Context: Muscle impairments associated with knee osteoarthritis (OA) are the primary underlying cause of functional limitations. Understanding the extent of muscle impairments, its relationship with physical function and disease progression, and the evidence behind exercise therapy that targets muscle impairments is crucial. Evidence Acquisition: An electronic search for relevant articles using MEDLINE and CINHAL databases up to September 2011 was performed. In addition to the electronic search, retrieved articles were searched manually for relevant studies. Results: Quadriceps, hamstrings, and hip muscles are significantly impaired in subjects with knee OA compared with age-matched controls. Muscle strength, especially quadriceps, is a major determinant of both performance-based and self-reported physical function. Whether stronger quadriceps is protective against knee OA onset and progression is not clear. Exercise therapy, including global and targeted resistance training, is effective in reducing pain and improving function in subjects with knee OA. Conclusions: Subjects with knee OA have significant muscle impairments. These muscle impairments affect physical function and should be targeted in therapy. Further research is needed to explore the relationship between quadriceps strength and knee OA initiation and progression and to determine the optimal exercise prescription that augments outcomes in this patient population.

After unilateral total knee arthroplasty (TKA), osteoarthritis (OA) in the non-operated often progresses. The altered gait mechanics exhibited by patients after TKA increase the loading on the non-operated knee and predispose it to disease progression. Therefore, our objective was to examine the potentially detrimental changes in frontal plane kinetics and kinematics during walking in patients who underwent unilateral TKA. Thirty one subjects six months after TKA, forty four subjects one year after unilateral TKA and twenty control subjects were recruited. All subjects underwent three dimensional gait analysis. In the TKA groups, the non-operated knee had a higher adduction angle and higher dynamic loading, knee adduction moment and impulse, compared to the operated knee. This increased loading may be an underlying reason for OA progression in the non-operated knee. Measures of loading in the control knee did not differ from that of the non-operated knee in the TKA group, but the TKA group walked with shorter step length. Whilst the non-operated knee loading was not different from controls, there may be greater risk of cumulative loading in the non-operated knee of the TKA group given their shorter step length.

Objectives:To develop and test the psychometric properties of an Arabic version of Fatigue Severity Scale (FSS-Ar) that can be used to measure fatigue in Arabic patients with disorders where fatigue is a major symptom.Methods:Forward and backward translations of FSS were undertaken to develop an Arabic version. The validity and reliability of the FSS-Ar was then tested on 28 patients with systemic lupus erythematosus (SLE), 24 patients with multiple sclerosis (MS), and 31 healthy subjects. Exploratory factor analysis and hypothesis testing methods were used to examine construct validity. The correlation between FSS-Ar and the vitality domain of the RAND 36-Item Health was examined to test construct validity. The study was conducted at the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between February and June 2012.Results:Using a score of ≥4.05 to define fatigue, 39 of 52 (75%) participants were fatigued compared with 10 out of 31 (32%) healthy participants. The correlation between the FSS-Ar and the vitality domain of the RAND-36 was acceptable (r = -0.46). Factor analysis showed that items of the FSS-Ar measured one underlying construct, namely, fatigue. Test-retest reliability and internal consistency of the FSS-Ar was acceptable (intraclass correlation coefficient model 2,1 = 0.80; Cronbach’s alpha = 0.84).Conclusion:The Arabic version of the FSS demonstrated acceptable psychometric properties and was able to differentiate between patients with SLE or MS, and healthy subjects.

In people with unilateral TKA, HHD testing of hip abductor strength is reliable. Hip abductor strength contributes to performance-based but not patient-reported measures of physical function in people with unilateral TKA.

The Arabic Lower Extremity Functional Scale (LEFS-Ar) is a reliable and valid measure of activity limitation due to lower extremity musculoskeletal disorders with relatively small measurement error. LEFS-Ar can be used in daily clinical practice and for research purposes to quantify activity limitation in Arabic-speaking individuals with lower extremity musculoskeletal disorders.

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The Knee Injury Osteoarthritis Outcome Score (KOOS) is a widely used joint-specific measure employed to evaluate pain, symptoms, activities of daily living, recreational activities, and quality of life in patients with knee osteoarthritis (OA). Although the original KOOS has been translated into many languages, a Saudi Arabic version is not available. This study aimed to culturally adapt and evaluate the psychometric properties of the Saudi Arabic version of the KOOS in patients with knee OA. The original KOOS was translated and adapted into Saudi Arabic version over six stages according to the guidelines suggested by Beaton and recommended by the American Association of Orthopedic Surgeons Outcome Committee. Patients diagnosed with knee OA (n = 136) were recruited to examine the psychometric properties, such as internal consistency that was tested using Cronbach's alpha, test-retest reliability that was analyzed using the intra-class correlation coefficient (ICC), and construct validity that examined by testing the correlations between the new version subscales, Form 36 Health Survey subscales, and the Visual Analog Scale, Spearman's correlation coefficient (r) was used to measure the correlations. A total of 122 (89.7%) of the 136 participants with knee OA completed the second re-test of new Saudi Arabic version. Excellent internal consistency (Cronbach's alpha = 0.87-0.92) was detected in the subscales of the adapted version, as well as excellent test-retest reliability (ICC = 0.92-0.94). The pattern of correlation between the subscales of the Saudi Arabic version of the KOOS, SF-36 domains and the Visual Analog Scale for pain supported the construct validity of the adapted version. The Saudi Arabic version of the KOOS was well accepted and exhibited excellent reliability, internal consistency, and construct validity in Saudi patients with knee OA.

[Purpose] This study aimed to establish gender-specific reference values for the Y Balance Test (YBT) and the Arabic version of the Lower Extremity Functional Scale (LEFS-Ar) in healthy young adults in Saudi Arabia, and to examine gender differences in the YBT and LEFS-Ar values. [Subjects and Methods] Healthy young adults (31 females, 30 males) completed the YBT and LEFS-Ar in 1 test session. Descriptive statistical analysis (mean, standard deviation, 95% confidence interval) was used to compute the YBT and LEFS-Ar reference values. Independent t-tests were used to examine gender differences in the YBT and LEFS-Ar values. [Results] Gender-specific reference values were obtained for the right, left, dominant, and non-dominant leg as well as for the average performance of both the legs. males showed greater YBT normalized reach distances than females did in the anterior, posteromedial, and posterolateral directions; furthermore, males showed higher YBT composite scores than females did. However, the LEFS-Ar values did not differ between males and females. [Conclusion] Gender-specific reference values were obtained for the YBT and LEFS-Ar in healthy young adults in Saudi Arabia. males performed better than females did in the YBT. However, no gender differences were noted in LEFS-Ar.