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Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis

Overview of attention for article published in BMC Musculoskeletal Disorders, August 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)

Mentioned by

1 news outlet
16 tweeters
8 Facebook pages


32 Dimensions

Readers on

133 Mendeley
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Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis
Published in
BMC Musculoskeletal Disorders, August 2016
DOI 10.1186/s12891-016-1209-2
Pubmed ID

Stephen J. Preece, Richard K. Jones, Christopher A. Brown, Timothy W. Cacciatore, Anthony K. P. Jones


Both increased knee muscle co-contraction and alterations in central pain processing have been suggested to play a role in knee osteoarthritis pain. However, current interventions do not target either of these mechanisms. The Alexander Technique provides neuromuscular re-education and may also influence anticipation of pain. This study therefore sought to investigate the potential clinical effectiveness of the AT intervention in the management of knee osteoarthritis and also to identify a possible mechanism of action. A cohort of 21 participants with confirmed knee osteoarthritis were given 20 lessons of instruction in the Alexander Technique. In addition to clinical outcomes EMG data, quantifying knee muscle co-contraction and EEG data, characterising brain activity during anticipation of pain, were collected. All data were compared between baseline and post-intervention time points with a further 15-month clinical follow up. In addition, biomechanical data were collected from a healthy control group and compared with the data from the osteoarthritis subjects. Following AT instruction the mean WOMAC pain score reduced by 56 % from 9.6 to 4.2 (P < 0.01) and this reduction was maintained at 15 month follow up. There was a clear decrease in medial co-contraction at the end of the intervention, towards the levels observed in the healthy control group, both during a pre-contact phase of gait (p < 0.05) and during early stance (p < 0.01). However, no changes in pain-anticipatory brain activity were observed. Interestingly, decreases in WOMAC pain were associated with reductions in medial co-contraction during the pre-contact phase of gait. This is the first study to investigate the potential effectiveness of an intervention aimed at increasing awareness of muscle behaviour in the clinical management of knee osteoarthritis. These data suggest a complex relationship between muscle contraction, joint loading and pain and support the idea that excessive muscle co-contraction may be a maladaptive response in this patient group. Furthermore, these data provide evidence that, if the activation of certain muscles can be reduced during gait, this may lead to positive long-term clinical outcomes. This finding challenges clinical management models of knee osteoarthritis which focus primarily on muscle strengthening. ISRCTN74086288 , 4th January 2016, retrospectively registered.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 133 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 133 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 14%
Student > Bachelor 17 13%
Student > Ph. D. Student 16 12%
Researcher 11 8%
Other 9 7%
Other 28 21%
Unknown 33 25%
Readers by discipline Count As %
Nursing and Health Professions 22 17%
Medicine and Dentistry 20 15%
Engineering 13 10%
Sports and Recreations 11 8%
Agricultural and Biological Sciences 7 5%
Other 18 14%
Unknown 42 32%

Attention Score in Context

This research output has an Altmetric Attention Score of 25. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 March 2018.
All research outputs
of 19,868,278 outputs
Outputs from BMC Musculoskeletal Disorders
of 3,571 outputs
Outputs of similar age
of 282,377 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
of 1 outputs
Altmetric has tracked 19,868,278 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,571 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 282,377 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them