Muscle recruitment strategies can reduce joint loading during level walking

Bart van Veen, Erica Montefiori, Luca Modenese, Claudia Mazzà, Marco Viceconti

Research output: Contribution to journalArticle

Abstract

Joint inflammation, with consequent cartilage damage and pain, typically reduces functionality and affects activities of daily life in a variety of musculoskeletal diseases. Since mechanical loading is an important determinant of the disease process, a possible conservative treatment is the unloading of joints. In principle, a neuromuscular rehabilitation program aimed to promote alternative muscle recruitments could reduce the loads on the lower-limb joints during walking. The extent of joint load reduction one could expect from this approach remains unknown. Furthermore, assuming significant reductions of the load on the affected joint can be achieved, it is unclear whether, and to what extent, the other joints will be overloaded. Using subject-specific musculoskeletal models of four different participants, we computed the muscle recruitment strategies that minimised the hip, knee and ankle contact force, and predicted the contact forces such strategies induced at the other joints. Significant reductions of the peak force and impulse at the knee and hip were obtained, while only a minimal effect was found at the ankle joint. Adversely, the peak force and the impulse in non-targeted joints increased when aiming to minimize the load in an adjacent joint. These results confirm the potential of alternative muscle recruitment strategies to reduce the loading at the knee and the hip, but not at the ankle. Therefore, neuromuscular rehabilitation can be targeted to reduce the loading at affected joints but must be considered carefully in patients with multiple joints affected due to the potential adverse effects in non-targeted joints.

Original languageEnglish
JournalJournal of Biomechanics
DOIs
Publication statusE-pub ahead of print - Sep 27 2019

Fingerprint

Neuromuscular rehabilitation
Walking
Muscle
Joints
Muscles
Cartilage
Unloading
Hip
Knee
Ankle
Rehabilitation
Musculoskeletal Diseases
Ankle Joint
Lower Extremity

Keywords

  • Joint load
  • Level walking
  • Muscle recruitment
  • Musculoskeletal modelling
  • Neuromuscular control

Cite this

Muscle recruitment strategies can reduce joint loading during level walking. / van Veen, Bart; Montefiori, Erica; Modenese, Luca; Mazzà, Claudia; Viceconti, Marco.

In: Journal of Biomechanics, 27.09.2019.

Research output: Contribution to journalArticle

van Veen, Bart ; Montefiori, Erica ; Modenese, Luca ; Mazzà, Claudia ; Viceconti, Marco. / Muscle recruitment strategies can reduce joint loading during level walking. In: Journal of Biomechanics. 2019.
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