PM&R
Volume 1, Issue 5 , Pages 459-465, May 2009

Knee Extensor Strength Does Not Protect Against Incident Knee Symptoms at 30 Months in the Multicenter Knee Osteoarthritis (MOST) Cohort

  • Neil A. Segal, MD, MS

      Affiliations

    • Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, 0728 JPP, Iowa City, IA 52242-1088†
    • Corresponding Author InformationAddress correspondence to: N.A.S.
    • ,
  • James C. Torner, PhD

      Affiliations

    • Department of Epidemiology, University of Iowa, Iowa City, IA‡
    • ,
  • David T. Felson, MD, MPH

      Affiliations

    • Clinical Epidemiology & Training Unit, Boston University School of Medicine, Boston, MA§
    • ,
  • Jingbo Niu, DSc

      Affiliations

    • Clinical Epidemiology & Training Unit, Boston University School of Medicine, Boston, MA
    • ,
  • Leena Sharma, MD

      Affiliations

    • Division of Rheumatology, Feinberg School of Medicine, Chicago, IL∥
    • ,
  • Cora E. Lewis, MD, MSPH

      Affiliations

    • Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL#
    • ,
  • Michael Nevitt, PhD

      Affiliations

    • Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA⁎⁎

Received 25 October 2008; accepted 9 March 2009.

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/m2. 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.

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 
  • † Disclosure: nothing to disclose.
  • ‡ Disclosure: nothing to disclose
  • § Disclosure: 8B, NIH
  •  Disclosure: nothing to disclose
  • ∥ Disclosure: 8B, NIH
  • # Disclosure: nothing to disclose
  • ⁎⁎ Disclosure: nothing to disclose

 Funded by the following NIH grants: U01 AG18820, R01 HD43502; U01 AG18832, U01 AG18947, U01 AG19069, and the Paul B. Beeson Career Development Awards Program (K23AG030945).

 Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org

PII: S1934-1482(09)00258-5

doi:10.1016/j.pmrj.2009.03.005

PM&R
Volume 1, Issue 5 , Pages 459-465, May 2009

Article Tools

* Image Usage & Resolution