Effects of gait retraining in knee joint position sense

IF 1.6 3区心理学 Q4 NEUROSCIENCES Human Movement Science Pub Date : 2024-09-14 DOI:10.1016/j.humov.2024.103288

Patricia C. Teran-Wodzinski , H. John Yack , J. Cole Kelly , Yangxin Huang , Yayi Zhao , Irene S. Davis

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Abstract

Background

Joint position sense (JPS) is crucial for maintaining posture, protecting joints, and carrying out daily activities such as walking. Studies show that exercises to strengthen muscles and improve proprioception can positively impact JPS during passive and less complex activities. Evidence suggests that motor training can effectively enhance sensory function, including JPS, due to the extensive connections between the motor cortex and somatosensory areas. Gait retraining using real-time feedback has improved outcomes among patients with musculoskeletal disorders. The effect of gait retraining on JPS has not been investigated. This study assessed the effects of gait retraining to reduce knee extension in joint position sense in individuals with knee hyperextension walking patterns.

Methods

Ten women with asymptomatic knee hyperextension (KH) >5° during overground walking participated in this study. Sagittal-plane kinematics were assessed using a three-dimensional (3D) motion analysis system. The JPS was assessed using the Knee Position Active Reproduction Test. The knee with the highest hyperextension was the focus of the gait retraining intervention, which consisted of six 1-h sessions using verbal instructions and visual kinematic feedback. Comparisons of peak knee extension during walking and knee JPS overall error (RMSE) were made using a paired t-test.

Results

Gait retraining intervention significantly reduced knee extension angle during walking (83.8 % change; p < 0.001; Cohen's d = −1.6) and improved knee JPS (62 % change; p = 0.023; Cohen's d = 0.8) post-training. In addition, the improvements in joint kinematics (36.7 % change; p = 0.005; Cohen's d = −1.2) and JPS (52.6 % change; p = 0.015; Cohen's d = 0.9) were observed in the untrained knee.

Significance

Gait retraining can improve joint position sense. This study addresses a gap in our understanding of how gait retraining can influence JPS. Our results corroborate that gait retraining is an evolving and promising strategy for improving gait outcomes, particularly in individuals with KH walking patterns.

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步态再训练对膝关节位置感的影响

背景关节位置感（JPS）对于保持姿势、保护关节和进行行走等日常活动至关重要。研究表明，在被动和不太复杂的活动中，加强肌肉力量和改善本体感觉的锻炼可对关节位置感产生积极影响。有证据表明，由于运动皮层和躯体感觉区域之间存在广泛的联系，运动训练可以有效增强包括 JPS 在内的感觉功能。使用实时反馈进行步态再训练可改善肌肉骨骼疾病患者的治疗效果。步态再训练对 JPS 的影响尚未得到研究。本研究评估了步态再训练对减少膝关节过伸行走模式患者的膝关节伸展对关节位置感的影响。使用三维（3D）运动分析系统对矢状面运动学进行评估。膝关节位置主动再现测试（Knee Position Active Reproduction Test）对JPS进行了评估。膝关节过伸幅度最大的部位是步态再训练干预的重点，该干预包括六次为期 1 小时的训练，采用口头指导和视觉运动学反馈。结果步态再训练干预显著减少了行走时的膝关节伸展角度（变化率为83.8%；p = 0.001；Cohen's d =-1.6），并改善了训练后的膝关节JPS（变化率为62%；p = 0.023；Cohen's d = 0.8）。此外，在未经训练的膝关节中也观察到了关节运动学的改善（36.7% 的变化；p = 0.005；Cohen's d =-1.2）和 JPS 的改善（52.6% 的变化；p = 0.015；Cohen's d = 0.9）。本研究填补了我们对步态再训练如何影响关节位置感的认识空白。我们的研究结果证实，步态再训练是一种不断发展且前景广阔的改善步态结果的策略，尤其适用于具有 KH 步行模式的个体。

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来源期刊

Human Movement Science 医学-神经科学

CiteScore

3.80

自引率

4.80%

发文量

审稿时长

42 days

期刊介绍： Human Movement Science provides a medium for publishing disciplinary and multidisciplinary studies on human movement. It brings together psychological, biomechanical and neurophysiological research on the control, organization and learning of human movement, including the perceptual support of movement. The overarching goal of the journal is to publish articles that help advance theoretical understanding of the control and organization of human movement, as well as changes therein as a function of development, learning and rehabilitation. The nature of the research reported may vary from fundamental theoretical or empirical studies to more applied studies in the fields of, for example, sport, dance and rehabilitation with the proviso that all studies have a distinct theoretical bearing. Also, reviews and meta-studies advancing the understanding of human movement are welcome. These aims and scope imply that purely descriptive studies are not acceptable, while methodological articles are only acceptable if the methodology in question opens up new vistas in understanding the control and organization of human movement. The same holds for articles on exercise physiology, which in general are not supported, unless they speak to the control and organization of human movement. In general, it is required that the theoretical message of articles published in Human Movement Science is, to a certain extent, innovative and not dismissible as just "more of the same."