Muscle strength, physical performance and physical activity as predictors of future knee replacement: a prospective cohort study

Abstract

Objective To investigate associations between lower levels of muscle strength, physical performance and physical activity and the risk of knee replacement (KR) in older adults with frequent knee pain. Method Participants from the Multicenter Osteoarthritis Study (MOST) with knee pain on most of the past 30 days at baseline were included (n=1,257; mean (SD) age of 62.2 (8.2)). We examined the association between 1) baseline peak isokinetic knee extensor strength, (60°/sec, maximum out of 4 trials), 2) best time to stand in timed chair stand (2 trials of 5 repetitions), and 3) baseline Physical Activity Scale for the Elderly score with incident KR between baseline and the 84-month follow-up. Results 1,252 (99.6%) participants (1,682 knees) completed the follow-up visits. 331 participants (394 knees) underwent a KR during the 84 months (229 women and 102 men). The crude analysis demonstrated a decreased risk of KR in women (p < .0001) with higher knee extensor strength (Hazard Ratio (HR; 95% CI) 0.99 (0.98 to 0.99)). The risk remained significant (p = 0.03) when adjusting for age, BMI, race, clinic site, education, occupation, previous knee injury, previous knee surgery, and WOMAC pain (HR (95% CI) 0.99 (0.99 to 1.00)), but not when adjusting for Kellgren-Lawrence grade (p = 0.97). Conclusion Lower levels of chair stand performance and self-reported physical activity are not associated with an increased risk of KR within 7 years, while the independent effect of knee extensor strength on risk for KR in women is non-significant after adjusting for radiographic severity.

FIT & STRONG! PLUS: DESCRIPTIVE DEMOGRAPHIC AND RISK CHARACTERISTICS IN A COMPARATIVE EFFECTIVENESS TRIAL FOR OLDER AFRICAN-AMERICAN ADULTS WITH OSTEOARTHRITIS

“…The mean score on the PASE (33) was 97.2 (SD = 61.3), which is lower than the mean scores of 169.3 (SD = 88.2) reported by Skou and colleagues (40) and 131.4 (SD = 71.1) by Martin and colleagues (41) in work with older adult samples. Participants had a low mean score of 8.7 (SD = 3.6) on the 30-second chair stand as well as a low mean score of 356.3 meters (SD = 97.1) on the six-minute walk test.…”

The effects of preoperative balance training on balance and functional outcome after total knee replacement: a randomized controlled trial

“…[36][37][38] Given that proprioception may take time to recover after knee replacement 34 and given that proprioceptive work could bear fruit over longer periods than the one studied and be maintained for longer, 36 assessments beyond six weeks could have provided relevant information. And yet, it has to be also emphasized that there are additional factors -such as lifestyle and continued physical exercise -that will most likely have an even greater influence on the one-year outcomes, 39 when the plateau capacities are usually reached. 40 Focusing on the study period and contextualizing with the current literature, few previous trials assessed the effects of preoperative sensorimotor training on patients undergoing total knee replacement.…”

Lower Quadriceps Rate of Force Development Is Associated With Worsening Physical Function in Adults With or at Risk for Knee Osteoarthritis: 36-Month Follow-Up Data From the Osteoarthritis Initiative

“…10 In addition, a decreased risk of knee replacement from 0 to 84 months was only found in women with higher knee extensor strength at baseline. 48…”