scholarly journals Rate of Force Development in the Quadriceps of Individuals With Severe Knee Osteoarthritis: A Cross-Sectional Study

Author(s):  
Yusuke Suzuki ◽  
Hirotaka Iijima ◽  
Masatoshi Nakamura ◽  
Tomoki Aoyama

Abstract We tested the following hypotheses: individuals with severe knee osteoarthritis (KOA) would display a significantly decreased quadriceps rate of force development (RFD); and this decrease would be greater than the decrease in maximum quadriceps strength. Maximum isometric strength of the quadriceps was assessed in individuals with mild (Kellgren and Lawrence [K&L] grade 1–2) and severe KOA (K&L grade 3–4). RFD was analyzed at 200 ms from torque onset and normalized to body mass and maximum voluntary isometric contraction torque. The decrease in quadriceps RFD and the difference between this and the decrease in maximum quadriceps strength was tested with logistic regression analysis with a propensity-score-adjusted model and analysis of covariance, respectively. Effect size by Hedges’ g with a 95% confidence interval (CI) was calculated for the quadriceps RFD and maximum quadriceps strength. Sixty-six participants were analyzed. Individuals with severe KOA displayed significantly decreased quadriceps RFD (odds ratio: 0.50; 95% CI: 0.26-0.82), the decrease being greater than that in maximum quadriceps strength (between-group difference, ES: 0.88, -1.07 vs. 0.06, -0.22). The results suggest that a decreased quadriceps RFD is a modifiable risk factor for progressive KOA. This could lead to the early detection and prevention of severe KOA.

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262508
Author(s):  
Yusuke Suzuki ◽  
Hirotaka Iijima ◽  
Masatoshi Nakamura ◽  
Tomoki Aoyama

Knee osteoarthritis (KOA) is a leading cause of knee pain and disability due to irreversible cartilage degeneration. Previous studies have not identified modifiable risk factors for KOA. In this preliminary cross-sectional study, we aimed to test the following hypotheses: individuals with severe KOA would have a significantly lower quadriceps rate of force development (RFD) than individuals with early KOA, and the decrease in quadriceps RFD would be greater than the decrease in maximum quadriceps strength in individuals with severe KOA. The maximum isometric strength of the quadriceps was assessed in individuals with mild (Kellgren and Lawrence [K&L] grade 1–2) and severe KOA (K&L grade 3–4) using a handheld dynamometer. The RFD was analyzed at 200 ms from torque onset and normalized to the body mass and maximum voluntary isometric contraction torque. To test whether the quadriceps RFD was lowered and whether the lower in the quadriceps RFD was greater than the lower in maximum quadriceps strength in individuals with severe knee OA, the Mann–Whitney U-test and analysis of covariance were performed, respectively. The effect size (ES) based on Hedges’ g with a 95% confidence interval (CI) was calculated for the quadriceps RFD and maximum quadriceps strength. Sixty-six participants were analyzed. Individuals with severe KOA displayed significantly lower quadriceps RFD (p = 0.009), the lower being greater than the lower in maximum quadriceps strength (between-group difference, ES: 0.88, -1.07 vs. 0.06, -0.22). Our results suggest that a decreased quadriceps RFD is a modifiable risk factor for progressive KOA. Our finding could help in the early detection and prevention of severe KOA.


2021 ◽  
Vol 15 ◽  
Author(s):  
Darjan Smajla ◽  
Jure Žitnik ◽  
Nejc Šarabon

Brief submaximal actions are important for wide range of functional movements. Until now, rate of force development and relaxation scaling factor (RFD-SF and RFR-SF) have been used for neuromuscular assessment using 100–120 isometric pulses which requires a high level of attention from the participant and may be influenced by physiological and/or psychological fatigue. All previous studies have been conducted on a smaller number of participants which calls into question the eligibility of some of the outcome measures reported to date. Our aims were: (1) to find the smallest number of rapid isometric force pulses at different force amplitudes is still valid and reliable for RFD-SF slope (kRFD–SF) and RFR-SF slope (kRFR–SF) calculation, (2) to introduce a new outcome measure – theoretical peak of rate of force development/relaxation (TPRFD and TPRFR) and (3) to investigate differences and associations between kRFD–SF and kRFR–SF. A cross-sectional study was conducted on a group of young healthy participants; 40 in the reliability study and 336 in the comparison/association study. We investigated the smallest number of rapid isometric pulses for knee extensors that still provides excellent reliability of the calculated kRFD–SF and kRFR–SF (ICC2,1 ≥ 0.95, CV < 5%). Our results showed excellent reliability of the reduced protocol when 36 pulses (nine for each of the four intensity ranges) were used for the calculations of kRFD–SF and kRFR–SF. We confirmed the negligibility of the y-intercepts and confirmed the reliability of the newly introduced TPRFD and TPRFR. Large negative associations were found between kRFD–SF and kRFR–SF (r = 0.502, p < 0.001), while comparison of the absolute values showed a significantly higher kRFD–SF (8.86 ± 1.0/s) compared to kRFR–SF (8.03 ± 1.3/s) (p < 0.001). The advantage of the reduced protocol (4 intensities × 9 pulses = 36 pulses) is the shorter assessment time and the reduction of possible influence of fatigue. In addition, the introduction of TPRFD and TPRFR as an outcome measure provides valuable information about the participant’s maximal theoretical RFD/RFR capacity. This can be useful for the assessment of maximal capacity in people with various impairments or pain problems.


