TKA patients with unsatisfying knee function show changes in neuromotor synergy pattern but not joint biomechanics. (December 2017)

• Record Type: Journal Article
• Authors: Ardestani, Marzieh M.; Malloy, Philip; Nam, Denis; Rosenberg, Aaron G.; Wimmer, Markus A.
• Is Part Of: Journal of electromyography and kinesiology. Volume 37(2017:Dec.)
• Page Start: 90
• Page End: 100
• Publication Date: 2017-12
• Subjects: Total knee arthroplasty -- Electromyography -- Neuro-motor synergy -- Gait analysis -- Knee function; Electromyography -- Periodicals; Kinesiology -- Periodicals; Electromyography -- Periodicals; Movement -- physiology -- Periodicals; Muscles -- physiology -- Periodicals; Électromyographie -- Périodiques; Cinésiologie -- Périodiques; Electromyography; Kinesiology; Electronic journals; Periodicals; 616.740757
• DOI: 10.1016/j.jelekin.2017.09.006
• Languages: English
• ISSNs: 1050-6411

Abstract

Abstract: Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies. Gait and electromyography (EMG) data were collected during level walking for three groups of participants: (i) high-functional TKA patients (n = 13); (ii) low-functional TKA patients (n = 13) and (iii) non-operative controls (n = 18). Synergies were extracted from EMG data using non-negative matrix factorization. Analysis of variance and Spearman correlation analyses were used to investigate between-group differences in gait and neuro-motor synergies. Results showed that synergy patterns were different among the three groups. Control subjects used 5–6 independent neural commands to execute a gait cycle. High functional TKA patients used 4–5 independent neural commands while low-functional TKA patients relied on only 2–3 independent neural commands to execute a gait cycle. Furthermore, stride-to-stride variability of muscles' response to the neural commands was reduced up to 15% in low-functional TKAs compared to the other two groups.