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PM R. 2009 May;1(5):459-65. doi: 10.1016/j.pmrj.2009.03.005.

Knee extensor strength does not protect against incident knee symptoms at 30 months in the multicenter knee osteoarthritis (MOST) cohort.

Author information

  • 1Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, 0728 JPP, Iowa City, IA 52242-1088, USA. segal-research@uiowa.edu

Abstract

OBJECTIVE:

Knee extensor weakness has not been associated consistently with the risk for incident knee pain. Additionally, the balance of hamstring-to-quadriceps strength (H:Q ratio) may affect risk and has not been studied. The authors determined whether knee extensor weakness or muscle imbalance is a risk factor for development of frequent knee pain or stiffness and whether the effect is modified by lower limb alignment.

DESIGN:

Observational study.

SETTING:

Community.

PARTICIPANTS:

Community-dwelling adults ages 50-79 years with or at risk of knee osteoarthritis based on obesity, knee injury, or surgery. A total of 1269 knees from women and 1006 knees from men without frequent knee symptoms at baseline and with 15- or 30- month follow-up outcome data were included.

ASSESSMENT OF RISK FACTORS:

Isokinetic knee extensor and flexor strength as well as radiographic hip-knee-ankle alignment were measured at baseline. H:Q ratio was dichotomized, with normal being considered to be >/=0.6.

MAIN OUTCOME MEASUREMENTS:

Frequent knee symptoms at 15- or 30-month follow-up (frequent knee pain, aching, or stiffness on most days of the past month reported at both telephone contact just before and at visit).

RESULTS:

Mean +/- SD age was 62.2 +/- 8.0 years and mean body mass index (BMI) was 30.1 +/- 5.4 kg/m(2). Mean peak knee extensor strength (KES) was 132.6 +/- 42.4 and 76.9 +/- 25.3 N.m in men and women, respectively. Approximately 50% of knees in men and 59% of knees in women had an H:Q ratio <0.6. A total of 307 of 2275 eligible knees developed frequent knee symptoms at follow-up. Logistic regression controlling for age, BMI, femoral neck bone mineral density, activity score, and baseline Kellgren Lawrence grade revealed that neither KES nor H:Q ratio predicted the development of knee symptoms in gender-stratified or combined analyses. These results were unaffected by adjusting for lower limb alignment.

CONCLUSIONS:

Neither concentric quadriceps strength nor H:Q ratios predicted the development of frequent knee symptoms at 15- or 30-month follow-up in this cohort.

PMID:
19627933
[PubMed - indexed for MEDLINE]
PMCID:
PMC2763276
Free PMC Article
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