Effects of Fear of Movement on Lower Limb Muscle Activation in Patients with Knee Osteoarthritis
10.16156/j.1004-7220.2025.03.012
- VernacularTitle:运动恐惧对膝骨关节炎患者下肢肌肉激活的影响
- Author:
Bixuan DUAN
1
;
Yuxuan ZHANG
;
Pei MA
;
Wei LI
Author Information
1. 滨州医学院特殊教育与康复学院,山东滨州 256600
- Publication Type:Journal Article
- Keywords:
knee osteoarthritis;
fear of movement;
lower limb;
muscle activation;
surface electromyography;
biomechanics
- From:
Journal of Medical Biomechanics
2025;40(3):606-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze muscle activation intensity in patients with knee osteoarthritis(KOA)during physical activity by applying surface electromyography(sEMG),and investigate the impact of fear of movement on lower limb muscle function in patients with KOA.Methods A total of 30 patients with KOA were selected and categorized into a high-fear group(n=16)and a low-fear group(n=14)based on the TSK-17 scale(Tampa Scale for Kinesiophobia)scores,with 14 healthy individuals serving as the control group.A wireless sEMG system was used to record sEMG signals of different muscles.Test activities included walking at normal speed,stair ascent,and stair descent.Muscle activation was normalized to maximum voluntary contraction(MVC)by calculating the root mean square(RMS)of the EMG signals to compare muscle activation under different conditions.Correlation analyses were conducted to evaluate the relationship between muscle activation and TSK-17 scores.Results During normal walking,the healthy limb side of the high-fear group showed significantly greater activation in the rectus femoris(P＜0.05),vastus medialis(P＜0.01),and vastus lateralis(P＜0.01)compared to the affected limb side.Muscle activation of the healthy limb side was also elevated during stair ascent and stair descent in the high-fear group,with significant differences in the rectus femoris(P＜0.01),vastus medialis(P＜0.01),and vastus lateralis(P＜0.01).In the high-fear group,the affected/undominant and healthy/dominant limb side exhibited significantly increased activation in the rectus femoris(P＜0.05)during normal walking compared with the low-fear group and control group.The affected/undominant and healthy/dominant side also exhibited increased activation in the rectus femoris(P＜0.05)during stair ascent compared to the low-fear group and control group.There was a significant positive association between TSK-17 scores and rectus femoris activation on the healthy limb side during stair descent(r=0.95,P＜0.01).Conclusions Fear of movement has a significant impact on muscle activation patterns in patients with,particularly during stair descent,which places a greater functional demand on the lower limbs.Therefore,great attention should be paid to the intervention of psychological factors in KOA treatment,so as to comprehensively improve both motor function and life quality of the patients.
