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
|
Verdini E, Maestroni L, Clark M, Turner A, Huber J. Do people with musculoskeletal pain differ from healthy cohorts in terms of global measures of strength? A systematic review and meta-analysis. Clin Rehabil 2023; 37:244-260. [PMID: 36154313 PMCID: PMC9772898 DOI: 10.1177/02692155221128724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE It is currently unknown if people with musculoskeletal pain display different multi-joint strength capacities than healthy cohorts. The aim was to investigate whether people with musculoskeletal pain show differences in global measures of strength in comparison to healthy cohorts. DATA SOURCES A systematic review was conducted using three databases (Medline, CINAHL and SPORTDiscus) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. REVIEW METHODS Studies involving participants with painful musculoskeletal conditions and multi-joint strength assessment measured at baseline were included. A meta-analysis was also performed to compute standardized mean differences (± 95% confidence intervals), using Hedge's g, and examined the differences in multi-joint strength at baseline between participants with painful musculoskeletal conditions and healthy participants. RESULTS In total, 5043 articles were identified, of which 20 articles met the inclusion criteria and were included in the qualitative analysis. The available evidence revealed that multi-joint strength values were limited to knee osteoarthritis, fibromyalgia, chronic low back pain, and rheumatoid arthritis. Only four studies were included in the quantitative synthesis and revealed that only small differences in both chest press (g = -0.34, 95% CI [-0.64, -0.03]) and leg press (g = -0.25, 95% CI [-0.49, -0.02]) existed between adult women with fibromyalgia and active community women. CONCLUSION There is a paucity of multi-joint strength values in participants with musculoskeletal pain. Quantitative comparison with healthy cohorts was limited, except for those with fibromyalgia. Adult women with fibromyalgia displayed reduced multi-joint strength values in comparison to active community women.
Collapse
Affiliation(s)
- Enrico Verdini
- School of Health Sciences, University of Brighton, Brighton, UK,Studio Medico Jacini, Rome, Italy,Enrico Verdini, School of Health Sciences, University of Brighton, Brighton, United Kingdom and Studio Medico Jacini, Piazza Stefano Jacini 26a, 00191, Rome, Italy
| | - Luca Maestroni
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | | | - Anthony Turner
- London Sport Institute, School of Science and Technology, Middlesex University, London, UK
| | - Jörg Huber
- School of Health Sciences, University of Brighton, Brighton, UK
| |
Collapse
|
3
|
Foldager F, Jørgensen PB, Tønning LU, Petersen ET, Jakobsen SS, Vainorius D, Homilius M, Hansen TB, Stilling M, Mechlenburg I. The relationship between muscle power, functional performance, accelerometer-based measurement of physical activity and patient-reported outcomes in patients with hip osteoarthritis: A cross-sectional study. Musculoskelet Sci Pract 2022; 62:102678. [PMID: 36335851 DOI: 10.1016/j.msksp.2022.102678] [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: 08/29/2022] [Revised: 09/27/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with unilateral hip osteoarthritis appear to have between-leg differences in leg extension power (LEP). The Nottingham Leg Extensor Power Rig provides reliable and valid results but requires sensitive equipment. It would be relevant to identify measures closely associated with this test. OBJECTIVE (i) To investigate if LEP is lower in the affected leg compared to the non-affected leg. Furthermore, to investigate the associations between LEP and the measures: (ii) Functional performance, (iii) accelerometer-based measurement of physical activity and (iv) patient-reported outcome measures (PROM). DESIGN Cross-sectional study including 60 patients (30 men, 30 women) with hip osteoarthritis scheduled for hip replacement. METHOD The counter movement jump and 10-m sprint tests were used to determine functional performance, accelerometer-sensors were used to determine physical activity and the Copenhagen Hip and Groin Outcome Score (HAGOS) was used to determine PROM. RESULTS (i) LEP in the affected leg corresponded to 79% [95% CI 74%; 85%] of the non-affected leg, (ii) LEP was positively associated with functional performance tests (β 0.63 to 0.78, p < 0.05), (iii) positively associated although non-significantly with physical activity (β 0.16 to 0.23, p > 0.05) and (iv) positively associated with the six HAGOS subscales (β 0.25 to 0.54, p < 0.05). CONCLUSION Functional performance tests may be used as feasible, inexpensive and fast ways to assess LEP in clinical settings. These results may suggest that interventions aimed at improving LEP can improve functional performance and PROM, but not physical activity. Future research is needed to confirm the causality of these cross-sectional findings. THE CLINICAL TRIAL REGISTRATION NUMBERS Danish Data Protection Agency (1-16-02-640-14), ClinicalTrials.gov (NTC02301182) and approved by the Danish Biomedical Research Ethics Committee (1-10-72- 343-14) prior to data collection.
