An Investigation into the use of Stochastic Resonance Electrical Stimulation and Knee Sleeve to Improve Proprioception, Postural Control, and Gait Biomechanics in the Osteoarthritic Knee.

摘要

Knee osteoarthritis (OA) is a common joint disorder and a leading cause of disability in the US. Current treatment options focus on symptom modification rather than preventing or delaying OA progression. Abnormal proprioception has been demonstrated in this population and improvements in proprioception may lead to secondary improvements in postural control and in walking biomechanics. Stochastic resonance (SR), a novel phenomenon in which the introduction of subthreshold electrical or mechanical "noise" into a sensory system increases its sensitivity to weak stimuli, may be a disease-modifying treatment by way of enhancing proprioception. By incorporation of SR into a knee sleeve for clinical applicability, we aimed to determine whether proprioception, postural control and gait biomechanics would improve in those with osteoarthritis of the knee.;Proprioception was assessed via joint position sense (JPS) in those with minimal to moderate, medial knee OA under several conditions that combine SR and a neoprene knee sleeve in both a partial weight bearing (PWB) and a nonweight bearing (NWB) task. Gait kinetics and kinematics as well as postural control were also assessed under similar treatment conditions combining SR and a knee sleeve.;JPS was improved with the combination of SR and a knee sleeve as well as with the sleeve alone in a PWB task relative to the control condition, with no difference between the treatment conditions and no improvements in the NWB task. Similarly, gait kinetics and kinematics, and postural control measures improved with the combination of SR and a knee sleeve as well as with the sleeve alone compared to the control condition; however no improvements were seen between the combination of SR and knee sleeve and the sleeve alone conditions.;The improvement of JPS during a PWB task with a neoprene knee sleeve is a novel finding and these improvements in JPS may be the cause of further improvements in walking biomechanics and postural control measures when wearing a sleeve. However, there seems to be no added benefit of SR; perhaps optimization of SR's parameters may lead to future improvements with this therapy in those with knee OA or other populations with neuromuscular deficits.