1
|
Langgård Jørgensen S, Mechlenburg I, Bagger Bohn M, Aagaard P. Sit-to-stand power predicts functional performance and patient-reported outcomes in patients with advanced knee osteoarthritis. A cross-sectional study. Musculoskelet Sci Pract 2024; 69:102899. [PMID: 38141496 DOI: 10.1016/j.msksp.2023.102899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Lower limb muscle power is positively associated with functional performance and patient-reported outcomes (PROMs) and suggested as an important variable to evaluate in patients with advanced knee osteoarthritis (OA). OBJECTIVES To explore the association between muscle power derived from the 30-sec sit-to-stand test (STS power) with functional performance and PROMs compared to maximal isometric knee extensor strength (KE MVC) in male- and female patients with advanced OA. STUDY DESIGN Cross-sectional design. METHODS Eighty-six patients (66.6 [64.9-67.7]years) with advanced knee OA were included. Dependent variables were STS power and KE MVC. Independent variables were Timed Up&Go (TUG), 40-m fast-paced walk test (40mFWT), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales. COVARIATE Age. ANALYSES Simple linear- and multiple regression analyses with and without adjusting for age. Pitman's test was used to evaluate differences in correlation strength among dependent variables. RESULTS STS power demonstrated a statistical relationship with TUG and 40mFWT for both sexes (β coefficients -1.11 to -4.36 (p < 0.05), r2 = 0.47-0.55 (p < 0.05)), and with KOOS Pain, ADL, and Sport for male patients (β coefficients 6.53 to 7.17 (p < 0.05), r2 = 0.29-0.33 (p < 0.05)). Knee extensor MVC demonstrated no relationship with any outcomes for male patients or female patients. STS power displayed statistically stronger correlation to functional performance. CONCLUSION STS power was associated with functional performance in both male patients and female patients suffering from advanced knee OA. Moreover, STS power was associated with KOOS Pain, Sport, and ADLin male patients. The assessment of STS power should be considered in the evaluation of patients with advanced knee OA. TRIAL REGISTRATION NUMBER NCT04081493.
Collapse
Affiliation(s)
- Stian Langgård Jørgensen
- Department of Occupational and Physical Therapy. Regional Hospital Horsens, Denmark; H-HIP, Department of Orthopedic Surgery, Regional Hospital Horsens, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Inger Mechlenburg
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Orthopedic Surgery, Aarhus University Hospital, Denmark
| | - Marie Bagger Bohn
- H-HIP, Department of Orthopedic Surgery, Regional Hospital Horsens, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| |
Collapse
|
2
|
Effect of functional weightbearing versus non-weightbearing quadriceps strengthening exercise on contact force in varus-malaligned medial knee osteoarthritis: A secondary analysis of a randomized controlled trial. Knee 2022; 39:50-61. [PMID: 36162143 DOI: 10.1016/j.knee.2022.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/30/2022] [Accepted: 09/10/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Knee osteoarthritis progression may be related to altered knee loads, particularly in those with varus malalignment. Using randomized controlled trial data, this secondary analysis of complete datasets (n = 67) compared the effects of a functional weightbearing (WB) and non-weightbearing quadriceps strengthening exercise (NWB) program on measures of medial tibiofemoral joint contact force (MTCF) during walking. METHODS Participants aged ≥50 years and with medial knee osteoarthritis and varus malalignment were randomly allocated to a 12-week, home-based, physiotherapist-prescribed exercise program comprised of WB exercises (n = 31), or NWB exercise (n = 36). Three-dimensional lower-body motion, ground reaction forces, and surface electromyograms from six lower-limb muscles were acquired during walking at baseline and at 12-weeks follow-up. An electromyogram-informed neuromusculoskeletal model estimated bodyweight (BW) normalized MTCF (peak and impulse), including external and muscular contributions to MTCF. RESULTS There was no between-group difference in the change in peak MTCF (-0.02 [-0.12, 0.09] BW) or MTCF impulse (-0.01 [-0.06, 0.03] BW·s). There was a between-group difference in the muscle contribution to peak MTCF (-0.08 [-0.15, -0.00] BW) and MTCF impulse (-0.04 [-0.08, -0.00] BW·s), whereby the muscle contribution reduced more in the NWB group over time compared to the WB group. There was also a between group-difference in the external contribution to peak MTCF (0.09 [0.01, 0.18] BW), but this reduced more in the WB group than in the NWB group. CONCLUSIONS Our findings suggest no difference in MTCF between the two exercise programs, but differences in the contribution to MTCF between the two exercise programs were observed in those with medial knee osteoarthritis and varus malalignment.
