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Zhu X, Pang Y, Li L, Sun W, Ding L, Song Q, Shen P. Standard isometric contraction has higher reliability than maximum voluntary isometric contraction for normalizing electromyography during level walking among older adults with knee osteoarthritis. Front Bioeng Biotechnol 2024; 12:1276793. [PMID: 38433819 PMCID: PMC10904509 DOI: 10.3389/fbioe.2024.1276793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction: Electromyography (EMG) normalization often relies on maximum voluntary isometric contraction (MVIC), which may not be suitable for knee osteoarthritis (KOA) patients due to difficulties in generating maximum joint torques caused by pain. This study aims to assess the reliability of standard isometric contraction (SIC) for EMG normalization in older adults with KOA, comparing it with MVIC. Methods: We recruited thirty-five older adults with KOA and collected root mean square EMG amplitudes from seven muscles in the affected limb during level walking, SIC, and MVIC tests. EMG data during level walking were normalized using both SIC and MVIC methods. This process was repeated after at least 1 week. We calculated intra-class correlation coefficients (ICCs) with 95% confidence intervals to evaluate between- and within-day reliabilities. Results: SIC tests showed higher between- (ICC: 0.75-0.86) and within-day (ICC: 0.84-0.95) ICCs across all seven muscles compared to MVIC tests. When normalized with SIC, all seven muscles exhibited higher between- (ICC: 0.67-0.85) and within-day (ICC: 0.88-0.99) ICCs compared to MVIC normalization. Conclusion: This study suggests that SIC may offer superior movement consistency and reliability compared to MVIC for EMG normalization during level walking in older adults with KOA.
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Affiliation(s)
- Xiaoxue Zhu
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Yaya Pang
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Li Li
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA, United States
| | - Wei Sun
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Lijie Ding
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Qipeng Song
- College of Sports and Health, Shandong Sport University, Jinan, China
| | - Peixin Shen
- College of Sports and Health, Shandong Sport University, Jinan, China
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Simis M, Pacheco-Barrios K, Vasquez-Avila K, Rebello-Sanchez I, Parente J, Castelo-Branco L, Marduy A, de Melo PS, Imamura M, Battistella L, Fregni F. Functional and Neural Correlates Associated with Conditioned Pain Modulation in Patients with Chronic Knee Osteoarthritis Pain: A Cross-Sectional Study. Life (Basel) 2023; 13:1697. [PMID: 37629554 PMCID: PMC10455308 DOI: 10.3390/life13081697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023] Open
Abstract
Background: In this study, we aimed to assess the factors that predict a dysfunctional conditioned pain modulation (CPM) in chronic knee OA. Methods: This is a cross-sectional analysis of patients with chronic knee OA from a prospective cohort study in Brazil (n = 85). We performed linear and logistic multivariate regression models using the purposeful selection approach to test the relationship between the CPM in both knees (average) as a dependent variable and demographics, clinical, and neurophysiological as independent variables. Results: A significant negative association between WOMAC pain scores and CPM (β: -0.13) was found. This association was modified by the subjects' race, being stronger in the non-white subjects. In our logistic regression models, pain intensity indexed with the WOMAC pain scale remained a significant association with dichotomized CPM. Furthermore, a significant CPM association with balance, indexed with the Berg Balance score, was evidenced (β: 0.04). Neurophysiological variables showed a significant negative relationship with CPM, such as the relative power of delta oscillations in the frontal area (β: -3.11) and central area (β: -3.23). There was no significant relationship between CPM and the following domains: cognitive, emotion, sleep, opioid receptor polymorphisms, and intrinsic variables of OA disease. There was no association of CPM with TMS-indexed inhibitory markers. Conclusions: These results may indicate that less function of the pain descending inhibitory system in patients with OA is correlated with higher activity-related pain (WOMAC), less balance, and cortical plasticity especially with increased low-frequency (delta) brain oscillations. These associations seem modified by race.
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Affiliation(s)
- Marcel Simis
- Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo 01002, Brazil; (M.S.); (M.I.); (L.B.)
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
- Unidad de Investigación para la Generación y Síntesis de Evidencia en Salud, Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Lima 15026, Peru
| | - Karen Vasquez-Avila
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Ingrid Rebello-Sanchez
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Joao Parente
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Luis Castelo-Branco
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Anna Marduy
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Paulo S. de Melo
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
| | - Marta Imamura
- Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo 01002, Brazil; (M.S.); (M.I.); (L.B.)
| | - Linamara Battistella
- Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo 01002, Brazil; (M.S.); (M.I.); (L.B.)
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA; (K.P.-B.); (K.V.-A.); (I.R.-S.); (J.P.); (L.C.-B.); (A.M.); (P.S.d.M.)
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