These findings suggest that individuals with mild to moderate knee osteoarthritis had primary and secondary hyperalgesia, independent of unilateral or bilateral involvement. These results suggest that the pain have to be an assertive focus in the clinical practice, independent of the level of severity or involvement of knee osteoarthritis.
Background
The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). This study aimed examine the clinical measures and hyperalgesia’s effect on muscle activity, knee range of motion (ROM) and postural control during the single-leg mini squat (SLMS) in individuals with KOA, determining the correlation between variables.
Methods
In this cross-sectional study, 60 individuals, 30 healthy (HG, 57.4 ± 6.86 years), and 30 with mild to moderate KOA (KOAG, 59.4 ± 5.46 years) were evaluated by the visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC), and the pressure pain threshold (PPT) in subcutaneous, myotomal, and sclerotomal structures. Muscle activity, knee ROM and postural control were assessed during a SLMS. The analyses were performed in the two phases of the SLMS. Phase 1 - during descending movement (eccentric contraction), Phase 2 - during ascending movement (concentric contraction). Analysis of covariance was applied for each variable separately, using weight as a co-variable. We used Spearman’s test for determining the correlation.
Results
There was no difference between groups for age, height, and postural control (p > 0.059), but KOAG presented the highest values for VAS and WOMAC (p = 0.000). In addition, EMG activity was higher in KOAG for gastrocnemius medialis and tibialis anterior muscles during phase 1 (p < 0.027), and for gastrocnemius medialis and gluteus medius muscles during phase 2 (p < 0.007), and reduced values for PPT and knee ROM (p = 0.000). Also, the correlations between PPT with muscle activity and postural control were moderate (rho< 0.482), while strong relationships were observed between some PPT points with VAS and WOMAC (rho> 0.507).
Conclusion
Hyperalgesia affects the functionality during a single-limb mini squat. There is an important correlation between hyperalgesia and muscle activity, postural control, and clinical measures in individuals with KOA.
Introdução: O corticoide inalatório (CI) utilizado em indivíduos com Doença Pulmonar Obstrutiva Crônica (DPOC) pode comprometer a função dos músculos respiratórios e dos membros inferiores, levando ao aumento da severidade das limitações funcionais.Objetivo: Avaliar a ação do CI na capacidade funcional, no deficit de equilíbrio estático e funcional, no risco de quedas e na acuidade proprioceptiva em indivíduos com DPOC.Métodos: Participaram 20 indivíduos com DPOC, sendo 12 que utilizavam CI (G1) e oito que não utilizavam CI (G2), e outros 12 indivíduos no grupo controle (GC). Esses foram avaliados por: Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE), questionário de Baecke, escala de equilíbrio de Berg, risco de quedas, equilíbrio estático em plataforma de força e a acuidade proprioceptiva do joelho.Resultados: O índice de BODE foi diferente entre os grupos (p0,001), e o G1 for maior do que o G2. Para o Baecke, os grupos G1 e G2 tiveram menores escores que o GC (p=0,03). O escore de Berg foi similar entre os grupos G1 e G2 e entre os grupos GC e G2. O risco de quedas foi maior para G1 e G2 do que para o GC (p0,001), e G1 maior do que G2. Não houve diferenças para a acuidade proprioceptiva (p0,14) e para a análise do equilíbrio estático (p0,05).Conclusão: O CI influenciou o índice BODE e os riscos de queda, mas não alterou a capacidade funcional, o equilíbrio estático e funcional e a acuidade proprioceptiva do joelho em indivíduos com DPOC.
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