Abstract
Objective: Stand-to-sit task is an important daily function, but there is a lack of research evidence on whether knee osteoarthritis (knee OA) affects the postural balance during the task. This study aimed to compare individuals with knee OA and asymptomatic controls in postural balance and identify kinematic and lower extremity muscle activity characteristics in individuals with knee OA during the stand-to-sit task.Methods: In total, 30 individuals with knee OA and 30 age-matched asymptomatic controls performed the 30-s Chair Stand Test (30sCST) at self-selected speeds. Motion analysis data and surface electromyography (sEMG) were collected while participants performed the 30sCST. To quantify postural balance, the displacement of the center of mass (CoM) and the peak instantaneous velocity of the CoM were calculated. The kinematic data included forward lean angles of the trunk and pelvic, range of motion (RoM) of the hip, knee, and ankle joints in the sagittal plane. The averaged activation levels of gluteus maximus, vastus lateralis, vastus medialis, rectus femoris, biceps femoris (BF), tibialis anterior (TA), and medial head of gastrocnemius muscles were indicated by the normalized root mean square amplitudes.Results: Compared with the asymptomatic control group, the knee OA group prolonged the duration of the stand-to-sit task, demonstrated significantly larger CoM displacement and peak instantaneous CoM velocity in the anterior-posterior direction, reduced ankle dorsiflexion RoM, greater anterior pelvic tilt RoM, and lower quadriceps femoris and muscles activation level coupled with higher BF muscle activation level during the stand-to-sit task.Conclusion: This study indicates that individuals with knee OA adopt greater pelvic forward lean RoM and higher BF muscle activation level during the stand-to-sit task. However, these individuals exist greater CoM excursion in the anterior-posterior direction and take more time to complete the task. This daily functional activity should be added to the rehabilitation goals for individuals with knee OA. The knee OA group performs reduced ankle dorsiflexion RoM, quadriceps femoris, and TA activation deficit. In the future, the rehabilitation programs targeting these impairments could be beneficial for restoring the functional transfer in individuals with knee OA.
Highlights
Knee osteoarthritis is the most common degenerative joint disease, affecting an estimated 18% population in China (Wang et al, 2018)
This study aimed to investigate the influence of Knee osteoarthritis (knee OA) on postural balance and investigate the differences in the measures of the trunk, pelvic, lower extremity kinematics, and lower extremity muscle activity between the knee OA group and the control group during the stand-to-sit task
We found that individuals with knee OA showed greater postural sway and prolonged duration of the stand-to-sit task, reduced ankle dorsiflexion range of motion (RoM), quadriceps femoris, and tibialis anterior (TA) activation level during the stand-to-sit task in comparison with the control group
Summary
Knee osteoarthritis (knee OA) is the most common degenerative joint disease, affecting an estimated 18% population in China (Wang et al, 2018). The disease is associated with pain, joint stiffness, quadriceps weakness, instability, and functional disability (Hunter and Bierma-Zeinstra, 2019). In daily life, walking function is the basic activity, while sit-to-stand and stand-to-sit tasks can be the prerequisite and termination of gait, respectively. Sit and stand transition becomes a more demanding functional daily task (Galan-Mercant and Cuesta-Vargas, 2013). Sit-tostand or stand-to-sit motion variability has been proved to be significantly correlated with the risk of falling (Ghahramani et al, 2020). Analyzing sit and stand transition and developing targeted rehabilitation plans can help individuals with knee OA perform the abovementioned tasks and reduce fall risk
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