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.


Reumatismo ◽  
2021 ◽  
Vol 73 (2) ◽  
pp. 111-116
Author(s):  
M.A. Mortada ◽  
L.I. Kotb ◽  
Y.A. Amer

Calcific tendinopathy is most commonly seen around the shoulder joint. Only a few cases of quadriceps calcific tendinopathy (QCT) were reported. This study compares pain, function, clinical examination results, and ultrasonographic findings among primary knee osteoarthritis (KOA) patients with or without ultrasonography-detected QCT. A cross-sectional study was conducted on 214 patients with knee OA. Ultrasonography (US) of knee joints was performed according to the EULAR guidelines. Kellgren-Lawrence radiographic grading was used to score OA. Pain and functional status were assessed using the visual analog scale (VAS), the Health Assessment Questionnaire-II (HAQ-II), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). QCT was detected in 50 out of 428 knees (11.6%), i.e. in 46 out of 214 patients (21.49%). Most cases of QCT were detected in the following sites: 36 in the vastus lateralis (72%), 10 in the vastus intermedius (20%), and only 4 in the vastus medialis (8%). QCT was found mainly in advanced KOA stages: 44 cases of QCT were found in patients with grade 4 KOA and 6 cases in grade 3 KOA. The presence of QCT showed a statistically significant association (p<0.05) with VAS, HAQ-II, WOMAC subscales, synovitis, and effusion detected by US. In knees with ultrasound-detected QCT, ultrasonographic features of CPPD were found in 31 knees (62%). QCT was found in cases with advanced KOA and mainly with ultrasonographic findings of CPPD disease. QCT could be considered an independent poor prognostic finding regarding pain, functional activity, and response to NSAIDs.


2017 ◽  
Vol 8 (1) ◽  
pp. 10
Author(s):  
Narendra Kumar Singh ◽  
Nishant Goyal

Background: Schizophrenia is associated with a high familial, social and economic burden. Schizophrenia is also associated with a high level of disability which may create impediments on the social and economic areas of the patients as well as on their respective family networks. Families with schizophrenia may encounter problems such as impairment of health and well being of other family members, restriction of social activities of the family members and shrinking of support from the social network. Aims: The present study examined the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. Methods: This was a cross-sectional study examining the difference in perceived social support and burden of care between the male and female caregivers of patients with schizophrenia. The sample consisted of 60 (30 male and 30 female) caregivers of the patients with the diagnosis of schizophrenia as per ICD-10-DCR. Results and Conclusion: This study revealed that male caregivers perceived more social support and less burden of care as compared to female caregivers. Key words: Gender, social support, burden


2020 ◽  
Vol 5 (1) ◽  
pp. 29
Author(s):  
Nelson Sudiyono

Background: Canes have been recommended as walking aids for knee osteoarthritis to reduce the loading on the affected knee. Patients are usually recommended to hold the cane in the contralateral hand to the affected knee. Nevertheless, some patients prefer to hold the cane ipsilateral to the affected knee. However, the effect of using ipsilateral or contralateral tripod cane on functional mobility in patients with knee osteoarthritis is still unknown Objective: To compare the immediate effect of ipsilateral and contralateral tripod cane usage on functional mobility in patients with symptomatic knee osteoarthritis Method: This cross-sectional study involved 30 overweight or obese patients with symptomatic unilateral or bilateral knee osteoarthritis (Kellgren Lawrence grade 2 and 3) who never use a cane. Functional mobility was evaluated with Time Up and Go test in three conditions; without walking aid, with tripod cane contralateral and ipsilateral to the more painful knee. Results: The TUG time of aid-free walking is 4.75 (p < 0.001, 95% CI 3.79 - 5.71) seconds faster than ipsilateral cane use and 6.69 (p < 0.001, 95%CI 5.35 - 8.03) seconds faster than contralateral cane use. The TUG time of ipsilateral cane use is 1,94 (95% CI, 1.13 - 2.79) seconds faster than contralateral. Conclusion: Patients with symptomatic knee OA who use tripod cane ipsilateral to the more painful knee have higher functional mobility than the contralateral.


2020 ◽  
Vol 20 (5) ◽  
pp. 748-751
Author(s):  
Seyed Ali Dehghan Manshadi ◽  
Neda Alijani ◽  
Mohammadreza Salehi ◽  
Omid Dadras ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  

Introduction: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting. Methods: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19. Results: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001). Conclusion: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.


Sign in / Sign up

Export Citation Format

Share Document