Collapse
Affiliation(s)
- Frederik Foldager
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark.
| | - Peter Bo Jørgensen
- University Clinic for Hand, Hip and Knee Surgery, Department of Orthopaedics, Gødstrup Regional Hospital, Hospitalsparken 15, 7400, Herning, Denmark; AutoRSA Research Group, Orthopeadic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark
| | - Lisa Urup Tønning
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard, 828200, Aarhus N, Denmark
| | - Emil Toft Petersen
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark; AutoRSA Research Group, Orthopeadic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark
| | - Stig Storgaard Jakobsen
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark
| | - Dovydas Vainorius
- University Clinic for Hand, Hip and Knee Surgery, Department of Orthopaedics, Gødstrup Regional Hospital, Hospitalsparken 15, 7400, Herning, Denmark
| | - Morten Homilius
- University Clinic for Hand, Hip and Knee Surgery, Department of Orthopaedics, Gødstrup Regional Hospital, Hospitalsparken 15, 7400, Herning, Denmark
| | - Torben Bæk Hansen
- University Clinic for Hand, Hip and Knee Surgery, Department of Orthopaedics, Gødstrup Regional Hospital, Hospitalsparken 15, 7400, Herning, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard, 828200, Aarhus N, Denmark
| | - Maiken Stilling
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark; AutoRSA Research Group, Orthopeadic Research Unit, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard, 828200, Aarhus N, Denmark
| | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Denmark; Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard, 828200, Aarhus N, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| |
Collapse
|
4
|
Should We Use Unilateral or Bilateral Tasks to Assess Maximal and Explosive Knee Extensor Strength in Patients with Knee Osteoarthritis? A Cross-Sectional Study. J Clin Med 2021; 10:jcm10194353. [PMID: 34640371 PMCID: PMC8509120 DOI: 10.3390/jcm10194353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
Deficits in maximal and explosive knee extensor strength, which are usually assessed with unilateral tasks, are substantial in patients with knee osteoarthritis (KOA). The aim of this study was to investigate the clinical relevance of unilateral vs. bilateral tasks for assessing knee extensor strength in patients with KOA. This was achieved primarily by comparing unilateral and bilateral inter-limb strength asymmetries and secondarily by examining the relationship between unilaterally and bilaterally measured strength, and performance-based and self-reported function. Twenty-four patients with unilateral KOA (mean age: 65 ± 7 years) performed isometric gradual and explosive maximal voluntary contractions to assess, respectively their maximal and explosive strength. Performance-based and self-reported function were also evaluated with standard functional tests and questionnaires, respectively. Inter-limb asymmetries of maximal and explosive strength did not differ significantly between unilateral (mean asymmetry: 26 ± 15%) and bilateral tasks (22 ± 21%). In the same way, the relationships between knee extensor strength-measured either unilaterally or bilaterally-and performance-based or self-reported function were not influenced by the type of task. In conclusion, it does not seem to make a difference in terms of clinical relevance whether maximal and explosive knee extensor strength are evaluated with unilateral or bilateral tasks in KOA patients.
