Abstract
BackgroundOlder adults and individuals with knee osteoarthritis (KOA) often exhibit reduced locomotor function and altered muscle activity. Identifying age- and KOA-related changes to the modular control of gait may provide insight into the neurological mechanisms underlying reduced walking performance in these populations. The purpose of this pilot study was to determine if the modular control of walking differs between younger and older adults without KOA and adults with end-stage KOA.MethodsKinematic, kinetic, and electromyography data were collected from ten younger (23.5 ± 3.1 years) and ten older (63.5 ± 3.4 years) adults without KOA and ten adults with KOA (64.0 ± 4.0 years) walking at their self-selected speed. Separate non-negative matrix factorizations of 500 bootstrapped samples determined the number of modules required to reconstruct each participant’s electromyography. One-way Analysis of Variance tests assessed the effect of group on walking speed and the number of modules. Kendall rank correlations (τb) assessed the association between the number of modules and self-selected walking speed.ResultsThe number of modules required in the younger adults (3.2 ± 0.4) was greater than in the individuals with KOA (2.3 ± 0.7; p = 0.002), though neither cohorts’ required number of modules differed significantly from the unimpaired older adults (2.7 ± 0.5; p ≥ 0.113). A significant association between module number and walking speed was observed (τb = 0.350, p = 0.021) and individuals with KOA walked significantly slower (0.095 ± 0.21 m/s) than younger adults (1.24 ± 0.15 m/s; p = 0.005). Individuals with KOA also exhibited altered module activation patterns and composition (which muscles are associated with each module) compared to unimpaired adults.ConclusionThese findings suggest aging alone may not significantly alter modular control; however, the combined effects of knee osteoarthritis and aging may together impair the modular control of gait.
Highlights
Functional limitations, including difficulty walking, climbing stairs, or crouching, in community dwelling older adults have been shown to be predictive of future disability [1] as well as falls, pain, and medical expenses [2]
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Individuals with KOA exhibited altered module activation patterns and composition compared to unimpaired adults. These findings suggest aging alone may not significantly alter modular control; the combined effects of knee osteoarthritis and aging may together impair the modular control of gait
Summary
Functional limitations, including difficulty walking, climbing stairs, or crouching, in community dwelling older adults have been shown to be predictive of future disability [1] as well as falls, pain, and medical expenses [2]. Older adults exhibit highly repeatable electromyography (EMG) signals, which suggests an inability to adapt their motor control to perturbations and reflects a loss of neural plasticity [7, 10] This age-related decrease in control complexity and adaptability of the nervous system may indicate that changes to the organization of the neural mechanisms underlying motor control are responsible for impaired functional performance in older adults. Identifying age- and KOA-related changes to the modular control of gait may provide insight into the neurological mechanisms underlying reduced walking performance in these populations
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