Association of Eccentric Quadriceps Torque With Knee Pain, Physical Function and Extension Lag in Women With Grade ≤ II Knee Osteoarthritis-A Cross-Sectional Study

Author(s):  
Fares Arab ◽  
Nishat Quddus ◽  
Sohrab A. Khan ◽  
Ahmad H. Alghadir ◽  
Masood Khan

Abstract Background Knee osteoarthritis (OA) is a prevalent disabling disease among women. Quadriceps weakness is attributed to one of the causes of knee pain (KP) and disability. The study aimed to test the correlation of eccentric quadriceps torque (EQT) with 2 subscales of reduced WOMAC questionnaire (KP and physical function) and extension lag range of motion (ROM) at the knee joint in osteoarthritic women. Methods A cross-sectional design was used. A total of 70 (age 41.1 ± 7.1) female patients having grade ≤ II knee OA participated in the study. Pearson’s correlation coefficient was used to test the correlation between the independent variable (EQT) and dependent variables (2 subscales of reduced WOMAC questionnaire and extension lag in the knee). Results EQT presented a significant moderate negative correlation with the reduced WOMAC subscales (pain r = -0.489, p < 0.01 and physical function r = -0.425, p < 0.01), and low positive correlation with available ROM (r = 0.349, p < 0.01). Conclusions The self-reported symptoms of KP, physical function, and extension lag in the early stages of knee OA in women are associated with EQT. Thus designing a rehabilitation program having eccentric quadriceps strengthening exercises may improve KP and physical activities but further randomized controlled trials are needed to verify this.

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.


2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.


2021 ◽  
pp. jrheum.210285
Author(s):  
Holly T. Philpott ◽  
Trevor B. Birmingham ◽  
Ryan Pinto ◽  
Codie A. Primeau ◽  
Dominique Arsenault ◽  
...  

Objective To examine the association between ultrasound (US)-detected knee inflammation and intermittent and constant pain experiences in patients with knee osteoarthritis (OA). Methods Participants with radiographically early- (KL ≤ 2) and late-stage (KL ≥ 3) disease and frequent symptoms underwent musculoskeletal US measures of inflammation using the OMERACT knee US scoring system. Pain experiences were captured using the Intermittent and Constant OA Pain (ICOAP) tool. We assessed the association between US-synovitis and ICOAP pain experiences using a series of linear, logistic, or multinomial logistic regression models (as appropriate for each variable), while adjusting for age, sex, body mass index (BMI), and radiographic stage. Secondary analyses were performed similarly by radiographic stage. Results Pain and synovitis measures from 248 patients (453 knees) were included. Worse synovitis was associated with higher ICOAP constant pain scores (β 8.05 [95%CI 0.67, 15.43]), but not intermittent pain scores. Moderate-to-severe synovitis was associated with a 4.73-fold increased relative risk [95%CI 1.06, 8.80] of a constant pain pattern. In secondary analyses, moderate-to-severe synovitis in early radiographic OA was associated with 2.70-higher odds [95%CI 1.04, 7.02] of any constant pain, 3.28-higher odds [95%CI 1.43, 7.52] of any intermittent pain, and with higher intermittent (β 10.47 [95%CI 1.03, 19.91]) and constant (β 12.62 [95%CI 3.02, 22.23]) pain scores. No associations identified for synovitis in those with late radiographic OA. Conclusion In patients with knee OA, moderate-to-severe synovitis is most strongly associated with constant pain. Inflammation may play context-specific roles across pain experiences, especially in earlier radiographic stages of knee OA.


2017 ◽  
Vol 35 (11) ◽  
pp. 2490-2498 ◽  
Author(s):  
Hirotaka Iijima ◽  
Hiroshi Ohi ◽  
Takuya Isho ◽  
Tomoki Aoyama ◽  
Naoto Fukutani ◽  
...  

2020 ◽  
Author(s):  
Jeongwoo Jeon ◽  
Dongyeop Lee ◽  
Jaeho Yu ◽  
Jinseop Kim ◽  
Sang Hoon Lhee ◽  
...  

