiology associated with early osteoarthritis of the knee. Osteoarthr Cartil 2007;15:1134-40. doi: 10.1016/j.joca.2007.03.024.
Vaughan CL, O’Connor JC. Dynamics of human gait. 2nd ed. Western Cape: Kiboho Publishers; 1999.
Rajabi R, Johnson GM, Alizadeh MH, Meghdadi N. Radiographic knee osteoarthritis in ex-elite table tennis players. BMC Musculoskelet Disord 2012;13:12. doi: 10.1186/1471-2474-13-12.
Fraenkel L, Bathon JM, England BR, St Clair EW, Arayssi T, Carandang K, et al. 2021 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res 2021;73:924-39. doi: 10.1002/art.41752.
Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24. doi: 10.1002/art.1780310302.
Chaipinyo K. Test-retest reliability and construct validity of Thai version of knee osteoarthritis outcome score (KOOS). Thai J Phys Ther 2009;31:67-76.
Surface electromyography for the non-invasive assessment of muscles. Recommendations for sensor locations in hip or upper leg muscles [homepage on the Internet]. Enschede: SENIAM; 1996 [cited 2018 Nov 5] Available from: http://seniam.org/gluteusmedius.html
Choi B, Kim M, Jeon HS. The effects of an isometric knee extension with hip adduction (KEWHA) exercise on selective VMO muscle strengthening. J Electromyogr Kinesiol 2011;21:1011-6.
Konrad P. The ABC of EMG: a practical introduction to kinesiological electromyography. Scottsdale: Noraxon U.S.A. Inc; 2005.
Rutherford D, Baker M, Wong I, Stanish W. The effect of age and knee osteoarthritis on muscle activation patterns and knee joint biomechanics during dual belt treadmill gait. J Electromyogr Kinesiol 2017;34:58-64. doi: 10.1016/j.jelekin.2017.04.001.
Hálfdanardóttir F, Ramsey DK, Briem K. Timing of frontal plane trunk lean, not magnitude, mediates frontal plane knee joint loading in patients with moderate medial knee osteoarthritis. Adv Orthop 2018;4526872. doi: 10.1155/2018/4526872.
Sinsurin K, Valldecabres R, Richards J. An exploration of the differences in hip strength, gluteus medius activity, and trunk, pelvis, and lower-limb biomechanics during different functional tasks. Int Biomech 2020;7:35-43. doi: 10.1080/23335432.2020.1728381.
Gross K, Niu J, Chacko A, Zhang Y, Mattson DJ, Nevitt MC, et al. The relationship between pelvic drop during walking and radiographic medial knee osteoarthritis: the most study. Osteoarthr Cartil 2012;20:S95-6. doi: 10.1016/j.joca.2012.02.099.
Bechard DJ, Birmingham TB, Zecevic AA, Jones IC, Giffin JR, Jenkyn TR. Toe-out, lateral trunk lean, and pelvic obliquity during prolonged walking in patients with medial compartment knee osteoarthritis and healthy controls. Arthritis Care Res 2012;64:525-32. doi: 10.1002/acr.21584.
Hunt MA, Wrigley TV, Hinman RS, Bennell KL. Individuals with severe knee osteoarthritis (OA) exhibit altered proximal walking mechanics compared with individuals with less severe OA and those without knee pain. Arthritis Care Res (Hoboken) 2010;62:1426-32. doi: 10.1002/acr.20248.
Alkjaer T, Raffalt PC, Dalsgaard H, Simonsen EB, Petersen NC, Bliddal H, et al. Gait variability and motor control in people with knee osteoarthritis. Gait Posture 2015;42:479-84. doi: 10.1016/j.gaitpost.2015.07.063.
Hinman RS, Hunt MA, Creaby MW, Wrigley TV, McManus FJ, Bennell KL. Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res (Hoboken) 2010;62:1190-3. doi: 10.1002/acr.20199.
Rutherford DJ, Hubley-Kozey C, Stanish W. Hip abductor function in individuals with medial knee osteoarthritis: Implications for medial compartment loading during gait. Clin Biomech (Bristol) 2014;29:545-50. doi: 10.1016/j.clinbiomech.2014.03.009.
Refbacks
- There are currently no refbacks.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.