scholarly journals Predictive potentials of 8 muscle strength actions, KOOS-pain, and Örebro-psychosocial difficulties on self-reported activities-of-daily-life function in patients with knee osteoarthritis: an exploratory regression-based cross-sectional study

Abstract The authors have requested that this preprint be withdrawn due to author disagreement.

2020 ◽  
Author(s):  
Kjartan Vårbakken ◽  
Håvard Lorås ◽  
Kjell Nilsson ◽  
Monika Engdal ◽  
Ann-Katrin Stensdotter

Abstract BackgroundThe aim of the study was to explore the relative predictive potentials of a discriminative and comprehensive set of lower-limb muscle strength factors onto self-reported physical-activities-of-daily-life-function (SR-ADL-function) in patients with knee osteoarthritis (KOA), when adjusting for prior known strong prospective predictors in a statistical model which covers the functional domains of the International Classification of Function, Disability, and Health (ICF). MethodsThe design was exploratory, patient-only, cross-sectional, and multivariable regression-based, rotating 8 strength-variables onto a hierarchical model. The setting was an Osteoarthritis-school in a secondary-care hospital in Norway. The participants were 28 Caucasian patients with mild-to-moderate symptomatic and radiographic KOA (mean age 61; 64% women) referred by general physicians to an osteoarthritis-school. Excluded patients had trauma to the lower limbs, BMI >35, and age beyond 45 to 70. The dependent/outcome variable was SR-ADL-function (Knee Injury and Osteoarthritis Outcome Score [KOOS-ADL]). The known predictors were prior documented discriminative KOOS-Pain and psychosocial difficulties (Örebro Musculoskeletal Pain Questionnaire), together with 8 candidate predictor lower-limb muscle-strength actions (Biodex and Commander II dynamometer recorded).ResultsMutually adjusted for pain and psychosocial difficulties (R2 = 0.71), the predicting muscle-strength actions explained the following unique variances in SR-ADL-function: hip external rotation 7.6% (p<0.010), ankle eversion 4.0% (p=0.050), hip internal rotation 3.8% (p=0.060), ankle inversion 3.6% (p=0.066). The remaining 4 muscle-strength actions explained from 2.0% to 1.2% (p>0.099), where knee extensor strength explained the least unique variance. Flipped, the current three best potential prediction models explained the following substantial proportions of variance in SR-ADL-function: 1) KOOS-pain, 66%; 2) KOOS-pain and Örebro psychosocial difficulties, 71%; and 3) KOOS-pain, Örebro psychosocial difficulties, and hip external rotation strength, 78%.ConclusionsAdjusted for pain and psychosocial difficulties, hip rotations and ankle eversion-inversion strength indicate substantial cross-sectional potentials for predicting SR-ADL-function for patients with KOA aged 45 to 70 in primary/hospital health-care. Relevant for future prevention and prediction/treatment studies, however, we suggest clinical researchers to consider the current muscle-strength actions together with the even stronger biopsychosocial predictors KOOS-pain and Örebro psychosocial difficulties for future ICF domain-covering models of SR-ADL. Future confirmative studies are needed to refute or generalize these pioneering exploratory conclusions.


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
K. Vårbakken ◽  
H. Lorås ◽  
K. G. Nilsson ◽  
M. Engdal ◽  
A. K. Stensdotter

Abstract Background To improve the goal-directedness of strength exercises for patients with knee osteoarthritis (KOA), physical rehabilitation specialists need to know which muscle-groups are most substantially weakened across the kinetic chain of both lower extremities. The purpose was to improve the knowledge base for strength exercise therapy. The objective was to explore the relative differences in muscle strength in the main directions bilaterally across the hip, knee, and ankle joints between patients with light-to-moderate symptomatic and radiographic KOA and people without knee complaints. Methods The design was an exploratory, patient vs. healthy control, and cross-sectional study in primary/secondary care. Twenty-eight patients with mild to moderate KOA (18 females, mean age 61) and 31 matched healthy participants (16 females, mean age 55), participated. Peak strength was tested concentrically or isometrically in all main directions for the hip, knee, and ankle joints bilaterally, and compared between groups. Strength was measured by a Biodex Dynamometer or a Commander II Muscle Tester (Hand-Held Dynamometer). Effect sizes (ES) as Cohen’s d were applied to scale and rank the difference in strength measures between the groups. Adjustment for age was performed by analysis of covariance. Results The most substantial muscle weaknesses were found for ankle eversion and hip external and internal rotation in the involved leg in the KOA-group compared to the control-group (ES [95% CI] −0.73 [−1.26,-0.20], − 0.74 [−1.26,-0.21], −0.71 [−1.24,-0.19], respectively; p < 0.01). Additionally, smaller but still significant moderate muscle weaknesses were indicated in four joint–strength directions: the involved leg’s ankle inversion, ankle plantar flexion, and knee extension, as well as the uninvolved leg’s ankle dorsal flexion (p < 0.05). There was no significant difference for 17 of 24 tests. Conclusions For patients with KOA between 45 and 70 years old, these explorative findings indicate the most substantial weaknesses of the involved leg to be in ankle and hip muscles with main actions in the frontal and transverse plane in the kinetic chain of importance during gait. Slightly less substantial, they also indicate important weakness of the knee extensor muscles. Confirmatory studies are needed to further validate these exploratory findings.


2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Alexandre Moura dos Santos ◽  
Rafael Giovani Misse ◽  
Isabela Bruna Pires Borges ◽  
Bruno Gualano ◽  
Alexandre Wagner Silva de Souza ◽  
...  

Abstract Background Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results Patients with TAK had a mean age of 41.5 (38.0–46.3) years, disease duration of 16.0 (9.5–20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.


Sign in / Sign up

Export Citation Format

Share Document