Collapse
|
5
|
Rodriguez-Lopez C, Beckwée D, Luyten FP, Van Assche D, Van Roie E. Reduced knee extensor torque production at low to moderate velocities in postmenopausal women with knee osteoarthritis. Scand J Med Sci Sports 2021; 31:2144-2155. [PMID: 34409660 DOI: 10.1111/sms.14035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/12/2021] [Indexed: 11/30/2022]
Abstract
This study aimed to determine deficits in knee extensor muscle function through the torque-time and torque-velocity relationships and whether these deficits are associated with reduced functional performance in postmenopausal women with knee osteoarthritis (KOA). A clinical sample of postmenopausal women with established KOA (n = 18, ≥55 years) was compared to an age-matched healthy control sample (CON) (n = 26). The deficits in different parameters of the knee extensor torque-time (maximal isometric torque and rate of torque development) and torque-velocity relationship (maximum muscle power, maximal velocity and torque at 0-500°·s-1 ) were assessed through a protocol consisting of isometric, isotonic and isokinetic tests. Functional performance was evaluated with sit-to-stand and stair-climbing tasks using a sensor-based technology (ie, time- and power-based outcomes). Postmenopausal women with KOA showed reduced maximal isometric torque (Hedge's g effect size (g) = 1.05, p = 0.001) and rate of torque development (g = 0.77-1.17, all p ≤ 0.02), combined with impaired torque production at slow to moderate velocities (g = 0.92-1.70, p ≤ 0.004), but not at high or maximal velocities (g = 0.16, p > 0.05). KOA were slower (g = 0.81-0.92, p ≤ 0.011) and less powerful (g = 1.11-1.29, p ≤ 0.001) during functional tasks. Additionally, knee extensor deficits were moderately associated with power deficits in stair climbing (r = 0.492-0.659). To conclude, knee extensor muscle weakness was presented in postmenopausal women with KOA, not only as limited maximal and rapid torque development during isometric contractions, but also dynamically at low to moderate velocities. These deficits were related to impaired functional performance. The assessment of knee extensor muscle weakness through the torque-time and torque-velocity relationships might enable individual targets for tailored exercise interventions in KOA.
Collapse
Affiliation(s)
- Carlos Rodriguez-Lopez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.,CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium.,Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
| | - Frank P Luyten
- Department of Development & Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Evelien Van Roie
- Physical Activity, Sports & Health Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| |
Collapse
|
6
|
Holm PM, Kemnitz J, Bandholm T, Wernbom M, Schrøder HM, Skou ST. Muscle Function Tests as Supportive Outcome Measures for Performance-Based and Self-Reported Physical Function in Patients With Knee Osteoarthritis: Exploratory Analysis of Baseline Data From a Randomized Trial. J Strength Cond Res 2020; 36:2635-2642. [PMID: 33021580 DOI: 10.1519/jsc.0000000000003840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Holm, PM, Kemnitz, J, Bandholm, T, Wernbom, M, Schrøder, HM, and Skou, ST. Muscle function tests as supportive outcome measures for performance-based and self-reported physical function in patients with knee osteoarthritis: Exploratory analysis of baseline data from a randomized trial. J Strength Cond Res XX(X): 000-000, 2020-Uncertainty on the role of muscle function in relation to physical function in knee osteoarthritis (KOA) persists. This study aimed to assess the associations between muscle function and performance-based and self-reported physical function in patients with KOA. Physical function in 80 subjects with symptomatic and radiographic KOA was assessed using 40-m fast-paced walk, 30-second chair stand, 9-step stair climb tests, and the subscale activities of daily living from the Knee injury and Osteoarthritis Outcome Score (KOOS-ADL). Measurements of muscle function included leg extension (LE) power, knee extension (KE) torque, and estimated leg press one repetition maximum (LP RM). Associations were investigated using multivariable hierarchical linear regressions adjusted for age, sex, body mass index, self-reported physical activity, and thigh muscle lean area. Leg extension power was significantly associated with 40-m walk, stair climb, and 30-second chair stand, explaining 18, 8, and 3% of additional variance, respectively. Knee extension torque explained 13, 7, 17, and 7% of additional variance in the 40-m walk, stair climb, 30-second chair stand, and KOOS-ADL, respectively. Leg press one repetition maximum explained 11% of additional variance in the 30-second chair stand. In conclusion, LE power was the best explanatory variable for performance on the 40-m walk and stair climb tests, whereas KE torque best explained chair stand performance. Only KE torque was associated with KOOS-ADL. Our results highlight the importance of selecting supportive muscle function tests based on the specific physical function and suggest that other factors may be more important for certain physical function outcomes. Level of significance p < 0.05. Trial identifier: NCT03215602.
