نشریه علمی مهندسی پزشکی زیستی
Iranian Journal of Biomedical Engineering (IJBME)

بررسی اثر هم‌انقباضی عضلانی در تامین پایداری حین ایستادن بیماران با استئوآرتریت زانو

نوع مقاله : مقاله کامل پژوهشی

نویسندگان

زهرا یغمائی 1
ایمان حسینی 2
محمد نجفی آشتیانی 3

1 دانشجوی کارشناسی ارشد، گروه فیزیوتراپی، دانشکده‌ی علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران

2 کارشناسی ارشد، گروه فیزیوتراپی، دانشکده‌ی علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران

3 استادیار، گروه فیزیوتراپی، دانشکده‌ی علوم پزشکی، دانشگاه تربیت مدرس، تهران، ایران

https://doi.org/10.22041/ijbme.2024.2028321.1898
چکیده
استئوآرتریت زانو یکی از رایج‌ترین بیماری‌های مزمن اسکلتی عضلانی است که به طور قابل توجهی بر پایداری وضعیتی اثر گذاشته و احتمال افتادن فرد را افزایش می‌دهد. با توجه به درد و اختلالات حس عمقی در این افراد، هم‌انقباضی عضلانی نقش مهمی در ایجاد پایداری دارد. هم‌چنین بازخوردهای بینایی در حفظ تعادل به خصوص هنگام ایستادن روی سطوح ناپایدار نقشی کلیدی ایفا می­کنند. هدف این پژوهش بررسی شاخص هم‌انقباضی عضلات زانو و مچ پا حین ایستادن روی سطح ناپایدار، با و بدون بازخوردهای بینایی در بیماران مبتلا به استئوآرتریت متوسط زانو است. در این مطالعه­ی مقطعی، 28 نفر (14 مرد مبتلا به استئوآرتریت زانو و 14 مرد سالم) از نظر کنترل وضعیتی حین ایستادن روی سطح ناپایدار با چشم‌های باز و بسته مورد بررسی قرار گرفته‌اند. از روش الکترومایوگرافی با الکترودهای سطحی برای ثبت فعالیت هفت عضله حین آزمون‌های ایستادن استفاده شده است. نتایج نشان داده است که وجود بیماری استئوآرتریت زانو متغیر قطع صفر تفاضلی در مفصل مچ پا و زانو را به دنبال دارد. بستن چشم‌ها در هر دو گروه منجر به افزایش بازه‌ی تغییرات هم‌انقباضی مچ پا و کاهش قطع صفر تفاضلی مفاصل زانو و مچ پا شده است. قطع صفر تفاضلی هم‌انقباضی عضلات زانو در حالت با چشمان باز به طور معناداری با نمره­ی پرسش‌نامه­ی وومک همبستگی مثبت داشته است (048/0p=، 52/0r=). با توجه به کاهش تغییرات هم‌انقباضی در مفصل زانوی افراد بیمار، دستگاه عصبی مرکزی به منظور جلوگیری از افتادن از تغییر میزان هم‌انقباضی عضلات مچ پا استفاده می‌کند. نتایج مشاهده شده در حین بستن چشم‌ها حاکی از افزایش ناپایداری در پی حذف بازخوردهای بینایی است. همبستگی مثبت و معنادار مشاهده شده بین میزان وخامت بیماری و تغییرات هم‌انقباضی نشان می‌دهد که بدن در واکنش به درد از مچ پا به عنوان واکنش جبرانی استفاده می­کند.

کلیدواژه‌ها

استئوآرتریت زانو
هم‌انقباضی عضلانی
پایداری
درد مفصلی

موضوعات

عنوان مقاله English

Investigating the Effect of Muscle Co-Contraction in Providing Stability while Standing in Patients with Knee Osteoarthritis

نویسندگان English

Zahra Yaghmaei 1
Iman Hosseini 2
Mohammed N. Ashtiani 3
1 M.Sc. Student, Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 M.Sc., Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
3 Assistant Professor, Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
چکیده English

Knee osteoarthritis is a prevalent chronic musculoskeletal disorder that has a significant impact on postural stability and increases the risk of falls. Individuals with knee osteoarthritis often experience pain and proprioceptive deficits, highlighting the importance of muscle contraction in maintaining stability. Visual feedback also plays a crucial role in balance maintenance, particularly on unstable surfaces. This study aims to explore the co-contraction index of knee and ankle muscles in patients with moderate knee osteoarthritis while standing on an unstable surface, with and without visual feedback. A cross-sectional study involving 28 participants (14 men with knee osteoarthritis and 14 healthy men) was conducted to assess postural control during standing on an unstable surface with eyes open and closed. Electromyography with surface electrodes was utilized to measure the activity of seven muscles during the standing tests. The findings revealed that knee osteoarthritis leads to distinct changes in the co-contraction patterns of the ankle and knee joints. Closing the eyes during the tests resulted in increased ankle co-contraction variability and decreased knee and ankle joint co-contraction patterns. The co-contraction differential zeros cross of knee muscles with eyes open exhibited a significant positive correlation with the WOMAC questionnaire score (p = 0.048, r = 0.52). The central nervous system compensates for reduced co-contraction in the knee joint of individuals with knee osteoarthritis by adjusting the co-contraction rate of ankle muscles to prevent falls. The study also demonstrated increased instability when visual feedback was removed, emphasizing the role of visual cues in balance maintenance. The significant correlation between disease severity and co-contraction changes suggests that the body utilizes ankle muscles as a compensatory mechanism in response to knee pain.

کلیدواژه‌ها English

Knee Osteoarthritis
Muscle Co-Contraction
Stability
Articular Pain
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نشریه علمی مهندسی پزشکی زیستی
دوره 17، شماره 3
پاییز 1402
صفحه 273-283

  • تاریخ دریافت 17 اردیبهشت 1403
  • تاریخ بازنگری 13 تیر 1403
  • تاریخ پذیرش 28 تیر 1403

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