Collapse
|
3
|
Hutchison L, Grayson J, Hiller C, D'Souza N, Kobayashi S, Simic M. Relationship Between Knee Biomechanics and Pain in People With Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2022; 75:1351-1361. [PMID: 35997473 DOI: 10.1002/acr.25001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/25/2022] [Accepted: 08/16/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Our primary aim was to determine the cross-sectional relationship between knee biomechanics during gait and pain in people with medial knee osteoarthritis. Our secondary aim was to evaluate differences in knee biomechanics between symptomatic and asymptomatic participants with medial knee osteoarthritis. METHODS Four online databases were searched from inception to July 2021. Eligible studies included people with medial/nonspecific knee osteoarthritis and a reported relationship between knee biomechanics during gait and pain or biomechanics of symptomatic and asymptomatic participants. Two reviewers independently extracted data and evaluated risk of bias. Random-effects meta-analyses were performed when three or more studies reported the same biomechanical variable for pooling (knee adduction moment [KAM], KAM impulse, varus thrust, and peak knee flexion moment [KFM]). RESULTS Forty studies were included. Methodological quality ranged from 4 to 9/10. Forty-seven unique biomechanical variables were reported. For the KAM, there was no correlation with pain for peak values pooled (early stance and overall) (r = 0.00, 95% confidence interval [95% CI]: -0.12, 0.11, k = 16), a small negative correlation for early stance peak alone (r = -0.09, 95% CI -0.18, -0.002, k = 12), and a medium positive correlation for the overall peak during stance (r = 0.30, 95% CI 0.17, 0.42, k = 4). Metaregression identified that body mass index moderated the peak KAM-pain relationship (P < 0.001). KAM impulse had a small positive correlation with pain (r = 0.23, 95% CI 0.04, 0.40, k = 5), and people with varus thrust had 3.84 greater odds of reporting pain compared with people without (95% CI 1.72, 8.53, k = 3). Meta-analyses for the peak KFM and pain correlation and secondary aim were nonsignificant. CONCLUSION Some knee gait biomechanics were associated with pain in this cohort. Longitudinal studies are required to determine causality.
Collapse
Affiliation(s)
- Laura Hutchison
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Jane Grayson
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Claire Hiller
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Nicole D'Souza
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Sarah Kobayashi
- The University of Sydney, Camperdown, New South Wales, Australia, and Australian Catholic University, North Sydney, New South Wales, Australia
| | - Milena Simic
- The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
4
|
Association Between Knee Moments During Stair Navigation and Participant-Related Factors in Individuals With Anterior Cruciate Ligament Reconstruction: A Cross-Sectional Study. J Sport Rehabil 2021; 31:174-180. [PMID: 34794119 DOI: 10.1123/jsr.2021-0104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Altered knee joint mechanics may be related to quadriceps muscle strength, time since surgery, and sex following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to investigate the association between knee moments, with participant-related factors during stair navigation post-ACLR. DESIGN Cross-sectional study. METHODS A total of 30 participants (14 women) with ACLR, on average 7.0 (SD 4.4) years postsurgery were tested during stair ascent and descent in a gait laboratory. Motion capture was conducted using a floor-embedded force plate and 11 infrared cameras. Quadriceps concentric and eccentric muscle strength was measured with an isokinetic dynamometer at 60°/s, and peak torques recorded. Multiple regression analyses were performed between external knee flexion and adduction moments, respectively, and quadriceps peak torque, sex, and time since ACLR. RESULTS Higher concentric quadriceps strength and female sex accounted for 55.7% of the total variance for peak knee flexion moment during stair ascent (P < .001). None of the independent variables accounted for variance in knee adduction moment (P = .698). No significant associations were found for knee flexion and adduction moments during for stair descent. CONCLUSION Higher quadriceps concentric strength and sex explains major variance in knee flexion moments during stair ascent. The strong association between muscle strength and external knee flexion moments during stair ascent indicate rehabilitation tailored for quadriceps may optimize knee mechanics, particularly for women.