Collapse
Affiliation(s)
- Pætur Mikal Holm
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | - Jana Kemnitz
- Institute of Anatomy & Department of Imaging and Functional Musculoskeletal Research, Paracelsus Medical University Salzburg, Salzburg, Austria.,Chondrometrics GmbH Ainring, Ainring, Germany.,Department of Computer Science, University of Vienna, Vienna, Austria
| | - Thomas Bandholm
- Department of Physical and Occupational Therapy, Physical Medicine & Rehabilitation Research, Copenhagen (PMR-C), Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark.,Department of Orthopedic Surgery, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark.,Clinical Research Center, Copenhagen University Hospital, Amager and Hvidovre, Copenhagen, Denmark
| | - Mathias Wernbom
- Department of Food and Nutrition and Sport Science, Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden.,Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Søren Thorgaard Skou
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| |
Collapse
|
7
|
Holm PM, Schrøder HM, Wernbom M, Skou ST. Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care - a randomized controlled trial. Osteoarthritis Cartilage 2020; 28:744-754. [PMID: 32179197 DOI: 10.1016/j.joca.2020.02.839] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the effects of lower limb strength training in addition to neuromuscular exercise and education (ST + NEMEX-EDU) compared to neuromuscular exercise and education alone (NEMEX-EDU) on self-reported physical function in patients with knee osteoarthritis (KOA). DESIGN Patient-blinded, parallel-group randomized controlled trial (RCT). METHODS The trial included 90 patients in secondary care with radiographic and symptomatic KOA, ineligible for knee replacement. Both groups exercised twice weekly for 12 weeks. Additional strength training consisted of a single, fatiguing knee extension set (30-60RM) before four sets of leg-press (8-12RM). Primary outcome was the between-group difference on the subscale activities of daily living from the Knee Injury and Osteoarthritis Outcome Score (KOOSADL) at 12 weeks. Secondary outcomes included KOOS symptoms, pain, function in sport and recreation, and quality of life, 40 m walk, stair climb, leg extension power, EuroQol-5D-5L, pain medication usage, and adverse events. RESULTS There was no statistically significant between-group difference in KOOSADL at 12-weeks; adjusted mean difference -1.15 (-6.78 to 4.48). Except for the stair climb test, which demonstrated an adjusted mean difference of 1.15 (0.09-2.21) in favor of ST + NEMEX-EDU, all other outcomes showed no statistically significant between-group differences. Neither group improved leg extension power. CONCLUSION The addition of lower-limb strength training, using a low-dose approach, to neuromuscular exercise and education carried no additional benefits on self-reported physical function or on most secondary outcomes. Both groups displayed similar improvements at 12-week follow-up. Hence, the current low-dose strength training approach provided no additional clinical value in this group of KOA patients. Trial identifier (ClinicalTrials.gov): NCT03215602.
