Korean J Sports Med.  2013 Jun;31(1):1-6. 10.5763/kjsm.2013.31.1.1.

The Effects of Knee Pain on the Quadriceps Strength, Proprioception and Balance in Patients with Knee Osteoarthritis

Affiliations
  • 1Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hwanglee@skku.edu
  • 2Division of Biomedical Engineering, Chonbuk National University, Jeonju, Korea.

Abstract

The purpose of this study was to assess the effects of knee pain on the quadriceps strength, proprioception and balance in subjects with bilateral knee osteoarthritis and the correlation between muscle strength, proprioception, and balance in knee osteoarthritis patients with knee pain. The inclusion criteria were symptomatic and radiographic bilateral knee osteoarthritis (Kellgren-Lawrence grade > or =2), visual analogue scale difference of the both knees > or =2. Thirty three participants (32 women, 1 men: mean age, 59.18 years) underwent assessment of maximal voluntary contraction of quadriceps and hamstring muscles, knee proprioceptive acuity (measure passive joint reposition sense) and balance index using Biodex System 3 isokinetic dynamometer and Biodex balance System. In this study, the more pain knee had weaker quadriceps strength than less pain knee (p<0.05) but proprioceptive acuity and balance index did not show significant differences in both knees (p>0.05). Poor proprioception was associated with low quadriceps strength and poor Medio-lateral Stability Index (p<0.05). Future studies needed to account the influence of pain on neuromuscular factors as well as attempt to further clarify the relationships between these factors.

Keyword

Balance; Knee osteoarthritis; Pain; Proprioception; Strength

MeSH Terms

Contracts
Female
Humans
Joints
Knee
Muscle Strength
Muscles
Osteoarthritis, Knee
Proprioception

Reference

References

1. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994; 84:351–8.
Article
2. Hurley MV, Rees J, Newham DJ. Quadriceps function, proprioceptive acuity and functional performance in healthy young, middle-aged and elderly subjects. Age Ageing. 1998; 27:55–62.
Article
3. Mun KH, Oh SH, Kang BG, Lee YG. The effect of closed-needle irrigation of knee in patients with osteoarthritis. J Korean Acad Rehabil Med. 1998; 22:196–203.
4. Nordesjo LO, Nordgren B, Wigren A, Kolstad K. Isometric strength and endurance in patients with severe rheumatoid arthritis or osteoarthrosis in the knee joints. A comparative study in healthy men and women. Scand J Rheumatol. 1983; 12:152–6.
5. Marks R, Quinney HA, Wessel J. Proprioceptive sensibility in women with normal and osteoarthritic knee joints. Clin Rheumatol. 1993; 12:170–5.
Article
6. Hassan BS, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis. 2001; 60:612–8.
Article
7. Wegener L, Kisner C, Nichols D. Static and dynamic balance responses in persons with bilateral knee osteoarthritis. J Orthop Sports Phys Ther. 1997; 25:13–8.
Article
8. Spencer JD, Hayes KC, Alexander IJ. Knee joint effusion and quadriceps reflex inhibition in man. Arch Phys Med Rehabil. 1984; 65:171–7.
9. Cho YR, Hong BY, Lim SH, et al. Effects of joint effusion on proprioception in patients with knee osteoarthritis: a single-blind, randomized controlled clinical trial. Osteoarthritis Cartilage. 2011; 19:22–8.
Article
10. Hassan BS, Doherty SA, Mockett S, Doherty M. Effect of pain reduction on postural sway, proprioception, and quadriceps strength in subjects with knee osteoarthritis. Ann Rheum Dis. 2002; 61:422–8.
Article
11. Messier SP, Glasser JL, Ettinger WH Jr, Craven TE, Miller ME. Declines in strength and balance in older adults with chronic knee pain: a 30-month longitudinal, observational study. Arthritis Rheum. 2002; 47:141–8.
Article
12. Felson DT, Gross KD, Nevitt MC, et al. The effects of impaired joint position sense on the development and progression of pain and structural damage in knee osteoarthritis. Arthritis Rheum. 2009; 61:1070–6.
Article
13. Sharma L, Pai YC, Holtkamp K, Rymer WZ. Is knee joint proprioception worse in the arthritic knee versus the unaffected knee in unilateral knee osteoarthritis? Arthritis Rheum. 1997; 40:1518–25.
Article
14. Hall MC, Mockett SP, Doherty M. Relative impact of radiographic osteoarthritis and pain on quadriceps strength, proprioception, static postural sway and lower limb function. Ann Rheum Dis. 2006; 65:865–70.
Article
15. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986; 29:1039–49.
16. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957; 16:494–502.
Article
17. Sahin N, Baskent A, Cakmak A, Salli A, Ugurlu H, Berker E. Evaluation of knee proprioception and effects of proprioception exercise in patients with benign joint hypermobility syndrome. Rheumatol Int. 2008; 28:995–1000.
Article
18. Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986; 80:429–34.
Article
19. Wang L, Li JX, Xu DQ, Hong YL. Proprioception of ankle and knee joints in obese boys and nonobese boys. Med Sci Monit. 2008; 14:CR129–35.
20. Grob KR, Kuster MS, Higgins SA, Lloyd DG, Yata H. Lack of correlation between different measurements of proprioception in the knee. J Bone Joint Surg Br. 2002; 84:614–8.
Article
21. Koceja DM, Allway D, Earles DR. Age differences in postural sway during volitional head movement. Arch Phys Med Rehabil. 1999; 80:1537–41.
Article
22. Whipple R, Wolfson L, Derby C, Singh D, Tobin J. Altered sensory function and balance in older persons. J Gerontol. 1993; 48:71–6.
23. van der Esch M, Steultjens M, Harlaar J, Knol D, Lems W, Dekker J. Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee. Arthritis Rheum. 2007; 57:787–93.
Article
24. Zakas A, Grammatikopoulou MG, Zakas N, Zahariadis P, Vamvakoudis E. The effect of active warm-up and stretching on the flexibility of adolescent soccer players. J Sports Med Phys Fitness. 2006; 46:57–61.
Full Text Links
  • KJSM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr