Activating the somatosensory system enhances net quadriceps moment during gait |
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| Institution: | 1. BioMotion Laboratory, Department of Mechanical Engineering, Stanford University, CA, United States;2. Palo Alto Veterans Hospital, Palo Alto, CA, United States;3. Department of Orthopaedic Surgery, Stanford University, CA, United States;1. Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil;2. Laboratory of Functional Morphology, Department of Biology, University of Antwerp, Antwerp, Belgium;3. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium;5. Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Goiânia, Brazil;1. Department of Orthopaedic Surgery, Duke University, Durham, NC, USA;2. Department of Biomedical Engineering, Duke University, Durham, NC, USA;3. Department of Radiology, Duke University, Durham, NC, USA;4. Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA;1. Department of Mechanical Engineering, University of Alberta, Canada;2. Department of Radiology & Diagnostic Imaging, University of Alberta, Canada;1. Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States;2. Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, NY, United States |
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| Abstract: | Quadriceps muscle rehabilitation following knee injury or disease is often hampered by pain, proprioception deficits or instability associated with inhibition of quadriceps activation during walking. The cross-modal plasticity of the somatosensory system with common sensory pathways including pain, pressure and vibration offers a novel opportunity to enhance quadriceps function during walking. This study explores the effectiveness of an active knee brace that used intermittent cutaneous vibration during walking to enhance the peak knee flexion moment (KFM) during early stance phase as a surrogate for net quadriceps moment (balance between knee extensor and flexor muscle moments). The stimulus was turned on prior to heel strike and turned off at mid-stance of the gait cycle. Twenty-one subjects with knee pathologies known to inhibit quadriceps function were tested walking under three conditions: control (no brace), a passive brace, and an active brace. Findings show that compared to the control, subjects wearing an active brace during gait exhibited a significant (p < 0.001) increase in peak KFM and no significant difference when wearing a passive brace (p = 0.17). Furthermore, subjects with low KFM and knee flexion angle (KFA) in control exhibited the greatest increase in KFA at loading response in the active brace condition (R = 0.47, p < 0.05). Intermittent cutaneous stimulation during gait, therefore, provides an efficient method for increasing the KFM in patients with knee pathologies. This study’s results suggest that intermittent vibration stimulus can activate the cross-modalities of the somatosensory system in a manner that gates pain stimulus and possibly restores quadriceps function in patients with knee pain. |
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| Keywords: | Intermittent-cutaneous-stimulating knee brace Quadriceps weakness during gait Knee flexion moment Gait analysis |
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