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Title: Neuromuscular control in knee osteoarthritis (NEKO)
Author: Smith, Stephanie L.
ISNI:       0000 0004 6422 031X
Awarding Body: Glasgow Caledonian University
Current Institution: Glasgow Caledonian University
Date of Award: 2016
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Introduction: Knee osteoarthritis (KOA) is a degenerative joint disease with adverse biomechanics at the centre of the disease process. Previous research has shown biomechanical impairments (muscle strength; proprioception) are associated with functional ability. The loss of neuromuscular control which refers to the nervous systems control over muscle activation is thought to be a mechanism through which these impairments negatively impact on health outcomes. Therefore the aim of this study was to assess how the biomechanical impairments are associated with loss of neuromuscular control and subsequent health outcomes. Methods: Biomechanical impairments of 77 individuals with KOA (48 female; 62.5 ± 8.1 years; 29.4 ± 6.0 kg/m2) and 18 controls (9 female; 62.5 ± 10.4; 24.3 ±3.7 kg/m2) was assessed as muscle strength, passive position sense and passive motion sense proprioception. Neuromuscular control split into physical neuromuscular control assessed as active position sense proprioception; force accuracy, steadiness; and muscle coactivation and physiological neuromuscular control using electromechanical delay; rate of force development; and time to half peak force. Health outcomes were assessed using knee injury and osteoarthritis outcome score (KOOS); patients reported outcome measurement instrumented system (PROMIS); and 1.5T MRI scored using Boston Leeds Osteoarthritis Knee Score (BLOKS). Relationships were assessed with Pearson's correlations followed up with linear regression, alpha set at 0.05. Results: Muscle strength; muscle co-activation; force accuracy; rate of force development; and time to half peak force were impaired in individuals with KOA. Individuals with KOA had worse joint damage; pain and physical function. Biomechanical impairment muscle strength was associated with physical and physiological neuromuscular control. Physical and physiological neuromuscular control was associated with pain, physical function but not joint damage. The addition of neuromuscular control to the biomechanical impairments, health outcomes model was weak-moderate. Conclusion: Muscle weakness but not proprioception predicted the loss of physical and physiological neuromuscular control in participants with KOA, suggesting proprioception may be indirectly associated with neuromuscular control. Neuromuscular control was associated with poor health outcomes (pain; physical function) suggesting the role of loss of neuromuscular control in KOA, however, the association was only moderate, questioning whether this is a better model than the straight biomechanical impairments predicts health outcomes model.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available