Efficacy of rehabilitation programs for improving muscle strength in people with hip or knee osteoarthritis: a systematic review with meta-analysis

Zacharias, Anita; Green, Rodney; Semciw, Adam; Kingsley, Michael; Pizzari, Tania

doi:10.1016/j.joca.2014.07.005

Cited by 73 publications

(62 citation statements)

References 68 publications

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“…Bridging this gap may provide evidence for innovative interventions that target hip adductors in people with knee OA, a strategy that to date remains untested. 45 Further research is also required to investigate hip strength deficits in the sagittal (flexion/extension) and transverse (internal/external rotation) planes. Only 1 study 25 investigated these actions isometrically, and 1 isokinetically, 10 with limited to moderate-quality evidence of weaker hip strength in people with knee OA.…”

Section: Measure/studymentioning

confidence: 99%

“…17,38 Unknown are the optimal dose and type of exercise that would maximize outcomes over sustained periods. There are few studies that have evaluated targeted hip strengthening in knee OA as a management strategy 45 ; consequently, evidence to guide clinical decisions with regard to this is incomplete. The current review identified hip strength deficits that may potentially be targeted to optimize the outcomes of rehabilitation.…”

Section: Measure/studymentioning

confidence: 99%

See 1 more Smart Citation

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Deasy¹,

Leahy²,

Semciw³

2016

Journal of Orthopaedic & Sports Physical Therapy

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Standardized mean differences (SMDs; Hedges' g) were calculated from means and standard deviations (mean difference/pooled SD) of muscle strength data using Review Manager software (Version 5.2; The Cochrane Collaboration, London, UK). The SMDs of 0.2, 0.5, and 0.8 were considered small, moderate, and large, respectively. 9 The percentage difference in strength was also calculated to provide a further indication of the relative difference in strength between OA and control participants [(OA strength -control strength)/control strength × 100]. Results were grouped according to the type of strength measurement (eg, isometric or isokinetic) or hip action performed (eg, hip flexion or extension). Data were pooled for multiple studies in a meta-analysis within each group using a random-effects model. When studies reported on multiple grades of OA classification (eg, Kellgren-Lawrence grade 2 or 3) without reporting on muscle strength of the whole sample combined, only the more established OA grading was used in the meta-analysis, to avoid repeated assessment of control-group data. When studies measured isokinetic strength at multiple speeds, the slower speed was used, as slower speeds are considered more reliable.35,41 When a study reported results of left and right knees of participants with bilateral knee OA, only the side with the most conservative SMD was presented, to avoid repeated inclusion of control-group data.10 Statistical heterogeneity across pooled studies was assessed using the I 2 statistic, in which a value of 25%, 50%, or 75% was considered a low, moderate, or high level of heterogeneity, respectively. 23 Assessment of Quality of Body of EvidenceA modified version of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence in each meta-analysis. 20,35,43 The GRADE tool has been modified to apply to observational, nonexperimental data. 35,43 Each meta-analysis was graded using the following predefined criteria: (1) inconsistency (downgraded if I 2 was 50% or greater), (2) Screened by title and abstract, n = 1737Screened by title and abstract, n = 1737Full-text articles assessed for eligibility, n = 102Full-text articles assessed for eligibility, n = 102Hip strength in knee OA compared to control, n = 5Hip strength in knee OA compared to control, n = 5Hip strength as a risk factor for knee OA development, n = 0Hip strength as a risk factor for knee OA development, n = 0

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Section: Measure/studymentioning

confidence: 99%

Section: Measure/studymentioning

confidence: 99%

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Deasy¹,

Leahy²,

Semciw³

2016

Journal of Orthopaedic & Sports Physical Therapy

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“…Kalça ve diz OA hastalarında rehabilitasyon programlarının kas gücü üzerine etkinliğini değerlendiren metaanalizli bir sistematik derlemede diz OA konusunda çok sayıda çalışmaya değinilirken, kalça OA konusunda kas gücü üzerine etkiyi değerlendiren ve kontrol grubu içeren çalışma olmadığı belirtilmiş ve kısa dönem izlem içeren sadece bir çalışmaya yer verilmiştir (24). Bu çalışmada kalça abduksiyon gücü üzerine orta düzeyde etkinlik saptanırken ekstansiyon veya iç rotasyon üzerine belirgin bir etki saptanmamıştır (25).…”

