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Shock attenuation at the knee during walking in people with knee osteoarthritis: association with disease severity and effects of exercise

BACKGROUND: Knee osteoarthritis is a debilitating disease largely affecting the elderly population, impacting their quality of life through joint pain and decreased mobility. Shock attenuation at the knee has been one measure associated with increased pain due to the inability to properly absorb shock as one performs physical activities such as walking and running. Although there is currently no cure to knee osteoarthritis, there are many treatments ranging from exercise to surgical interventions that aim to minimize these negative symptoms and prevent further joint degradation and disease severity.
RESEARCH QUESTION/PURPOSE: This thesis aims to examine shock attenuation at the knee during walking and its association with muscle activation and disease severity in people with knee osteoarthritis. In addition, this study will investigate the effects of exercise intervention on shock attenuation at the knee in this population of individuals.
METHODS: 295 individuals with confirmed knee osteoarthritis were recruited from surrounding communities in this study. Of these 295 participants, 58 participants were included in a 12-week follow-up study to compare the effects of exercise therapy. All muscle activation and shock attenuation data were collected using a 13-camera motion capture system and muscle co-contraction was measured using electromyography (EMG) sensors. A multivariate regression model accounting for age, sex, and BMI was sued to analyze the association between shock attenuation at the knee and disease severity as well as with muscle activation. A linear mixed model was also used to the difference between repeated measures in analyzing the effects of exercise intervention on shock attenuation.
RESULTS: Shock attenuation from shank to thigh and as calculated by coupled vector angle had a significant negative correlation with disease severity characterized by an increase in Kellgren-Lawrence grade as well as a positive correlation with Knee Injury and Osteoarthritis Outcome (KOOS) pain scores. An increase in vastus lateralis and left hamstring muscle co-contraction was also associated with a decrease in coupled vector angle. In analyzing the effects of exercise intervention on shock absorption, there was a significant decrease in shock attenuation from the shank to thigh after a 12-week follow-up study.
DISCUSSION: As the knee osteoarthritis disease severity progresses, patients will also experience lower shock attenuation and increased pain. In addition, increased muscular co-contraction between the vastus lateralis and left hamstring corresponded with a decrease in coupled vector angle. Our results also suggest that exercise may decrease a patient’s ability to absorb shock at the knee. / 2026-03-15T00:00:00Z

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48412
Date15 March 2024
CreatorsYu, Gavin
ContributorsKumar, Deepak, Gerstenfeld, Louis C.
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation

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