Collapse
Affiliation(s)
- P M Holm
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse & Næstved, Denmark.
| | - H M Schrøder
- Department of Orthopedic Surgery, Næstved-Slagelse-Ringsted Hospitals, Næstved, Denmark
| | - M Wernbom
- Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden; Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S T Skou
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse & Næstved, Denmark
| |
Collapse
|
8
|
Vincent KR, Vasilopoulos T, Montero C, Vincent HK. Eccentric and Concentric Resistance Exercise Comparison for Knee Osteoarthritis. Med Sci Sports Exerc 2020; 51:1977-1986. [PMID: 31033900 DOI: 10.1249/mss.0000000000002010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION This study aimed to compare the efficacy of eccentrically focused resistance exercise (ECC RT) to concentrically focused resistance exercise (CNC RT) on knee osteoarthritis (OA) symptoms and strength. METHODS Ninety participants consented. Participants were randomized to CNC RT, ECC RT, or a wait-list, no-exercise control group. Four months of supervised exercise training was completed using traditional weight machines (CNC RT) or modified-matched machines that overloaded the eccentric action (ECC RT). Main outcomes included one-repetition maximal strength (knee extension, leg flexion, and leg press), weekly rate of strength gain, Western Ontario and McMaster University Osteoarthritis Index (WOMAC) total score and subscores. RESULTS Fifty-four participants (60-85 yr, 61% women) completed the study. Both CNC RT and ECC RT groups showed 16%-28% improvement relative to the wait-list, no-exercise control group (P = 0.003-0.005) for all leg strength measures. The rate of weekly strength gain was greater for CNC RT than for ECC RT for leg press and knee flexion (by 2.9%-4.8%; both, P < 0.05) but not knee extension (0.7%; P = 0.38). There were no significant differences in WOMAC total and subscores across groups over time. Leg press strength change was the greatest contributor to change in WOMAC total scores (R = 0.223). The change in knee flexion strength from baseline to month 4 was a significant predictor of the change in WOMAC pain subscore (F ratio = 4.84, df = 45, P = 0.032). Both modes of strength training were well tolerated. CONCLUSIONS Both resistance training types effectively increased leg strength. Knee flexion and knee extension muscle strength can modify function and pain symptoms irrespective of muscle contraction type. Which mode to pick could be determined by preference, goals, tolerance to the contraction type, and equipment availability.
Collapse
Affiliation(s)
- Kevin R Vincent
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
| | - Terrie Vasilopoulos
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL.,Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL
| | - Cindy Montero
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
| | - Heather K Vincent
- Department of Orthopaedics and Rehabilitation, College of Medicine, University of Florida, Gainesville, FL
| |
Collapse
|
9
|
Vassão PG, Silva BA, de Souza MC, Parisi JR, de Camargo MR, Renno ACM. Level of pain, muscle strength and posture: effects of PBM on an exercise program in women with knee osteoarthritis - a randomized controlled trial. Lasers Med Sci 2020; 35:1967-1974. [PMID: 32157582 DOI: 10.1007/s10103-020-02989-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
To evaluate the effectiveness of an exercise program associated to photobiomodulation (PBM) on pain, postural changes, functionally, and muscular strength in women, one of the risk factors, with knee osteoarthritis (OA). A randomized controlled trial, with a blinded assessor and intention-to-treat analysis and placebo control. Sixty-two participants with knee OA (with confirmed radiological diagnosis) were evaluated for this study. However, 34 were considered eligible and were randomized into two groups: EPPG - exercise and PBM placebo group (n = 17) and EPAG - exercise and PBM active group (n = 16), but one participant was excluded of EPAG. The exercise program and PBM (808 nm, 100 mW/point, 4 J/point, 56 J total, 91 J/cm2) were realized twice a week, during 8 weeks. West Ontario and the McMaster University Osteoarthritis Index (WOMAC) and Lequesne questionnaires, 1-repetition maximum test (1-RM) and posture evaluation software (SAPO) were used to analyze the effects of the therapies. In intragroup analysis, a significant improvement in pain WOMAC (p < 0.001), stiffness (p < 0.001), function (p < 0.001), Lequesne (p < 0.001), and 1-RM (all muscle groups) (p < 0.001) were observed. In this study, the exercise program improved pain, function, and muscle strength of all the participants. However, PBM, in the parameters used, did not optimize the effects of the exercise program in women with knee OA.
