Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee

103

Objective. To determine whether muscle strength, proprioceptive accuracy, and laxity are associated with self-reported knee instability in a large cohort of knee osteoarthritis (OA) patients, and to investigate whether muscle strength may compensate for impairment in proprioceptive accuracy or laxity, in order to maintain knee stability. Methods. Data from 283 knee OA patients from the Amsterdam Osteoarthritis cohort were used. Univariable and multivariable logistic regression analyses were performed to assess the association between muscle strength, proprioceptive accuracy (motion sense), frontal plane varus-valgus laxity, and self-reported knee instability. Additionally, effect modification between muscle strength and proprioceptive accuracy and between muscle strength and laxity was determined. Results. Self-reported knee instability was present in 67% of the knee OA patients and mainly occurred during walking. Lower muscle strength was significantly associated with the presence of self-reported knee instability, even after adjusting for relevant confounding. Impaired proprioceptive accuracy and high laxity were not associated with self-reported knee instability. No effect modification between muscle strength and proprioceptive accuracy or laxity was found. Conclusion. Lower muscle strength is strongly associated with self-reported knee instability in knee OA patients, while impairments in proprioceptive accuracy and laxity are not. A compensatory role of muscle strength for impaired proprioceptive accuracy or high laxity, in order to stabilize the knee, could not be demonstrated.

Section: Biomechanical Factorsmentioning

confidence: 99%

Section: Biomechanical Factorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Association of lower muscle strength with self‐reported knee instability in osteoarthritis of the knee: Results from the Amsterdam Osteoarthritis Cohort

Knoop¹,

Leeden²,

Esch³

et al. 2011

103

Association between skeletal muscle inflammatory markers and walking pattern in people with knee osteoarthritis

Levinger

Caldow

Feller

et al. 2011

Objective. Patients with knee osteoarthritis (OA) are characterized by increased muscle inflammation and altered gait. We investigated the association between proinflammatory mediators in the vastus lateralis and physical function and gait in patients with knee OA. Methods. Nineteen patients with knee OA underwent gait analysis, assessment of self-reported pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and a muscle biopsy that was taken during their knee replacement surgery. Muscle was analyzed for cellular protein inflammatory mediators, interleukin-6, monocyte chemotactic protein 1 (MCP-1), p65 NF-B, signal transducer and activator of transcription 3 (STAT-3), and JNK-1. Sagittal plane knee function, including early stance knee range of motion (ROM) and knee sagittal plane impulse, was measured using a motion analysis system. Pearson's correlation was used to assess relationships between selected variables. Results. Significant positive correlations were found between MCP-1 and self-perceived stiffness, physical function, and the total WOMAC score (P < 0.05). MCP-1 was also negatively correlated with early stance knee ROM (r ‫؍‬ ؊0.52, P ‫؍‬ 0.023). Reduced velocity was associated with elevated levels of p65 NF-B and STAT-3 (P < 0.05). Knee sagittal plane impulse was negatively correlated with JNK-1 (P ‫؍‬ 0.02), indicating reduction in knee impulse with an increased level of JNK-1. Conclusion. Increased levels of several proinflammatory mediators were correlated with altered knee function during walking as well as greater physical disability and slower gait velocity. Identification of the cellular and molecular mechanisms associated with muscle inflammation is important to better understand the underlying mechanism responsible for altered gait and function in patients with knee OA.

Associations between frontal plane joint stiffness and proprioceptive acuity in knee osteoarthritis

Cammarata¹,

Dhaher²

2012

Objective It has been proposed that proprioceptive impairments observed in knee osteoarthritis (OA) may be associated with disease-related changes in joint mechanics. The aim of this study was to quantify joint proprioception and stiffness in the frontal plane of the knee in persons with and without knee OA and to report the associations between these two metrics. Methods Thirteen persons with knee OA and fourteen healthy age-matched subjects participated. Proprioceptive acuity was assessed in varus and valgus using the threshold to detection of movement (TDPM). Passive joint stiffness was estimated as the slope of the normalized torque-angle relationship at 0° joint rotation (neutral) and several rotations in varus and valgus. Analyses of variance were performed to determine the effect of OA and gender on each metric. Linear regression was used to assess the correlation between TDPM and joint stiffness. Results TDPM was significantly higher (P<0.05) in the OA group compared to controls for both varus and valgus, but significant gender differences were observed. Passive joint stiffness was significantly reduced (P<0.05) in OA participants compared to the control group in neutral and valgus, but not varus, and significantly reduced in females compared to males. A weak negative correlation was observed between TDPM and stiffness estimates, suggesting that poorer proprioception was associated with less joint stiffness. Conclusions While both joint stiffness and proprioception were reduced in the OA population, they were only weakly correlated. This suggests that other neurophysiological factors play a larger role in the proprioceptive deficits in knee OA.