Martin van der Esch1, Jasmijn F Holla2, Marike van der Leeden3, Dirk L Knol4, Willem F Lems5, Leo D Roorda2, Joost Dekker6. 1. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands. Electronic address: m.vd.esch@reade.nl. 2. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands. 3. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. 4. EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. 5. Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands; Jan van Breemen Research Institute, Reade, Amsterdam, The Netherlands. 6. Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands; Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: To determine whether a decrease in muscle strength over 3 years is associated with an increase in activity limitations in persons with early symptomatic knee osteoarthritis (OA), and to examine whether the longitudinal association between muscle strength and activity limitations is moderated by knee joint proprioception and laxity. DESIGN: A longitudinal cohort study with 3-year follow-up. Measurements were performed at the second (t0) and fifth (t1) year of the Cohort Hip and Cohort Knee (CHECK) study. Statistical analyses included paired t tests, chi-square tests, and regression analyses. In regression analyses, the association between muscle strength and activity limitations was adjusted for confounders. SETTING: A rehabilitation and rheumatology center. PARTICIPANTS: Subjects (N=146) with early symptomatic knee OA from the CHECK study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Muscle strength, proprioception, and laxity were assessed using specifically designed measurement devices. Self-reported and performance-based activity limitations were measured with the Western Ontario and McMaster Universities Osteoarthritis Index, the Get Up and Go test, the walk test, and the stair-climb test. RESULTS: A total of 116 women (79.5%) and 30 men (20.5%), with a mean age ± SD of 58.4±4.9 years and a mean body mass index ± SD of 25.5±3.6, were included in the study. Overall, small 3-year changes in muscle strength and activity limitations were observed. At the group level, the average muscle strength increased by 10% (1.0±0.3 to 1.1±0.3Nm/kg) over the 3 years. The 3-year decrease in muscle strength was independently associated with an increase in performance-based activity limitations on all 3 measures (B=-1.12, B=-5.83, and B=-1.25, respectively). Proprioception and laxity did not moderate this association. CONCLUSIONS: In patients with early knee OA, decreased muscle strength is associated with an increase in activity limitations. Our results are a step toward understanding the role of muscle weakness in the development of activity limitations in knee OA. Further well-designed experimental studies are indicated to establish the causal role of muscle weakness in activity limitations.
OBJECTIVE: To determine whether a decrease in muscle strength over 3 years is associated with an increase in activity limitations in persons with early symptomatic knee osteoarthritis (OA), and to examine whether the longitudinal association between muscle strength and activity limitations is moderated by knee joint proprioception and laxity. DESIGN: A longitudinal cohort study with 3-year follow-up. Measurements were performed at the second (t0) and fifth (t1) year of the Cohort Hip and Cohort Knee (CHECK) study. Statistical analyses included paired t tests, chi-square tests, and regression analyses. In regression analyses, the association between muscle strength and activity limitations was adjusted for confounders. SETTING: A rehabilitation and rheumatology center. PARTICIPANTS: Subjects (N=146) with early symptomatic knee OA from the CHECK study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Muscle strength, proprioception, and laxity were assessed using specifically designed measurement devices. Self-reported and performance-based activity limitations were measured with the Western Ontario and McMaster Universities Osteoarthritis Index, the Get Up and Go test, the walk test, and the stair-climb test. RESULTS: A total of 116 women (79.5%) and 30 men (20.5%), with a mean age ± SD of 58.4±4.9 years and a mean body mass index ± SD of 25.5±3.6, were included in the study. Overall, small 3-year changes in muscle strength and activity limitations were observed. At the group level, the average muscle strength increased by 10% (1.0±0.3 to 1.1±0.3Nm/kg) over the 3 years. The 3-year decrease in muscle strength was independently associated with an increase in performance-based activity limitations on all 3 measures (B=-1.12, B=-5.83, and B=-1.25, respectively). Proprioception and laxity did not moderate this association. CONCLUSIONS: In patients with early knee OA, decreased muscle strength is associated with an increase in activity limitations. Our results are a step toward understanding the role of muscle weakness in the development of activity limitations in knee OA. Further well-designed experimental studies are indicated to establish the causal role of muscle weakness in activity limitations.
Authors: Leena Sharma; Kent Kwoh; Jungwha Julia Lee; Jane Cauley; Rebecca Jackson; Marc Hochberg; Alison H Chang; Charles Eaton; Michael Nevitt; Jing Song; Orit Almagor; Joan S Chmiel Journal: Ann Rheum Dis Date: 2019-06-26 Impact factor: 19.103
Authors: Rasmus Skov Husted; Anders Troelsen; Kristian Thorborg; Michael Skovdal Rathleff; Henrik Husted; Thomas Bandholm Journal: Trials Date: 2018-01-18 Impact factor: 2.279
Authors: Stephen J Preece; Nathan Brookes; Anita E Williams; Richard K Jones; Chelsea Starbuck; Anthony Jones; Nicola E Walsh Journal: BMC Musculoskelet Disord Date: 2021-06-08 Impact factor: 2.362