Collapse
Affiliation(s)
- Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.
| | - Bruna Arcaim Silva
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Mayra Cavenague de Souza
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Julia Risso Parisi
- Department of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Marcela Regina de Camargo
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Ana Claudia Muniz Renno
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| |
Collapse
|
10
|
Shere C, Fuggle NR, Edward MH, Parsons CM, Jameson KA, Cooper C, Dennison EM, Ward KA. Jumping Joints: The Complex Relationship Between Osteoarthritis and Jumping Mechanography. Calcif Tissue Int 2020; 106:115-123. [PMID: 31655874 PMCID: PMC6994439 DOI: 10.1007/s00223-019-00622-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/09/2019] [Indexed: 12/31/2022]
Abstract
We investigated the relationship between lower limb osteoarthritis (OA) and muscle strength and power (assessed by jumping mechanography) in UK community-dwelling older adults. We recruited 249 older adults (144 males, 105 females). OA was assessed clinically at the knee according to ACR criteria and radiographically, at the knee and hip, using Kellgren and Lawrence grading. Two-footed jumping tests were performed using a Leonardo Mechanography Ground Reaction Force Platform to assess maximum muscle force, power and Esslinger Fitness Index. Linear regression was used to assess the relationship between OA and jumping outcomes. Results are presented as β (95% confidence interval). The mean age of participants was 75.2 years (SD 2.6). Males had a significantly higher maximum relative power during lift off (mean 25.7 W/kg vs. 19.9 W/kg) and maximum total force during lift off (mean 21.0 N/kg vs. 19.1 N/kg) than females. In adjusted models, we found significant associations in males between clinical knee OA and maximum relative power [- 6.00 (CI - 9.10, - 2.94)] and Esslinger Fitness Index [- 19.3 (- 29.0, - 9.7)]. In females, radiographic knee OA was associated with total maximum power [- 2.0 (- 3.9, - 0.1)] and Esslinger Fitness Index [- 8.2 (- 15.9, - 0.4)]. No significant associations were observed for maximum total force. We observed significant negative associations between maximum relative power and Esslinger Fitness Index and clinical knee OA in males and radiographic knee OA in females. We have used novel methodology to demonstrate relationships between muscle function and OA in older adults.
Collapse
Affiliation(s)
- C Shere
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - N R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - M H Edward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- Portsmouth Hospitals NHS Trust, Portsmouth, UK
| | - C M Parsons
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - K A Jameson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| |
Collapse
|
11
|
Vassão PG, de Souza MC, Silva BA, Junqueira RG, de Camargo MR, Dourado VZ, Tucci HT, Renno AC. Photobiomodulation via a cluster device associated with a physical exercise program in the level of pain and muscle strength in middle-aged and older women with knee osteoarthritis: a randomized placebo-controlled trial. Lasers Med Sci 2019; 35:139-148. [PMID: 31144070 DOI: 10.1007/s10103-019-02807-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/10/2019] [Indexed: 12/28/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease that leads to pain and functional incapacity. The aim of the study is to investigate the effects of the incorporation of photobiomodulation (PBM) (via cluster) into a physical exercise program on the level of pain, lower limb muscle strength, and physical capacity, in patients with knee OA. Sixty-two female volunteers with a diagnosis of knee OA were distributed in 4 groups: exercise associated with placebo PBM group, exercise associated with active PBM group, active PBM group, and placebo PBM group. Sixteen sessions of lower limb strength exercises and PBM via cluster (808 nm, 100 mW, 7 points each side, 56 J total) were performed. The level of pain, physical capacity, and lower limb muscle strength were evaluated with the use of the numeric pain rating scale (NPRS), 6-min walking test (6-MWT) and timed up and go (TUG), and maximal voluntary isometric torque (MVIT) before and after the interventions. Both groups presented a significant decrease in the level of pain when compared with the placebo-treated women. Furthermore, the 6-MWT showed that the trained groups (with or without PBM) demonstrated higher values in the distance walked comparing pre and post-treatment values. The same behavior was found for the MVIT load before and after intervention. TUG was higher for all the treated with exercise groups comparing the pre and post-treatment values. Physical exercise and PBM showed analgesic effects. However, PBM did not have any extra effect along with the effects of exercise in improving the distance walked, the TUG, and the muscle strength.Trial registration: RBR-7t6nzr.
