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Comparative Study
. 2007 Nov;87(11):1422-32.
doi: 10.2522/ptj.20060137. Epub 2007 Sep 4.

Age-related changes in strength, joint laxity, and walking patterns: are they related to knee osteoarthritis?

Affiliations
Comparative Study

Age-related changes in strength, joint laxity, and walking patterns: are they related to knee osteoarthritis?

Katherine S Rudolph et al. Phys Ther. 2007 Nov.

Abstract

Background and purpose: Aging is associated with musculoskeletal changes and altered walking patterns. These changes are common in people with knee osteoarthritis (OA) and may precipitate the development of OA. We examined age-related changes in musculoskeletal structures and walking patterns to better understand the relationship between aging and knee OA.

Methods: Forty-four individuals without OA (15 younger, 15 middle-aged, 14 older adults) and 15 individuals with medial knee OA participated. Knee laxity, quadriceps femoris muscle strength (force-generating capacity), and gait were assessed.

Results: Medial laxity was greater in the OA group, but there were no differences between the middle-aged and older control groups. Quadriceps femoris strength was less in the older control group and in the OA group. During the stance phase of walking, the OA group demonstrated less knee flexion and greater knee adduction, but there were no differences in knee motion among the control groups. During walking, the older control group exhibited greater quadriceps femoris muscle activity and the OA group used greater muscle co-contraction.

Discussion and conclusion: Although weaker, the older control group did not use truncated motion or higher co-contraction. The maintenance of movement patterns that were similar to the subjects in the young control group may have helped to prevent development of knee OA. Further investigation is warranted regarding age-related musculoskeletal changes and their influence on the development of knee OA.

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Figures

Figure 1
Figure 1
Setup for stress radiographs. The top images show the limb alignment in the TELOS device (top left) and the resulting radiograph (top right), and the method of calculating medial laxity is shown in the lower images. Lateral laxity was calculated similarly but with subtraction of the lateral joint space in valgus from lateral joint space in varus.
Figure 2
Figure 2
Medial and lateral joint laxity. MA=middle-aged control group, O=older control group, OA=group with osteoarthritis. * P=.001. Error bars represent standard deviation.
Figure 3
Figure 3
Quadriceps femoris muscle force production. Y=young control group, MA=middle-aged control group, O=older control group, OA=group with osteoarthritis, N/BMI=highest volitional force during contraction normalized to body mass index. * P=.000, † P=.000, ‡ P=.002, § P=.003. Error bars represent standard deviation.
Figure 4
Figure 4
Mean electromyographic (EMG) muscle activation during loading and 95% confidence interval (indicated by bars). MVIC=maximal voluntary isometric contraction, LQ=lateral quadriceps femoris muscle, MQ=medial quadriceps femoris muscle, LH=lateral hamstring muscle, MH=medial hamstring muscle, LG=lateral gastrocnemius muscle, MG=medial gastrocnemius muscle.
Figure 5
Figure 5
Mean muscle co-contraction index during loading and 95% confidence interval (indicated by bars). LQH=lateral quadriceps femoris-lateral hamstring, MQH=medial quadriceps femoris-medial hamstring, LQG=lateral quadriceps femoris-lateral gastrocnemius, and MQG=medial quadriceps femoris-medial gastrocnemius muscle pairs.

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