Abstract Background: Tibial rotation accompanying sagittal movement contains the phenomenon of screw-home movement of the knee, which plays an important role in knee stability during extension. This study aimed to investigate the alteration of screw-home movement in patients with knee osteoarthritis (OA).Methods: Participants (n =67) in this cross-sectional study were outpatients in the department of orthopedics of a general hospital and included patients with knee OA (n=31) and asymptomatic control subjects (n=36).Knee kinematic data were measured using an inertial measurement unit. The total tibial rotation was obtainedduring knee sagittal movement. The acquired angle of tibial rotation was divided into four periodseach extension and flexion. The total tibial rotation and the variation of each period were compared between the OA and control groups.Results: Significant differences arose between the OA and control groups in the total tibial rotation during knee extension and flexion(P< 0.001).The variation of tibial rotation was also significantly different between groups for all periods (P< 0.001; knee extensionat 70° to 45°,P = 0.014).Conclusions: We found a reduction in the total tibial rotation and loss of the screw-home movement in the unloaded OA knee. To normalize the screw-home movement, it is necessary to promote proper articular movement of the knee joint and suppress the hyperexcitability of the medial muscles.


2012 ◽  
Vol 8 (3) ◽  
pp. 144 ◽  
Author(s):  
Nyoman Kertia

Background: Knee osteoarthritis (OA) is a common disorder that is associated with significant morbidity, disability, and medical costs, particularly in its advanced stages. While the cause of knee OA remains unclear, it has been associated with various risk factors, such as age, sex, genetic predisposition, biomechanical, and obesity. Pain in osteoarthritis occurs due to combination of various factors. Pain significantly increases the medical and non medical cost in OA. Data showed that obesity will increase the mechanical stress and pain of knee OA. However, uncertainty remains regarding potential relationship between body mass index (BMI) and pain in osteoarthritis. Moreover, since obesity is one of modifiable and preventable risk factors for the onset and progression of the disease, it is important to know the correlation between BMI and severity of pain in knee OA.Objectives: To investigate the relationship between body mass index and severity of joint pain in knee osteoarthritis.Methods: A cross sectional study was conducted and subjects were osteoarthritis patients in rheumatology clinic of Sardjito general hospital. Body mass index and visual analogue scale (VAS) score were measured. Correlation between BMI and VAS score were analyzed by bivariate correlation test.Results: There were 80 patients with osteoarthritis who participated in the study. Mean BMI was 26.36 +4.23 kg/m2 and VAS score was 52.40+24.53 mm. The correlation test showed that there was a positive but non significant correlation between BMI and VAS scores (r = 0,11; p = 0,33).Conclusion: There was a positive but non significant correlation between body mass index and the severity of joint pain in knee osteoarthritis.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen. Huang ◽  
Ping-Keung. Chan ◽  
Kwong-Yuen. Chiu ◽  
Chun-Hoi. Yan ◽  
Shun-Shing. Yeung ◽  
...  

Abstract Background High biomechanical loading is believed to be a risk factor to pain in people with knee osteoarthritis (OA), but controversial findings have been reported on the relationship between external knee adduction moment (KAM) and pain. A more comprehensive analysis considering other factor such as external knee flexion moment (KFM) could help better reveal this relationship. This study explored the relationship between external knee adduction moment and pain intensity in participants with knee osteoarthritis (OA) using an integrated path analysis model. Methods This was a cross-sectional study based on laboratory setting. Forty-seven participants with clinical and radiographic medial knee OA were analyzed for their external knee adduction moment (KAM) and knee flexion moment (KFM) during walking using a motion analysis system. Pain intensity was measured by visual analogue scale (VAS) and the pain subscale of the Knee Injury and Osteoarthritis Outcome Score. Varus/valgus alignment was captured and quantified using a bi-planar X-ray system. Using a path analysis model, the relationships between pain intensity, KAM, KFM, OA radiographic severity, knee varus angle and walking speed were examined. Results The proposed path model met the goodness-of-fit criteria. Based on this model, KAM had a negative effect on VAS pain indirectly through the mediation of KFM. The model indicated KAM and KFM were negatively related to one another; and KFM was positively related to VAS. The KAM index, defined as (KAM/ (KAM + KFM)), was negatively related to VAS. Conclusions Path analysis enabled the construction of a more integrated pathokinematic framework for people with knee OA. The KAM index which reflected the load sharing on the frontal and sagittal planes also revealed its relationship with pain. Re-distribution of mechanical loading from frontal to sagittal plane might be a strategy for pain avoidance associated with mechanical irritation.


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