Collapse
Affiliation(s)
- Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.
| | - Mayra Cavenague de Souza
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Bruna Arcaim Silva
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Rheguel Grillo Junqueira
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Marcela Regina de Camargo
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Victor Zuniga Dourado
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Helga Tatiana Tucci
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Ana Claudia Renno
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| |
Collapse
|
12
|
Bily W, Sarabon N, Löfler S, Franz C, Wakolbinger R, Kern H. Relationship Between Strength Parameters and Functional Performance Tests in Patients With Severe Knee Osteoarthritis. PM R 2019; 11:834-842. [PMID: 30609315 DOI: 10.1002/pmrj.12056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/22/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Decreased leg muscle strength is a major determinant of reduced function in patients with knee osteoarthritis (OA). The identification of a strength parameter that is best correlated with functional performance is important for monitoring rehabilitation results. OBJECTIVE To determine which muscle strength measurements show the highest correlation with functional capacity in patients with severe knee OA shortly before total knee arthroplasty (TKA). DESIGN Cross-sectional exploratory study. SETTING Outpatient rehabilitation department at a university teaching hospital. PATIENTS The sample included 75 patients (51 female) scheduled for primary TKA, recruited through multistage sampling. METHODS OR INTERVENTIONS Independent variables were peak isometric, isokinetic concentric, and eccentric leg extensor strength measured on the leg press, as well as peak isometric knee extensor strength measured on the strength chair. Two multiple regression analyses were performed, one including all strength measures and the other including all of the strength ratios. Pearson correlation coefficients were calculated between the strength measures and functional test scores. MAIN OUTCOME MEASUREMENTS Dependent variables were the Timed Up and Go Test (TUG) and the Stair Test (ST). RESULTS The regression analysis including all strength measures could explain 11.9% of the variance of the TUG (P = .068, not significant [NS]) and 21.5% of the variance of the ST (P = .009, significant). The regression model for the strength ratios explained 11.8% of the variance of the TUG (P = .090, NS) and 6.3% of the ST (P = .217, NS). CONCLUSIONS Although univariate analysis confirmed significant correlations between strength measurements and functional tests, multiple regression analysis revealed a higher predictive value for the ST than for the TUG. The use of both muscle strength tests and performance-based function tests is advisable to evaluate functional impairments of patients with knee OA. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Walter Bily
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - Nejc Sarabon
- Department of Health Sciences, University of Primorska, Koper, Slovenia
- S2P, Science to Practice Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia
| | - Stefan Löfler
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - Carlo Franz
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - Robert Wakolbinger
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - Helmut Kern
- Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| |
Collapse
|
13
|
Acutherapy for Knee Osteoarthritis Relief in the Elderly: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1868107. [PMID: 30906410 PMCID: PMC6398067 DOI: 10.1155/2019/1868107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/22/2019] [Indexed: 12/20/2022]
Abstract
Purpose This systematic review and meta-analysis was conducted to investigate the effects of various acutherapies on knee osteoarthritis (KOA) relief in the elderly. Methods Five databases were accessed from inception to July 2017 for searching randomized controlled trials (RCTs) on acutherapy for KOA relief in the elderly. Data were pooled after trial quality assessment for meta-analysis. Outcomes were the scores of knee pain, knee stiffness, and physical function accessed by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. Results 17 RCTs including 4774 subjects were included. The results indicated that acutherapy significantly affected knee pain (standardized mean difference, i.e., SMD = - 0.73, [95% CI, -0.98 to -0.47], P <0.001), knee stiffness (SMD = -0.66, [95%CI, -0.85 to -0.47], P <0.001), and physical function (SMD = -1.56, [95%CI, -2.17 to -0.95], P<0.001) when compared with control condition without intervention of any acutherapy. Moreover, acutherapy was more effective than corresponding sham (placebo) intervention applied on nonacupoints (SMD = -0.16, [95% CI, -0.32 to -0.01], P = 0.04). However, no significant differences were found on treatment effects between acutherapy and sham acutherapy at the same acupoints (SMD= - 0.09, [95%CI, -0.40 to 0.21], P = 0.55). Conclusions Acutherapy was an effective approach for KOA relief in the elderly. The selection of acupoints position could be a crucial factor that influences the treatment efficacy of acutherapy.
