Update on the Role of Muscle in the Genesis and Management of Knee Osteoarthritis

Bennell, Kim L; Wrigley, Tim V.; Hunt, Michael A.; Lim, Boon‐Whatt; Hinman, Rana S

doi:10.1016/j.rdc.2012.11.003

Cited by 192 publications

(197 citation statements)

References 162 publications

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“…Quadriceps weakness is well documented in patients with knee OA (27), with evidence relating quadriceps weakness to disease onset (34 -37), while the relationship with progression remains inconclusive (38,39). However, our study further underlines the importance of involving muscle strengthening in the treatment of knee OA, since strength deficits (25) and worse knee confidence (5) have been shown to be related to poor functional outcome over a 3-year period.…”

Section: Discussionmentioning

confidence: 60%

“…Pain relief in knee OA has been found to increase the relative activation of the quadriceps muscle (26). This suggests that pain perhaps inhibits voluntary muscle activation (27) about the knee, leading to a lack of knee confidence during activities where the muscles are required to provide joint stability. Greater dynamic varus-valgus joint motion may be associated with inefficient use of muscle strength/control during gait, and the combination of greater varus-valgus joint motion and lower muscle strength is related to functional ability in knee OA (12).…”

Section: Discussionmentioning

confidence: 99%

“…Although the mechanisms of knee instability/giving way in knee OA remain unclear, muscles acting on the knee joint (i.e., the quadriceps muscle) are important to sustain knee stability in participants with knee OA (27,30). Quadriceps weakness is well documented in patients with knee OA (27), with evidence relating quadriceps weakness to disease onset (34 -37), while the relationship with progression remains inconclusive (38,39).…”

Section: Discussionmentioning

confidence: 99%

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Association of Knee Confidence With Pain, Knee Instability, Muscle Strength, and Dynamic Varus–Valgus Joint Motion in Knee Osteoarthritis

Skou

Wrigley

Metcalf

et al. 2014

Arthritis Care & Research

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Objective. To investigate associations between self-reported knee confidence and pain, self-reported knee instability, muscle strength, and dynamic varus-valgus joint motion during walking. Methods. We performed a cross-sectional analysis of baseline data from 100 participants with symptomatic and radiographic medial tibiofemoral compartment osteoarthritis (OA) and varus malalignment recruited for a randomized controlled trial. The extent of knee confidence, assessed using a 5-point Likert scale item from the Knee Injury and Osteoarthritis Outcome Score, was set as the dependent variable in univariable and multivariable ordinal regression, with pain during walking, self-reported knee instability, quadriceps strength, and dynamic varus-valgus joint motion during walking as independent variables. Results. One percent of the participants were not troubled with lack of knee confidence, 17% were mildly troubled, 50% were moderately troubled, 26% were severely troubled, and 6% were extremely troubled. Significant associations were found between worse knee confidence and higher pain intensity, worse self-reported knee instability, lower quadriceps strength, and greater dynamic varus-valgus joint motion. The multivariable model consisting of the same variables significantly accounted for 24% of the variance in knee confidence (P < 0.001). Conclusion. Worse knee confidence is associated with higher pain, worse self-reported knee instability, lower quadriceps muscle strength, and greater dynamic varus-valgus joint motion during walking. Since previous research has shown that worse knee confidence is predictive of functional decline in knee OA, addressing lack of knee confidence by treating these modifiable impairments could represent a new therapeutic target.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association of Knee Confidence With Pain, Knee Instability, Muscle Strength, and Dynamic Varus–Valgus Joint Motion in Knee Osteoarthritis

Skou

Wrigley

Metcalf

et al. 2014

Arthritis Care & Research

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“…Changes in muscle function are commonly see in patients with knee OA and is considered as both cause and consequence of the disease. The lower limb muscles absorb load and promote dynamic stability of the knee joint, functions that are impaired in OA because of changes in muscle strength and lexibility (8,9). Muscle weakness is considered the best predictor of disability in OA, as altered concentric and eccentric quadriceps strength is seen in patients with OA, and is considered to have an important role in disease onset and progression (9,10).…”

Section: Introductionmentioning

confidence: 99%

Effects of resistance training in individuals with knee osteoarthritis

et al. 2016

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“…Supervised group or individual exercise is superior to independent home exercise for pain reduction. 6 Mobility aids such as a stick (used in the opposite hand), knee braces and foot orthoses can also diminish pain and improve function. [7][8][9] Obesity is the single most important modifiable risk factor.…”

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confidence: 99%