The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis

Abstract

BackgroundPatients with knee osteoarthritis (OA) were reported to have quadriceps weakness, and impaired proprioception, both related to pain and swelling. It is unclear whether pain alone a causal factor to above findings over the knee joint. The purpose of this study was to assess the effects of knee pain alone on the quadriceps strength, proprioception and dynamic balance in subjects with bilateral knee OA without joint swelling.MethodsFourty females with mean age of 68.3 years were involved in this cross-sectional study. The inclusion criteria were bilateral knee OA without joint swelling, with a visual analogue pain scale difference (> 1) between each knee. Patients all underwent assessment of the isokinetic strength of knee muscles, knee proprioceptive acuity, and dynamic balance.ResultsPatients’ more painful knee had weaker isokinetic quadriceps strength than less painful knee at both 60 °/s and 180 °/s (p = 0.01, p = 0.01, respectively). There were no differences in proprioceptive acuity between both knees in all three knee positions. Meanwhile, there was a significant difference in the dynamic balance index measurement between both knees (more painful versus less painful: 3.88 ± 1.15 vs. 3.30 ± 1.00, p = 0.01). Quadriceps strength was associated with dynamic balance stability (60 °/s, r = − 0.578, p < 0.01; 180 °/s, r = − 0.439, p < 0.01).ConclusionsFor patients with knee OA, the more painful knee was associated with weaker quadriceps and poor balance ability. To improve lower limb function and balance stability of the older persons having knee OA, physicians should take the optimal pain management strategy.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0932-y) contains supplementary material, which is available to authorized users.

Influence of the clinical in postural balance in woman with knee osteoarthritis

“…Such changes can occur in individuals under conditions of low muscular co-activation or with a decline in nerve conduction speed, 31 both situations present in the pathophysiology of KOA. 5,15,17,32 Thus, increased muscle activity may be responsible for the increased stochastic activity (Dys) and hence may compromise an individual's ability to maintain postural stability, increasing the risk of falling. 3,5,8 The subjects with KOA had higher Dyl when compared with the asymptomatic ones.…”

“…5,15,17,32 Thus, increased muscle activity may be responsible for the increased stochastic activity (Dys) and hence may compromise an individual's ability to maintain postural stability, increasing the risk of falling. 3,5,8 The subjects with KOA had higher Dyl when compared with the asymptomatic ones. The region of Dyl corresponds to the mechanism in a closed circuit, which utilizes sensory information to generate corrective postural disturbances to compensate for muscle torque.…”

“…[2][3][4] KOA is characterized by the degeneration of the joint cartilage, with progressive loss of functional capacity due to increasing deficits in the proprioceptive and neuromuscular systems, thus limiting the performance of activities of daily living (ADL) and negatively affecting quality of life. [5][6][7][8] Individuals with KOA experience episodes of pain, restricted movement, muscle weakness, and decreased motor coordination 3,5,[7][8][9][10] as the disease gradually affects precision, agility, and reflexes and ultimately impairs postural balance. 11,12 According to recent studies, 6,[11][12][13][14][15] decreased postural balance and functional capacity are associated with increased risk of falling in the elderly.…”

“…3,6,14,15 Furthermore, it has been shown that patients with KOA are at greater risk of falling because of a lack of adequate neuromuscular response to balance disturbances 5,8,10 during the performance of functional tasks and because of greater fear of falling. 6,14 Current literature; 5,16,17 shows an association between decreased balance and decreased muscle strength (quadriceps) and proprioception in patients with KOA; however, the origin of that decreased balance remains unclear. Tarigan et al 18 found a correlation between body mass index and KOA severity, but there is no evidence of association between center of pressure (COP) parameters and clinical parameters (pain, severity of osteoarthritis, and age).…”

A comparison of the Effect of Quadriceps Taping versus Patellar Taping on Balance and Functional Performance in Patients with Knee Osteoarthritis

“…Individuals with knee OA display reductions in quadriceps strength and activation [4,5] as well as impairments in knee joint proprioception [6]. These deficits, in combination with the ageing process, may result in greater impairments in balance in patients with knee OA, compared with healthy subjects.…”