Collapse
|
14
|
Quadriceps Rate of Torque Development and Disability in Persons With Tibiofemoral Osteoarthritis. J Orthop Sports Phys Ther 2018; 48:694-703. [PMID: 29787693 DOI: 10.2519/jospt.2018.7898] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Declines in the ability to rapidly generate quadriceps muscle torque may underlie disability in individuals with tibiofemoral osteoarthritis. Objective To determine whether quadriceps rate of torque development (RTD) predicts self-reported disability and physical performance outcomes in individuals with tibiofemoral osteoarthritis. Methods This controlled laboratory, cross-sectional study assessed quadriceps strength and RTD in 76 individuals (55% female; mean ± SD age, 61.83 ± 7.11 years) with symptomatic and radiographic tibiofemoral osteoarthritis. Early (0-50 milliseconds), late (100-200 milliseconds), and overall peak RTDs were quantified in the symptomatic (involved) and contralateral limbs and used to calculate bilateral average values. Disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale and 3 physical performance tests, including the (1) 20-m fast-paced walk, (2) 30-second chair stand, and (3) timed stair climb. Separate univariate regression models were used to determine the unique associations among measures of quadriceps RTD, WOMAC function score, and physical performance outcomes after accounting for quadriceps strength (change in R2). Results Greater involved-side late RTD and greater bilateral average early RTD were associated with faster walking (change in R2 = 0.05, P = .013 and change in R2 = 0.05, P = .043, respectively). Greater bilateral average late RTD was associated with faster walking (change in R2 = 0.20, P<.001) and faster stair climb (change in R2 = 0.11, P = .001). No quadriceps RTD variable was significantly associated with WOMAC function score (change in R2 range, <0.01-0.017). Conclusion Involved-limb quadriceps RTD was weakly associated with physical performance outcomes, but not self-reported disability, in individuals with tibiofemoral osteoarthritis. Bilateral average quadriceps RTD was moderately associated with walking speed. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2018;48(9):694-703. Epub 22 May 2018. doi:10.2519/jospt.2018.7898.
Collapse
|
15
|
García-Molina R, Ruíz-Grao MC, Noguerón-García A, Martínez-Reig M, Esbrí-Víctor M, Izquierdo M, Abizanda P. Benefits of a multicomponent Falls Unit-based exercise program in older adults with falls in real life. Exp Gerontol 2018; 110:79-85. [DOI: 10.1016/j.exger.2018.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 11/17/2022]
|
16
|
Krishnasamy P, Hall M, Robbins SR. The role of skeletal muscle in the pathophysiology and management of knee osteoarthritis. Rheumatology (Oxford) 2018; 57:iv22-iv33. [DOI: 10.1093/rheumatology/kex515] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Indexed: 12/15/2022] Open
Affiliation(s)
- Priathashini Krishnasamy
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW
- Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW
| | - Michelle Hall
- Centre for Health Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah R Robbins
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW
- Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW
| |
Collapse
|