Collapse
|
5
|
Muscle strength gains after strengthening exercise explained by reductions in serum inflammation in women with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2021; 86:105381. [PMID: 34000629 DOI: 10.1016/j.clinbiomech.2021.105381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 03/13/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023]
Abstract
Background Individuals with knee osteoarthritis have elevated circulating inflammatory markers and altered cartilage properties but it is unclear if these features adapt to exercise. We aimed to determine (1) whether inflammatory markers, cartilage transverse relaxation time and thickness mediate the effect of body mass index (BMI) on quadriceps strength at baseline; and (2) whether these changes explain variance in quadriceps strength improvements after 12 weeks of exercise in women with knee osteoarthritis. Methods This secondary analysis (17 women with clinical knee osteoarthritis) of a randomized control trial compared supervised group interventions, 3 times/week for 12 weeks (36 sessions): (a) weight-bearing progressive resistive quadriceps exercise or (b) attention control. (1) From baseline, separate linear regressions were conducted with strength (Nm/kg) as the dependent, BMI as the predictor, and c-reactive protein, tumor necrosis factor, interleukin-6, cartilage transverse relaxation time or thickness as potential mediators. (2) Multiple linear regression analyses were completed with 12-week strength change (post-pre) as the dependent, change in serum inflammatory markers and cartilage measurements as predictors, and age, BMI and adherence as covariates. Findings (1) At baseline, there was no mediation. (2) A decrease in each of interleukin-6 (β = -0.104 (95% confidence intervals: -0.172, -0.036), R2 = 0.51, P < 0.007) and tumor necrosis factor (β = -0.024 (-0.038, -0.009), R2 = 0.54, P < 0.005) was associated with strength gains. Interpretation At baseline, inflammatory markers and cartilage measurements do not act as mediators of BMI on quadriceps strength. After 12 weeks of exercise, reduced interleukin-6 and tumor necrosis factor were associated with increased quadriceps strength in women with knee osteoarthritis.
Collapse
|
6
|
Randomized Controlled Trial Investigating the Role of Exercise in the Workplace to Improve Work Ability, Performance, and Patient-Reported Symptoms Among Older Workers With Osteoarthritis. J Occup Environ Med 2018; 59:550-556. [PMID: 28379878 DOI: 10.1097/jom.0000000000001020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of a 12-week workplace exercise program on work ability, performance, and patient-reported symptoms in older university employees with knee and/or hip osteoarthritis. METHODS Twenty-four participants with clinical hip and/or knee osteoarthritis were randomized to exercise or no exercise. At baseline and follow-up, several work (work ability, resilience), patient-reported (pain, physical function, depressive symptoms, self-efficacy), and performance outcomes (hip and knee strength, mobility performance) were measured. RESULTS Significant improvements in work ability (P < 0.049) and patient-reported outcomes (pain, function, depressive symptoms) existed in the exercise group. No improvements were demonstrated in the no exercise group. CONCLUSIONS Exercise in the workplace improved work ability and patient-reported symptoms in older workers with osteoarthritis. The benefits of workplace exercise programs should be studied in a larger sample in which attention is given to improving exercise adherence.
Collapse
|
7
|
Brenneman EC, Maly MR. Identifying changes in gait waveforms following a strengthening intervention for women with knee osteoarthritis using principal components analysis. Gait Posture 2018; 59:286-291. [PMID: 28754420 DOI: 10.1016/j.gaitpost.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/27/2017] [Accepted: 07/03/2017] [Indexed: 02/02/2023]
Abstract
Lower limb strengthening exercise is pivotal for the management of symptoms related to knee osteoarthritis (OA). Though improvement in clinical symptoms is well documented, concurrent changes in gait biomechanics are ill-defined. This may occur because discrete analyses miss changes following an intervention, analyses limited to the knee undermine potential mechanical trade-offs at other joints, or strengthening interventions not been designed based on biomechanical principles. The purpose of this study was to characterize differences in entire gait waveforms for sagittal plane ankle, knee, and hip angles and external moments; the knee adduction moment; and frontal plane hip angle and moment following 12-weeks of a previously designed novel lower limb strengthening program. Forty women with knee OA completed two laboratory visits: one at baseline and one immediately following intervention (follow-up). Self-report measures, strength, and gait analyses were completed at each visit. Principal components analyses were completed for sagittal angles and external moments at the ankle, knee, and hip joints, as well as frontal plane angle and moment for the hip. Participants improved self-report and strength (p≤0.004). Two significant, yet subtle differences in principal components were identified between baseline and follow-up waveforms (p<0.05) pertaining to the knee and hip sagittal external moments. The subtle changes in concert with the lack of differences in other joints and planes suggest the lower limb strengthening program does not translate to changes in the gait waveform. It is likely this program is improving symptoms without worsening mechanics.
