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Title: Changes in the electromyographic record of muscle activity and functioning of patients with hip joint osteoarthritis before and after surgery
Abstract:
Introduction: Osteoarthritis of the hip joint is a chronic disease characterized by gradual degenerative changes in both the joint and muscles, causing structural and functional disorders. The muscle system, which under normal conditions provides the necessary support for the joint, can be atrophied as a result of pain and reduced biomechanical abilities of the joint. Aim: The aim of the study was to assess the bioelectric activity of hip muscles and the functioning of patients with advanced hip degenerative changes before and after surgery treatment. Study sample: The study involved 49 randomly selected women and men aged 40-82 years, qualified for total hip arthroplasty due to the presence of advanced degenerative changes in one of the hip joints. The criterion for inclusion was the absence of permanent damage to the locomotor system, allowing independent movement and the assessment of degenerative changes in the X-ray image using the Altman scale (≥ II°). The assessment of the second hip joint showed no advanced radiological changes (0° or I°) and was a control group. The exclusion criteria were advanced, two-sided degenerative changes in the hip joints, previously undergone total hip arthroplasty procedures and significant balance and self-movement disorders. Methods: The clinical examination included the analysis of muscle activity of both hip joints (gluteus medius, gl ; uteus maximus, rectus femoris, tensor fascia latae) using surface electromyography (sEMG) during standing position on one lower limb. Kinematic measurement of the range of hip joint mobility (ROM) was performed. The energy expenditure during the 3-minute exercise test was also calculated with the Physiological Cost Index (PCI). The functional status of the patient was determined using The Western Ontario McMaster Osteoarthritis Index (WOMAC) and Harris Hip Score (HHS). Selected biomechanical parameters were measured before the procedure and three and six months after the total hip replacement. Results: Bioelectric recording of muscle activity showed statistically significant differences between the lower limb with OA and a healthy hip joint for GMed, GMax and TFL in the first study. The muscles on the non-degenerative side were more active and the muscle most involved in the attempt to stand on one lower limb was GMed. In the subsequent stages of the examination, the tensor fasciae latae of both hip joints took the greatest part in the task. In the third month after the operation the difference in muscle activity between limbs was statistically significant only for GMed and TFL, whereas in the sixth month only for RF. The activity of all examined lower limb muscles increased with each subsequent measurement with statistical significance especially for GMed and TFL. In the case ; of the other lower limb a significant difference was observed for TFL muscle in all measurements and for GMed muscle between the first and last examination. Mobility ranges of both hip joints was below ISOM standards and the difference between the lower limbs was statistically significant both before and after total hip arthroplasty. The most limited movements in the hip joint with advanced degenerative changes were the flexion and rotation. The range of movement was greater in subsequent measurements for both lower limbs. The hip joint extension deficit with OA persisted in all persons examined in the sixth month after surgery. There have also been improvements in functional efficiency. Patients assessed their health as bad in HHS before the surgery, and after three months as good and very good in the sixth month after the surgery. The assessment of pain levels, which is one of the HHS questions, showed an improvement between the first and third test by more than 44% in relation to moderate symptoms and by 53% to no or little pain. The functional limitations in the WOMAC questionnaire were evaluated at 43.9% and in subsequent studies at 17.3% and 12.7%. The energy expenditure (PCI) during the walk decreased systematically. Conclusions: 1. Advanced degenerative changes in the hip joint have a significant impact on the reduction of muscle activity and mobility, which may contr ; ibute to the deterioration of functioning and the formation of new, compensatory movement patterns. 2. The improvement of lower limb biomechanical parameters and subjective evaluation in the area of functioning and pain argues for a positive effect of total hip arthroplasty in the early months after surgery as well as in long-term results. 3. Increased activity of the examined muscles, especially those stabilizing the hip joint, may be a response to total hip replacement beneficial effect. However, the greater involvement of the tensor fasciae latae muscle, lasting six months after the surgery, proves that there is still a disturbed muscle interaction and the assumption of stabilizing functions by a stronger synergist muscle. 4. A decrease in energy expenditure (PCI) during the exercise test, and thus an improvement in gait performance, confirms the effectiveness of the surgery. In addition, the reduction of PCI is conditioned by the increased activity of the gluteus medius in the sixth month after the surgery.
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Rada Dyscypliny Nauki o zdrowiu
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Last modified:
Apr 8, 2024
In our library since:
Feb 2, 2022
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http://dl.cm-uj.krakow.pl:8080/publication/4466
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| Edition name | Date |
|---|---|
| ZB-132591 | Apr 8, 2024 |
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