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Is the relationship between increased knee muscle strength and improved physical function following exercise dependent on baseline physical function status?

Authors :
Michelle Hall
Rana S. Hinman
Martin van der Esch
Marike van der Leeden
Jessica Kasza
Tim V. Wrigley
Ben R. Metcalf
Fiona Dobson
Kim L. Bennell
Source :
Arthritis Research & Therapy, Vol 19, Iss 1, Pp 1-9 (2017)
Publication Year :
2017
Publisher :
BMC, 2017.

Abstract

Abstract Background Clinical guidelines recommend knee muscle strengthening exercises to improve physical function. However, the amount of knee muscle strength increase needed for clinically relevant improvements in physical function is unclear. Understanding how much increase in knee muscle strength is associated with improved physical function could assist clinicians in providing appropriate strength gain targets for their patients in order to optimise outcomes from exercise. The aim of this study was to investigate whether an increase in knee muscle strength is associated with improved self-reported physical function following exercise; and whether the relationship differs according to physical function status at baseline. Methods Data from 100 participants with medial knee osteoarthritis enrolled in a 12-week randomised controlled trial comparing neuromuscular exercise to quadriceps strengthening exercise were pooled. Participants were categorised as having mild, moderate or severe physical dysfunction at baseline using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Associations between 12-week changes in physical function (dependent variable) and peak isometric knee extensor and flexor strength (independent variables) were evaluated with and without accounting for baseline physical function status and covariates using linear regression models. Results In covariate-adjusted models without accounting for baseline physical function, every 1-unit (Nm/kg) increase in knee extensor strength was associated with physical function improvement of 17 WOMAC units (95% confidence interval (CI) −29 to −5). When accounting for baseline severity of physical function, every 1-unit increase in knee extensor strength was associated with physical function improvement of 24 WOMAC units (95% CI −42 to −7) in participants with severe physical dysfunction. There were no associations between change in strength and change in physical function in participants with mild or moderate physical dysfunction at baseline. The association between change in knee flexor strength and change in physical function was not significant, irrespective of baseline function status. Conclusions In patients with severe physical dysfunction, an increase in knee extensor strength and improved physical function were associated. Trial registration ANZCTR 12610000660088 . Registered 12 August 2010.

Details

Language :
English
ISSN :
14786362
Volume :
19
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Arthritis Research & Therapy
Publication Type :
Academic Journal
Accession number :
edsdoj.ba18582bbfab4b82ada4487c7a64513f
Document Type :
article
Full Text :
https://doi.org/10.1186/s13075-017-1477-8