Collapse
Affiliation(s)
- Elora C Brenneman
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Monica R Maly
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
| |
Collapse
|
8
|
Davison MJ, Maly MR, Keir PJ, Hapuhennedige SM, Kron AT, Adachi JD, Beattie KA. Lean muscle volume of the thigh has a stronger relationship with muscle power than muscle strength in women with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2017; 41:92-97. [PMID: 28038376 DOI: 10.1016/j.clinbiomech.2016.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 08/25/2016] [Accepted: 11/22/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thigh lean muscle and intramuscular fat have been implicated in the impairment of physical function observed in people with knee osteoarthritis. We investigated the relationships of quadriceps and hamstrings intramuscular fat fraction and lean muscle volume with muscle power and strength, controlling for neuromuscular activation, and physical performance in women with knee OA. METHODS Women (n=20) 55years or older with symptomatic, radiographic knee osteoarthritis underwent a 3.0T magnetic resonance imaging scan of the thigh of their most symptomatic knee. Axial fat-separated images were analyzed using software to quantify intramuscular fat and lean muscle volumes of the quadriceps and hamstrings. To quantify strength and power of the knee extensors and flexors, participants performed maximum voluntary isometric contraction and isotonic knee extensions and flexions, respectively. Electromyography of the quadriceps and hamstrings was measured. Participants also completed five physical performance tests. FINDINGS Quadriceps and hamstrings lean muscle volumes were related to isotonic knee extensor (B=0.624; p=0.017) and flexor (B=1.518; p=0.032) power, but not knee extensor (B=0.001; p=0.615) or flexor (B=0.001; p=0.564) isometric strength. Intramuscular fat fractions were not related to isotonic knee extensor or flexor power, nor isometric strength. No relationships were found between intramuscular fat or lean muscle volume and physical performance. INTERPRETATION Muscle power may be more sensitive than strength to lean muscle mass in women with knee osteoarthritis. Thigh lean muscle mass, but neither intramuscular nor intermuscular fat, is related to knee extensor and flexor power in women with knee osteoarthritis.
Collapse
Affiliation(s)
- Michael J Davison
- Department of Medicine, McMaster University, 501-25 Charlton Ave. East, Hamilton, ON L8N 1Y9, Canada.
| | - Monica R Maly
- School of Rehabilitation Science, McMaster University, Institute for Applied Health Sciences, Room 403, 1400 Main St. W. Hamilton, ON L8S 1C7, Canada; Department of Kinesiology, B.C. Matthews Hall, University of Waterloo, 200 University Ave. West, Waterloo, ON N2L 3G1, Canada.
| | - Peter J Keir
- Department of Kinesiology, McMaster University, Ivor Wynne Centre, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Sandani M Hapuhennedige
- Department of Medicine, McMaster University, 501-25 Charlton Ave. East, Hamilton, ON L8N 1Y9, Canada.
| | - Amie T Kron
- Faculty of Science, McMaster University, Burke Science Building (BSB), Room 102, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, 501-25 Charlton Ave. East, Hamilton, ON L8N 1Y9, Canada.
| | - Karen A Beattie
- Department of Medicine, McMaster University, 501-25 Charlton Ave. East, Hamilton, ON L8N 1Y9, Canada.
| |
Collapse
|
9
|
Reid KF, Price LL, Harvey WF, Driban JB, Hau C, Fielding RA, Wang C. Muscle Power Is an Independent Determinant of Pain and Quality of Life in Knee Osteoarthritis. Arthritis Rheumatol 2016; 67:3166-73. [PMID: 26315282 DOI: 10.1002/art.39336] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 08/13/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined the relationships between leg muscle strength, power, and perceived disease severity in subjects with knee osteoarthritis (OA) in order to determine whether dynamic leg extensor muscle power would be associated with pain and quality of life in knee OA. METHODS Baseline data on 190 subjects with knee OA (mean ± SD age 60.2 ± 10.4 years, body mass index 32.7 ± 7.2 kg/m(2) ) were obtained from a randomized controlled trial. Knee pain was measured using the Western Ontario and McMaster Universities Osteoarthritis Index, and health-related quality of life was assessed using the Short Form 36 (SF-36). One-repetition maximum (1RM) strength was assessed using the bilateral leg press, and peak muscle power was measured during 5 maximum voluntary velocity repetitions at 40% and 70% of 1RM. RESULTS In univariate analysis, greater muscle power was significantly associated with pain (r = -0.17, P < 0.02) and also significantly and positively associated with SF-36 physical component summary (PCS) scores (r = 0.16, P < 0.05). After adjustment for multiple covariates, muscle power was a significant independent predictor of pain (P ≤ 0.05) and PCS scores (P ≤ 0.04). However, muscle strength was not an independent determinant of pain or quality of life (P ≥ 0.06). CONCLUSION Muscle power is an independent determinant of pain and quality of life in knee OA. Compared to strength, muscle power may be a more clinically important measure of muscle function within this population. New trials to systematically examine the impact of muscle power training interventions on disease severity in knee OA are particularly warranted.
