Immediate Effects of Acupuncture Treatment on Intra- and Inter-Limb Contributions to Body Support During Gait in Patients with Bilateral Medial Knee Osteoarthritis

摘要

Knee osteoarthritis (OA) often leads to altered balance control, joint motion and loading patterns during gait. Acupuncture has been proven to be effective in pain relief but its effects on inter-joint load-sharing for body balance have not been reported. The current study bridged the gap by quantifying the immediate effects of acupuncture on the inter-joint and inter-limb load-sharing in patients with knee OA during level walking in terms of the total support moment (Ms) and the contribution of individual joints to the total support moment. Gait analysis was performed on fifteen healthy controls and on fifteen patients with mild to moderate bilateral medial knee OA. After acupuncture treatment the patients with bilateral knee OA walked with significantly increased speed (p = 0.031), and were able to resist greater and closer-to-normal knee flexion moments (p = 0.038). They also changed the interjoint sharing of the support moments with increased knee (p = 0.031) contributions, but reduced hip contributions (p = 0.022) to the sagittal Ms during single-limb support. They showed an asymmetric inter-limb load-sharing similar to the normal controls, with increased sharing of the time integral of both the sagittal and frontal whole body support moment by the leading limb during double-limb support (p = 0.024). The altered intra-and inter-limb contributions to the demand of supporting the body during gait suggests that acupuncture treatment led to immediate changes in the control strategy toward a normal pattern. However, the effects of these changes on the progression of the disease in the long term would require further investigation.