PTRCTArchives of physiotherapy2022

Muscle activation patterns around knee following neuromuscular training in patients with knee osteoarthritis: secondary analysis of a randomized clinical trial.

Shahzada Aadil Rashid, Mohammad Ejaz Hussain, Pooja Bhati and 4 others

PMID 35799287

WHAT IT FOUND

Neuromuscular training reduced co-contraction of quadriceps and hamstrings more than conventional strengthening in knee osteoarthritis.

Effects on quadriceps and gastrocnemius were similar. Both training types lowered co-contraction, suggesting NMT specifically targets hamstring-quadriceps stability.

Key findings

01Neuromuscular training was significantly more effective than conventional quadriceps training at reducing the co-contraction index for medial and lateral quadriceps-hamstring pairs.

02There was no significant difference between the two groups in reducing the co-contraction index for quadriceps-gastrocnemius pairs.

03Both neuromuscular training and conventional quadriceps training significantly reduced co-contraction indices within their respective groups.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was not adequately powered to determine long-term effects on disease progression. The sample size was relatively small. There was no non-exercise control group, so it is unclear how much of the change was due to the specific intervention versus time or placebo effects. EMG signals may have been contaminated by cross-talk during treadmill walking. The participants had mild to moderate osteoarthritis, so findings may not apply to those with severe disease.

The easy way to misread this

Do not interpret the reduction in co-contraction as proof that neuromuscular training prevents joint destruction or improves clinical outcomes like pain and function more than conventional strengthening. This study measured muscle activation patterns (a secondary outcome), not the primary clinical endpoints, and did not track long-term structural changes.

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