Alterations in quadriceps and hamstrings coordination in persons with medial compartment knee osteoarthritis

Altered muscle coordination strategies in persons with knee osteoarthritis (OA) result in an increase in co-contraction of the quadriceps and hamstrings during walking. While this may increase intersegmental joint contact force and expedite disease progression, it is not currently known whether the magnitude of co-contraction increases with a progressive loss of joint space or whether the level of co-contraction is dependent on walking speed. The purposes of this study were to (1) determine if co-contraction increased with OA severity and (2) discern whether differences in co-contraction were a result of altered freely chosen walking speeds or rather an inherent change associated with disease progression. Forty-two subjects with and without knee osteoarthritis were included in the study. Subjects were divided into groups based on disease severity. When walking at a controlled speed of 1.0m/s, subjects with moderate and severe knee OA showed significantly higher co-contraction when compared to a healthy control group. At freely chosen walking speeds only the moderate OA group had significantly higher co-contraction values. Increased walking speed also resulted in a significant increase in co-contraction, regardless of group. The results of this study demonstrate that persons with knee OA develop higher antagonistic muscle activity. This occurs despite differences in freely chosen walking speed. Although subjects with OA had higher co-contraction than the control group, co-contraction may not increase with disease severity.