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Changes in propioceptive weighting in women with knee osteoarthritis during quiet standing compared to healthy controls
Abstract   Peer reviewed

Changes in propioceptive weighting in women with knee osteoarthritis during quiet standing compared to healthy controls

A. Mahmoudian, F.P. Luyten, I. Jonkers, J.H. van Dieën, S.M. Bruijn, I.A. Baert, G.S. Faber and S.M. Verschueren
Osteoarthritis and Cartilage, Vol.23
Seattle, Washington, USA
2015

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Abstract

Purpose: Knee osteoarthritis (OA) is highly prevalent in people above the age of 60 and is associated with pain, muscle weakness, and proprioceptive deficits at the knee joint. Muscle-tendon vibration has been used in different populations such as elderly and patients with low back pain, to assess the use of proprioceptive information from different body parts in postural control. One recent study by Shanahan et al, used muscle vibration to assess the proprioceptive weighting in a group of subjects with knee osteoarthritis (KL grade 3 or 4). To the best of our knowledge this has not been done in patients with early medial knee OA. Therefore, to better understand the progression of proprioceptive impairments with the natural course of knee OA, we aimed to investigate the proprioceptive reweighting in group of subjects with early OA according to the classification criteria of Luyten (so beginning joint degeneration on MRI), and compare them to their healthy peers and patients with established OA. Methods: Standing was challenged by vibrating ankle muscles (i.e. tibialis anterior (TA) and triceps surae (TS)) and knee musculature (vastus medialis (VM)) in 27 women with early OA, 24 with established OA, and 27 healthy controls. Two muscle vibrators were utilized bilaterally with a frequency of 70 Hz and amplitude of approximately 0.5 mm. These specific vibration characteristics are used to induce a maximum illusory motion. Each trial lasted for 45 seconds, where muscle-tendon vibration was applied during the middle 15 seconds. Center of pressure (CoP) displacement was recorded using a force plate (1000 Hz). CoP position was calculated and averaged over the first 15 s of the trial (pre-vibration), during the 15 s of vibration, and after the cessation of vibration (post-vibration). The absolute difference in mean CoP position before and during vibration was then calculated as the response to muscle vibration. Also, the postural recovery from muscle vibration was defined and calculated as the absolute difference in mean CoP position during and after vibration. The ratio between the response to vibration of the VM and TS (TS/ (TS + VM) and VM and TA (TA/ (TA + VM)) was calculated as measure of proprioceptive weighting. Results: Both early and established OA groups showed significantly different postural control strategies compared to healthy controls in favor of ankle muscle proprioceptive control (ratio closer to 1) ( TS/VM= 0.87, P =0.033 and TS/VM= 0.89, P =0.015, respectively). Vibration of triceps surae resulted in a significantly larger effect on CoP both at response and recovery, in the early (PResponse=0.023 and PRecovery˂0.001) and established (PResponse=0.006 and PRecovery=0.003) OA groups compared to the healthy controls. Conclusions: The results from this study suggest that knee OA might lead to down weighting of the proprioceptive information from knee muscles. In conclusion, Subjects with knee OA seem to rely more on ankle proprioceptive input, as previously found in elderly, which suggests alterations in postural control that might be present early in the disease process.

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