Postural analysis and electromyographic activity in patients with osteoarthritis of the knee / Análise postural e atividade eletromiográfica em pacientes com osteoartrite de joelhos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Osteoarthritis (OA) is the result of articular cartilage degeneration and is currently considered a common condition with multifactorial causes that affects millions of individuals annually and is one of the principal causes of pain and functional incapacity. The knees are one of the articulations most affected due to the overload that constitutes the principal activator or determinant mechanism for the development of the disease. An in important reduction in movement amplitude and muscular strength occurs that provokes functional limitation and postural alterations, interfering in daily life activities. The main objective of this research was to characterize the postural alterations and electromyographic activity in patients with OA in the knee. This study involved 30 female volunteers, divided into two groups: Control group (CG), composed of 15 elderly women (66.0±4.5 years-old, BMI 25.4±2.29 Kg/m2); and the Osteoarthritis group (OG), composed of 15 elderly women (67.0±5.8 yearsold, BMI 26.2±2.98 Kg/m2), with bilateral radiographic diagnosis of OA of the knees, one symptomatic and one asymptomatic. The SAPO® program was used for postural analysis, based on sagital and frontal plane photographs, which measured the Q angle and angle of the knees bilaterally. Electromyographic evaluation was conducted bilaterally to determine the maximum voluntary isometric contraction (MVIC) of the vastus lateralis and medialis. MVIC was performed with the subjects seated on a bed with the knees at 90º flexion. The subject was asked to perform active extension of the knee against resistance for 5 seconds, repeating this process three times. For statistical analysis, the Shapiro-Wilk test was used for normality, the Levene test for homocedasticity and the Spearman correlation test. Group comparisons were performed by one-way ANOVA. In the OG, the subjects presented severely affected functional capacity (LFI=12) and moderately severe radiological evaluations (Kellgren scale=2), while the CG presented no pain. In the OG, the Q angle was 19.9º for the OA knee and 19.1º for the asymptomatic knee (p=0.732), while in the CG, a Q angle of 19.8º (p=0.955) was obtained for both knees. The intercondylar distance was 2.9 cm for the CG and 5.3 cm for the OG (p=0.168), while the intermalleolar distance was 2.9 cm for the CG and 7.2 cm for the OG (p=0,156). Significant differences occurred in RMS values for the vastus lateralis and medialis in the control knees (VL=545,2±40V / VM=456,9±45V) compared to the symptomatic knees (VL=338,6±54V / VM=291,7±40V) (p=0.001) for both muscles; however, no statistical differences were observed between the control (VL=545,2±40V / VM=456,9±45V) and asymptomatic knees (VL=540,9±19V / VM=443,8±18V). Comparisons between symptomatic (VL=338,6±54V / VM=291,7±40V) and asymptomatic knees (VL=540,9±19V / VM=443,8±18V) showed statistically significant differences in both muscles analyzed (p=0.001 for both). Predominance occurred for valgus knees in both groups with no statistical significance. In the surface electromyography, patients with OA in the knees presented alterations in muscular activity, including diminished MVIC muscular activity in the VL and VM compared to the CG and OG asymptomatic knee.

ASSUNTO(S)

osteoarthritis osteoartrite posture eletromiografia knee postura electromyography joelho

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