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Fri, Oct 15

Speaker: Amber Collins (University of North Carolina at Chapel Hill; post-doctoral fellow candidate)

Title: Stochastic Resonance Electrical Stimulation to Improve Proprioception, Gait Biomechanics, and Balance in the Osteoarthritic Knee

Osteoarthritis (OA) of the knee is a common joint disorder and a leading cause of disability among elderly men and women. Current treatment options focus on ameliorating the symptoms of the disease rather than prevention or delaying OA progression. Those with knee OA have been shown to exhibit abnormal proprioception and gait biomechanics. Improvements in proprioception may lead to secondary improvements in postural control and in knee joint biomechanics during dynamic activities such as walking. Further, improvements in postural control in those with knee OA, who are generally older, may translate into a reduction in their risk of falling. 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 its incorporation into a knee sleeve for clinical applicability, we aimed to determine whether proprioception, postural control and the biomechanics of gait could be improved in those with osteoarthritis of the knee.

Joint position sense (JPS), a valid method for the assessment of proprioception, was assessed in those with mild 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. In a separate study, gait kinetics and kinematics as well as postural control were assessed in those with mild to moderate, medial knee OA under similar treatment conditions combining SR and a knee sleeve.

JPS was improved with the combination of SR and a neoprene knee sleeve as well as the sleeve alone in a PWB task, with no improvements in the NWB task and no difference between SR and the sleeve alone conditions. Similarly, gait kinetics, kinematics, and postural control measures improved with the application of both SR and a knee sleeve and a sleeve alone condition, however no improvements were seen between the combination of SR and knee sleeve condition and the sleeve alone condition.

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 gait 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 in these measures.

Host: Dr. Todd Kuiken