Section: Kalça Osteoartriti (Oa)unclassified

Exercise Prescription for Painful Hip Disorders

Atalay¹,

Güven²

2014

Turk J Phys Med Rehab

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The hip is the joint that serves as a force transmitter for the upper and lower extremities and is vital for daily activities, such as walking. The hip joint has a deep socket and surrounding strong muscles; it relies on a balance of muscle flexibility and strength. For the prescription of exercises for the hip, the imbalance between muscle groups, muscles with signs of weakness, muscles under overload, and muscle shortness should be assessed. Strength progression usually advances as isometric, isotonic, isokinetic, and plyometrics; however, full strength can not be achieved until flexibility is restored. In this review, we aimed to summarize the exercises that can be used for the treatment of disorders, such as hip osteoarthritis, inflammatory conditions, osteoporosis, piriformis syndrome, great trochanteric pain syndrome, tendinopathies, labral tears, and femoroacetabular impingement, under the light of scientific evidence. Key Words: Exercise, hip, osteoarthritis, osteoporosis, strengthening ÖzetKalça; üst ve alt ekstremiteye kuvvet aktarımı sağlayan ve yürüme gibi günlük aktiviteler açısından temel olan bir eklemdir. Derin bir soketi ve etrafında güçlü kasları olan bu eklemde diğer eklemler gibi kasların esneklik ve güçleri arasındaki denge önem kazanır. Kalçaya yönelik egzersiz reçetelenirken mevcut kas dengesizliklerinin saptanması, zayıf kas gruplarının belirlenmesi, aşırı yüklenmeye maruz kalan veya kısalık belirtileri gösteren kasların saptanması reçeteleme açısından önemlidir. Egzersiz tipi olarak güçlendirme programı izometrik, izotonik, izokinetik ve pliometrik olarak ilerlemektedir ancak esneklik tam olarak kazanılmadan tam güce ulaşmak mümkün olmamaktadır. Bu derlemede kalça osteoartrit, inflamatuvar patolojiler, osteoporoz, piriformis sendromu, büyük trokanter ağrı sendromu, tendinopatiler, labral yırtıklar ve femoroasetabular sıkışma gibi hastalıklar ve bunların tedavisinde kullanılabilecek egzersiz önerileri bilimsel kanıtlar ışığında sunulmaya çalışılmıştır. S58Kalça bölgesinin insanlara özgü olan yapısı; insanların hayvanlarla karşılaştırıldığında bipedal olması ve dikey postür ile ilişki-lidir. Pelvis gövdenin yer çekimi nedeni ile oluşan yükü ve yer tepkime kuvvetinin femurun başı aracılığı ile iletimi arasında bir pivot olarak görev yapmaktadır (1). Üst ve alt ekstremiteye kuvvet aktarımı sağlayan; derin bir soketi olan bu derin eklemin etrafındaki güçlü kasların esneklikleri ve güçleri arasındaki denge önemlidir. Egzersizlerin etkin uygulanabilmesi, hedeflenen kas grubuna yöneltilebilmesi için bu bölgenin anatomik özel-likleri bilinmelidir. Kalça Çevresi Kasların Fonksiyonel AnatomisiKalça çevresi kaslarının anatomik özelliklerinin bilinmesi, egzersiz sırasında hedeflenen kas gruplarına yönelik egzersize olanak sağlar. Örneğin; ayakta kalça fleksör germe egzersizi sırasında (Şekil 1) dizin fleksiyonda tutularak kalçanın ekstansiyona getirilmesi ile hem rektus femoris hem iliopsoas kasına germe uygulanırken, diz ekstansiyonda iken kalçanın ekstansiyona getirilmesi ise sadece iliops...

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“…Progressive leg muscle weakness contributes to pain, functional disability, and mobility limitations in persons with advanced stages of knee OA . Therefore, improving muscle strength by means of resistance exercises for the lower limbs is a major method of prevention and rehabilitation in patients with knee OA and has already shown beneficial effects …”

Section: Introductionmentioning

confidence: 99%

Relationship Between Strength Parameters and Functional Performance Tests in Patients With Severe Knee Osteoarthritis

Bily

Šarabon

Löefler

et al. 2019

PM&R

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Background Decreased leg muscle strength is a major determinant of reduced function in patients with knee osteoarthritis (OA). The identification of a strength parameter that is best correlated with functional performance is important for monitoring rehabilitation results. Objective To determine which muscle strength measurements show the highest correlation with functional capacity in patients with severe knee OA shortly before total knee arthroplasty (TKA). Design Cross‐sectional exploratory study. Setting Outpatient rehabilitation department at a university teaching hospital. Patients The sample included 75 patients (51 female) scheduled for primary TKA, recruited through multistage sampling. Methods or Interventions Independent variables were peak isometric, isokinetic concentric, and eccentric leg extensor strength measured on the leg press, as well as peak isometric knee extensor strength measured on the strength chair. Two multiple regression analyses were performed, one including all strength measures and the other including all of the strength ratios. Pearson correlation coefficients were calculated between the strength measures and functional test scores. Main Outcome Measurements Dependent variables were the Timed Up and Go Test (TUG) and the Stair Test (ST). Results The regression analysis including all strength measures could explain 11.9% of the variance of the TUG (P = .068, not significant [NS]) and 21.5% of the variance of the ST (P = .009, significant). The regression model for the strength ratios explained 11.8% of the variance of the TUG (P = .090, NS) and 6.3% of the ST (P = .217, NS). Conclusions Although univariate analysis confirmed significant correlations between strength measurements and functional tests, multiple regression analysis revealed a higher predictive value for the ST than for the TUG. The use of both muscle strength tests and performance‐based function tests is advisable to evaluate functional impairments of patients with knee OA. Level of Evidence III

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Efficacy of rehabilitation programs for improving muscle strength in people with hip or knee osteoarthritis: a systematic review with meta-analysis

Cited by 73 publications

References 68 publications

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis

Exercise Prescription for Painful Hip Disorders

Relationship Between Strength Parameters and Functional Performance Tests in Patients With Severe Knee Osteoarthritis

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