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Understanding muscle coordination during gait based on muscle synergy and its association with symptoms in patients with knee osteoarthritis

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Abstract

Objective

We aimed to investigate the muscle coordination differences between a control group and patients with mild and severe knee osteoarthritis (KOA) using muscle synergy analysis and determine whether muscle coordination was associated with symptoms of KOA.

Method

Fifty-three women with medial KOA and 19 control patients participated in the study. The gait analyses and muscle activity measurements of seven lower limb muscles were assessed using a motion capture system and electromyography. Gait speed and knee adduction moment impulse were calculated. The spatiotemporal components of muscle synergy were extracted using non-negative matrix factorization, and the dynamic motor control index during walking (walk-DMC) was computed. The number of muscle synergy and their spatiotemporal components were compared among the mild KOA, severe KOA, and control groups. Moreover, the association between KOA symptoms with walk-DMC and other gait parameters was evaluated using multi-linear regression analysis.

Results

The number of muscle synergies was lower in mild and severe KOA compared with those in the control group. In synergy 1, the weightings of biceps femoris and gluteus medius in severe KOA were higher than that in the control group. In synergy 3, the weightings of higher tibial anterior and lower gastrocnemius lateralis were confirmed in the mild KOA group. Regression analysis showed that the walk-DMC was independently associated with knee-related symptoms of KOA after adjusting for the covariates.

Conclusions

Muscle coordination was altered in patients with KOA. The correlation between muscle coordination and KOA may be attributed to the knee-related symptoms.

Key points

• Patients with knee osteoarthritis (OA) experienced a deterioration in muscle coordination when walking.

• Loss of muscle coordination was associated with severe knee-related symptoms in knee OA.

• Considering muscle coordination as a knee OA symptom-related factor may provide improved treatment.

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Data availability

Data will be made available on request.

Code availability

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Acknowledgements

The authors would like to thank all staff and patients for their participation in this study. We would like to thank Editage (www.editage.jp) for English language editing.

Funding

This study was supported by the JSPS KAKENHI Grant-in-Aid for Scientific Research (18H03164 and 20K19376).

Author information

Author notes

  1. Masashi Taniguchi and Jun Umehara contributed equally to this work.

Authors and Affiliations

  1. Human Health Sciences, Graduate School of Medicine, Kyoto University, 53-Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Masashi Taniguchi, Jun Umehara, Momoko Yamagata, Masahide Yagi, Yoshiki Motomura, Sayaka Okada, Shogo Okada, Kaede Nakazato, Yoshihiro Fukumoto & Noriaki Ichihashi

  2. Faculty of Rehabilitation, Kansai Medical University, Osaka, Japan

    Jun Umehara, Momoko Yamagata & Yoshihiro Fukumoto

  3. Kobayashi Orthopaedic Clinic, Kyoto, Japan

    Yoshiki Motomura & Masashi Kobayashi

  4. Kanemitsu Clinic, Kyoto, Japan

    Kyoseki Kanemitsu

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  1. Masashi Taniguchi
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  2. Jun Umehara
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Contributions

All authors have made substantial contributions to the conception and design of the study, revising it critically for important intellectual content, and final approval of the version to be submitted. The specific contributions of each author are as follows. (1) Analysis and interpretation of data: MT, JU, MoY, and NI. (2) Article drafting: MT, JU, MoY, and NI.

Corresponding author

Correspondence to Masashi Taniguchi.

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Ethics approval

All study procedures were approved by the Ethics Committee of the Kyoto University Graduate School of Medicine (R3014) and were conducted in accordance with the principles of the Declaration of Helsinki.

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Written informed consent for participation and the use of data was obtained from all participants.

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Taniguchi, M., Umehara, J., Yamagata, M. et al. Understanding muscle coordination during gait based on muscle synergy and its association with symptoms in patients with knee osteoarthritis. Clin Rheumatol 43, 743–752 (2024). https://doi.org/10.1007/s10067-023-06852-w

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