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The Association between Lower Extremity Movement Patterns and Physical Function in People with Knee Osteoarthritis

Gil, Alexandra B. (2010) The Association between Lower Extremity Movement Patterns and Physical Function in People with Knee Osteoarthritis. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Purpose: Explore the association between movement pattern variables and physical function (PF), compare movement pattern changes between standard and agility/perturbation training and explore the association of movement pattern changes with PF changes after an exercise program.Methods: Baseline evaluation was performed to collect subject characteristics, self-reported and performance-based PF followed by motion analysis and electromyography tests performed during gait and step down tasks. Subjects randomized into standard or agility/perturbation groups underwent 12 training-sessions. Post-treatment evaluation was performed at 2 months.Analyses: All analyses were performed for gait and step down task separately. At baseline stepwise multiple regression analyses were performed to explore the association of lower extremity kinematics and co-contraction with the Western Ontario and McMaster Universities Osteoarthritis Index -PF subscale (WOMAC-PF) and the Get up and Go test (GUG) separately. At post-treatment, comparisons of the changes in lower extremity kinematics and changes in co-contraction patterns between subjects who received standard versus agility/perturbation training were performed. Following, stepwise multiple regression analyses were performed to explore the association of changes in lower extremity kinematics and changes in co-contraction with changes in WOMAC-PF and changes in GUG. Results: At baseline results indicated that increased co-contraction during gait and step down were associated with poorer PF. The increased co-contraction of lateral muscle couples during gait was probably an attempt to control knee loading. The increased co-contraction of lateral and medial muscle couples during the step down was likely an attempt to avoid pain and instability as well as control loading at the knee. At post-treatment there was no difference in movement patterns changes between the two exercise groups. Increased co-contraction during gait was associated with improvement in GUG whereas during step down increased co-contraction was associated with worsening in WOMAC-PF. At both time points the observed associations of co-contraction with PF were likely a response to the unique constraints imposed by gait and the step down. We believe in order to improve patterns of movement and thereby improve PF in this population, rehabilitation programs may need to focus on specific practice of tasks which are difficult to people with knee osteoarthritis.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gil, Alexandra B.abg8@pitt.eduABG8
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairFitzgerald, G. Kelleykfitzger@pitt.eduKFITZGER
Committee MemberBaker, Carol Eceb@pitt.eduCEB
Committee MemberCarvell, George Egcarvell@pitt.eduGCARVELL
Committee MemberIrrgang, James Jjirrgang@pitt.eduJIRRGANG
Committee MemberSparto, Patrick Jpsparto@pitt.eduPSPARTO
Date: 23 December 2010
Date Type: Completion
Defense Date: 17 September 2010
Approval Date: 23 December 2010
Submission Date: 24 November 2010
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: biomechanics; electromyography; gait and step down; knee joint; osteoarthritis; physical function
Other ID: http://etd.library.pitt.edu/ETD/available/etd-11242010-153645/, etd-11242010-153645
Date Deposited: 10 Nov 2011 20:06
Last Modified: 15 Nov 2016 13:52
URI: http://d-scholarship.pitt.edu/id/eprint/9793

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