Collapse
Affiliation(s)
| | - Lori Lyn Price
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | - William F Harvey
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | - Jeffrey B Driban
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| | | | | | - Chenchen Wang
- Tufts Medical Center and Tufts University, Boston, Massachusetts
| |
Collapse
|
10
|
Murray AM, Thomas AC, Armstrong CW, Pietrosimone BG, Tevald MA. The associations between quadriceps muscle strength, power, and knee joint mechanics in knee osteoarthritis: A cross-sectional study. Clin Biomech (Bristol, Avon) 2015; 30:1140-5. [PMID: 26342961 DOI: 10.1016/j.clinbiomech.2015.08.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 08/14/2015] [Accepted: 08/18/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Abnormal knee joint mechanics have been implicated in the pathogenesis and progression of knee osteoarthritis. Deficits in muscle function (i.e., strength and power) may contribute to abnormal knee joint loading. The associations between quadriceps strength, power and knee joint mechanics remain unclear in knee osteoarthritis. METHODS Three-dimensional motion analysis was used to collect peak knee joint angles and moments during the first 50% of stance phase of gait in 33 participants with knee osteoarthritis. Quadriceps strength and power were assessed using a knee extension machine. Strength was quantified as the one repetition maximum. Power was quantified as the peak power produced at 40-90% of the one repetition maximum. FINDINGS Quadriceps strength accounted for 15% of the variance in peak knee flexion angle (P=0.016). Quadriceps power accounted for 20-29% of the variance in peak knee flexion angle (P<0.05). Quadriceps power at 90% of one repetition maximum accounted for 9% of the variance in peak knee adduction moment (P=0.05). INTERPRETATION These data suggest that quadriceps power explains more variance in knee flexion angle and knee adduction moment during gait in knee osteoarthritis than quadriceps strength. Additionally, quadriceps power at multiple loads is associated with knee joint mechanics and therefore should be assessed at a variety of loads. Taken together, these results indicate that quadriceps power may be a potential target for interventions aimed at changing knee joint mechanics in knee osteoarthritis.
Collapse
Affiliation(s)
- Amanda M Murray
- Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Aurora, CO, United States.
| | - Abbey C Thomas
- Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC, United States
| | | | - Brian G Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Michael A Tevald
- Department of Rehabilitation Sciences, University of Toledo, Toledo, OH, United States
| |
Collapse
|
11
|
Lee SH, Lee JH, Ahn SE, Park MJ, Lee DH. Correlation between Quadriceps Endurance and Adduction Moment in Medial Knee Osteoarthritis. PLoS One 2015; 10:e0141972. [PMID: 26539830 PMCID: PMC4635012 DOI: 10.1371/journal.pone.0141972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 10/15/2015] [Indexed: 01/11/2023] Open
Abstract
It is not clear whether the strength or endurance of thigh muscles (quadriceps and hamstring) is positively or negatively correlated with the adduction moment of osteoarthritic knees. This study therefore assessed the relationships between the strength and endurance of the quadriceps and hamstring muscles and adduction moment in osteoarthritic knees and evaluated predictors of the adduction moment. The study cohort comprised 35 patients with unilateral medial osteoarthritis and varus deformity who were candidates for open wedge osteotomy. The maximal torque (60°/sec) and total work (180°/sec) of the quadriceps and hamstring muscles and knee adduction moment were evaluated using an isokinetic testing device and gait analysis system. The total work of the quadriceps (r = 0.429, P = 0.037) and hamstring (r = 0.426, P = 0.045) muscles at 180°/sec each correlated with knee adduction moment. Preoperative varus deformity was positively correlated with adduction moment (r = 0.421, P = 0.041). Multiple linear regression analysis showed that quadriceps endurance at 180°/sec was the only factor independently associated with adduction moment (β = 0.790, P = 0.032). The adduction moment of osteoarthritic knees correlated with the endurance, but not the strength, of the quadriceps muscle. However, knee adduction moment did not correlate with the strength or endurance of the hamstring muscle.
Collapse
Affiliation(s)
- Soon-Hyuck Lee
- Department of Orthopaedic Surgery, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Jin-Hyuck Lee
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Sung-Eun Ahn
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Min-Ji Park
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Korea
| | - Dae-Hee Lee
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail:
| |
Collapse
|