Abstract
BackgroundThe effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). This study aimed examine the clinical measures and hyperalgesia’s effect on muscle activity, knee range of motion (ROM) and postural control during the single-leg mini squat (SLMS) in individuals with KOA, determining the correlation between variables.MethodsIn this cross-sectional study, 60 individuals, 30 healthy (HG, 57.4 ± 6.86 years), and 30 with mild to moderate KOA (KOAG, 59.4 ± 5.46 years) were evaluated by the visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC), and the pressure pain threshold (PPT) in subcutaneous, myotomal, and sclerotomal structures. Muscle activity, knee ROM and postural control were assessed during a SLMS. The analyses were performed in the two phases of the SLMS. Phase 1 - during descending movement (eccentric contraction), Phase 2 - during ascending movement (concentric contraction). Analysis of covariance was applied for each variable separately, using weight as a co-variable. We used Spearman’s test for determining the correlation.ResultsThere was no difference between groups for age, height, and postural control (p > 0.059), but KOAG presented the highest values for VAS and WOMAC (p = 0.000). In addition, EMG activity was higher in KOAG for gastrocnemius medialis and tibialis anterior muscles during phase 1 (p < 0.027), and for gastrocnemius medialis and gluteus medius muscles during phase 2 (p < 0.007), and reduced values for PPT and knee ROM (p = 0.000). Also, the correlations between PPT with muscle activity and postural control were moderate (rho< 0.482), while strong relationships were observed between some PPT points with VAS and WOMAC (rho> 0.507).ConclusionHyperalgesia affects the functionality during a single-limb mini squat. There is an important correlation between hyperalgesia and muscle activity, postural control, and clinical measures in individuals with KOA.
Highlights
The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA)
The results showed that there was a moderate correlation between hyperalgesia and integrated EMG (iEMG) activity and hyperalgesia and postural control
Our results showed that the KOA group (KOAG) presented the highest visual analog scale (VAS) and Western Ontario and McMaster Universities Index (WOMAC) scores and the decrease of pressure pain threshold (PPT)
Summary
The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). Pain is the main symptom of KOA, which is associated initially with local peripheral sensitization, and can become chronic, promoting a neurological reorganization within the segments of the spinal cord and the cortical level [2,3,4]. Hyperalgesia could be assessed by the pressure pain threshold (PPT) [9], this segmental relationship has been poorly explored [8]. Understanding it can be considered the best way to recognize the sensory abnormalities [7] since pain is one of the main causes of functional limitation and disability in KOA [1]
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