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J Electromyogr Kinesiol. 2011 Oct;21(5):704-11. doi: 10.1016/j.jelekin.2011.05.001.

Foot center of pressure manipulation and gait therapy influence lower limb muscle activation in patients with osteoarthritis of the knee.

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  • 1Faculty of Mechanical Engineering, Technion-Israel Institute of Technology, Haifa, Israel.



Foot center of pressure (COP) manipulation has been associated with improved gait patterns. The purpose of this study was to determine lower limb muscle activation changes in knee osteoarthritis patients, both immediately after COP manipulation and when COP manipulation was combined with continuous gait therapy (AposTherapy).


Fourteen females with medial compartment knee osteoarthritis underwent EMG analyzes of key muscles of the leg. In the initial stage, trials were carried out at four COP positions. Following this, gait therapy was initiated for 3 months. The barefoot EMG was compared before and after therapy.


The average EMG varied significantly with COP in at least one phase of stance in all examined muscles of the less symptomatic leg and in three muscles of the more symptomatic leg. After training, a significant increase in average EMG was observed in most muscles. Most muscles of the less symptomatic leg showed significantly increased peak EMG. Activity duration was shorter for all muscles of the less symptomatic leg (significant in the lateral gastrocnemius) and three muscles of the more symptomatic leg (significant in the biceps femoris). These results were associated with reduced pain, increased function and improved spatiotemporal parameters.


COP manipulation influences the muscle activation patterns of the leg in patients with knee osteoarthritis. When combined with a therapy program, muscle activity increases and activity duration decreases.

[PubMed - indexed for MEDLINE]
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