Original articleDecrease of Muscle Strength Is Associated With Increase of Activity Limitations in Early Knee Osteoarthritis: 3-Year Results From the Cohort Hip and Cohort Knee Study
Section snippets
Study design
Of 1002 participants in the Cohort Hip and Cohort Knee (CHECK) cohort, the participants (n=151) in Reade, Center for Rehabilitation and Rheumatology, Amsterdam, The Netherlands, who reported knee symptoms at the second year were assessed for muscle strength, proprioception, laxity, and performance-based activity limitations and were included in the present 3-year follow-up study.9 Measurements performed at the second (t0) and fifth (t1) years of the CHECK study were used in the present study
Study population
Of 151 participants, 5 underwent total knee or total hip replacement during the 3-year follow-up. These 5 participants were excluded, leaving 146 participants for analysis. The 146 participants did not differ in age, sex, body mass index, K & L grade, pain, and WOMAC-pf compared with the total CHECK population. To be included in the analysis, participants had to have complete data at t0 and t1.
Missing data
For the WOMAC-pf, the number of participants with missing data at t1 (fifth year) was 9. These 9
Discussion
We evaluated the association between change in muscle strength and change in activity limitations among participants with early symptomatic knee OA over 3 years. The main finding was that a decrease in muscle strength was associated with an increase in activity limitations over time, independent of age, sex, change in pain, and radiographic severity. Both proprioception and laxity at t0 did not moderate this association. These results are in line with muscle weakness' playing an important role
Conclusions
Overall, we conclude that although changes in muscle strength and activity limitations over a 3-year period are small, a decrease in muscle strength is associated with an increase in activity limitations in patients with early knee OA. Our results are a step toward understanding the role of muscle weakness in the development of activity limitations in knee OA. To establish the causal role of muscle weakness in activity limitations, further well-designed experimental studies are indicated.
Suppliers
- a.
Enraf-Nonius BV, Vareseweg 127, PO Box 12080, NL-3004 GB Rotterdam, The Netherlands.
- b.
IBM Corp, 1 New Orchard Rd, Armonk, NY 10504-1722.
Acknowledgments
CHECK is led by a steering committee composed of 16 members with expertise in different fields of OA. It is chaired by J.W.J. Bijlsma, PhD, and coordinated by J. Wesseling, MSc. The following institutions are involved: Erasmus Medical Center Rotterdam; Kennemer Gasthuis Haarlem; Leiden University Medical Center; Maastricht University Medical Center; Martini Hospital Groningen/Allied Health Care Center for Rheumatology and Rehabilitation Groningen; Medical Spectrum Twente
References (48)
- et al.
Clinical update: treating osteoarthritis
Lancet
(2007) - et al.
The course of limitations in activities over 5 years in patients with knee and hip osteoarthritis with moderate functional limitations: risk factors for future functional decline
Osteoarthritis Cartilage
(2012) Prognosis of limitations in activities in osteoarthritis of the hip or knee: a 3-year cohort study
Arch Phys Med Rehabil
(2010)- et al.
Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention
Arch Phys Med Rehabil
(1999) - et al.
Get up and go test in patients with knee osteoarthritis
Arch Phys Med Rehabil
(2004) - et al.
OARSI recommended performance-based tests to assess physical function in osteoarthritis of the hip or knee: authors' reply
Osteoarthritis Cartilage
(2013) - et al.
Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty
Arch Phys Med Rehabil
(2010) - et al.
Minimal detectable change in quadriceps strength and voluntary muscle activation in patients with knee osteoarthritis
Arch Phys Med Rehabil
(2010) - et al.
Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis
J Orthop Res
(2003) - et al.
Proprioception in knee osteoarthritis: a narrative review
Osteoarthritis Cartilage
(2011)
Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature
Arthritis Rheum
Effects of self-reported osteoarthritis on physical performance: a longitudinal study with a 10-year follow-up
Aging Clin Exp Res
Exercise for osteoarthritis of the knee
Cochrane Database Syst Rev
Quadriceps weakness and osteoarthritis of the knee
Ann Intern Med
Risk factors for functional decline in osteoarthritis of the hip or knee
Curr Opin Rheumatol
Role of muscle in the genesis and management of knee osteoarthritis
Rheum Dis Clin North Am
Proprioception, laxity, muscle strength and activity limitations in early symptomatic knee osteoarthritis: results from the CHECK cohort
J Rehabil Med
Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee
Arthritis Rheum
Joint laxity modifies the relationship between muscle strength and disability in patients with osteoarthritis of the knee
Arthritis Rheum
Muscle strength, pain and disability in patients with osteoarthritis
Clin Rehabil
Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis
Arthritis Rheum
Knee confidence as it relates to physical function outcome in persons with or at high risk of knee osteoarthritis in the osteoarthritis initiative
Arthritis Rheum
Modifiers of change in physical functioning in older adults with knee pain: the Observational Arthritis Study in Seniors (OASIS)
Arthritis Rheum
Prognostic factors for the two-year course of activity limitations in early osteoarthritis of the hip and/or knee
Arthritis Care Res (Hoboken)
Cited by (47)
Functional characteristics associated with hip abductor torque in severe hip osteoarthritis
2021, Musculoskeletal Science and PracticeComparison of whole-body vibration training and quadriceps strength training on physical function and neuromuscular function of individuals with knee osteoarthritis: A randomised clinical trial
2021, Journal of Exercise Science and FitnessCitation Excerpt :Although there is no evidence showing the protective role of stronger knee muscle against the onset or progression of KOA, the mass and strength of muscles around the knee joint are associated with the symptoms, prevalence and progression of KOA.38–40 The weakness of muscles around the knee would contribute to joint instability, which would change the alignment and stress of the knee, thereby accelerating KOA progression.41 With lower load on the affected joint, several researchers considered WBV training as an alternative intervention that could yield effects similar to those of regular ST.17,27 Recently, as an additional or substitute method to conventional training, WBV has been recommended for ST in elderly people and several musculoskeletal system diseases.14,15,42
Longitudinal Changes in Muscle Mass, Muscle Strength, and Physical Performance in Acutely Hospitalized Older Adults
2021, Journal of the American Medical Directors AssociationThe relationship between prescribed pre-operative knee-extensor exercise dosage and effect on knee-extensor strength prior to and following total knee arthroplasty: a systematic review and meta-regression analysis of randomized controlled trials
2020, Osteoarthritis and CartilageCitation Excerpt :Patients diagnosed with knee osteoarthritis (OA) report knee pain, decreased physical function and quality of life1. Physically, patients with knee OA are characterized by low knee-extensor muscle strength which is associated with decreased physical function, independent of knee pain2. Further, patients diagnosed with severe knee OA awaiting total knee arthroplasty (TKA) have 35% lower knee-extensor muscle strength compared to age-matched controls3.
Course and predictors of upper leg muscle strength over 48 months in subjects with knee osteoarthritis: Data from the osteoarthritis initiative
2020, Osteoarthritis and Cartilage Open
Supported by the Dutch Arthritis Association. The sponsor of the study was not involved in study design, data collection, data analysis, interpretation of data, and writing of the report.
Disclosures: none.