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Neuromuscular Measures in Female Patients with Knee Osteoarthritis: A Pilot Study

Eley, Devon M
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430412150

Abstract Details

2015, Master of Science, University of Toledo, Exercise Science.
Context: Symptomatic knee osteoarthritis (OA) affects 12.1% of adults over the age of 60 in the United States, making OA the leading cause of disability for older adults in the U.S. OA is a degenerative disease characterized by joint space narrowing, development of osteophytes, and articular cartilage degeneration. Symptoms associated with knee OA include pain, loss of motion, and decreased functional ability. These factors lead to disability, decreased quality of life, and a higher risk of comorbidities including obesity and cardiovascular disease. OA has been shown to also affect voluntary quadriceps strength and activation, further impairing function and quality of life. These neuromuscular alterations affecting the injured joint are referred to as central activation deficits (CAD). This affects the ability to activate motor neurons around the joint for recruitment during normal muscular contractions. This results in decreased muscle contraction capabilities and becomes a problem when these deficits persist and limit the ability to regain optimal muscle function. However, it is not fully understood how these deficits contribute to and worsen knee OA. Objective: To understand how knee OA influences quadriceps strength and central activation. Additionally, we sought to determine if a group-based exercise intervention could augment CAD in women with knee OA. Design: Pilot investigation with an embedded case series. Setting: Research laboratory. Methods: Baseline demographics were recorded on all participants. Baseline MVIC and CAR were measured using the burst superimposition technique. Baseline TMS measures (AMT, SICI, LICI, ICF) were calculated. Participants completed the 8-week therapeutic exercise intervention. Follow-up MVIC and CAR were recorded. Participants: Nine patients (age=57.11±5.28, height=1.71±0.06m, mass=90.52±22.58kg, BMI=30.81±6.69) completed baseline strength and CAD measures. Three patients (age=59.67±2.89, height=1.70±0.00m, mass=85.13±8.95kg, BMI=29.46±3.10) completed baseline strength and CAD testing followed by the 8-week therapeutic exercise intervention and follow-up testing. Results: At baseline, quadriceps strength was 1.70±0.74 Nm/kg and CAR was 0.97±0.03. TMS measures at baseline were: AMT=46.50±7.85%, SICI=0.52±0.27, ICF=2.17±0.97, and LICI=0.36±0.21.For the subset of women who completed the intervention, strength decreased from baseline to follow-up (2.22±0.83 Nm/kg and 1.67±0.67 Nm/kg, respectively), while CAR remained relatively unchanged 0.99±0.01 and 0.97±0.03. Conclusions: Results show similarities among TMS between this and other studies done on this type of patient population. Quadriceps strength decreased after an 8-week therapeutic exercise intervention, which is counterintuitive. Additional studies are required to further understand the role of quadriceps central activation in the osteoarthritic process so that appropriate interventions can be developed and implemented.
Luke Donovan (Committee Chair)
Abbey Thomas (Committee Member)
Michele Pye (Committee Member)
106 p.
Health; Health Care; Health Sciences
Knee osteoarthritis; knee OA; CAR; TMS; central activation ratio; transcranial magnetic stimulation; therapeutic exercise; rehabilitation; group therapy; women

Recommended Citations

Citations

  • Eley, D. M. (2015). Neuromuscular Measures in Female Patients with Knee Osteoarthritis: A Pilot Study [Master's thesis, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430412150

    APA Style (7th edition)

  • Eley, Devon. Neuromuscular Measures in Female Patients with Knee Osteoarthritis: A Pilot Study. 2015. University of Toledo, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430412150.

    MLA Style (8th edition)

  • Eley, Devon. "Neuromuscular Measures in Female Patients with Knee Osteoarthritis: A Pilot Study." Master's thesis, University of Toledo, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1430412150

    Chicago Manual of Style (17th edition)

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This open access ETD is published by University of Toledo and OhioLINK.