Accettura Angela J, Brenneman Elora C, Stratford Paul W, Maly Monica R
A.J. Accettura, MPT, MSc, School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada.
E.C. Brenneman, MSc, School of Rehabilitation Sciences, McMaster University.
Phys Ther. 2015 Jul;95(7):989-95. doi: 10.2522/ptj.20140360. Epub 2015 Feb 5.
Quadriceps femoris muscle strengthening is a common rehabilitation exercise for knee osteoarthritis (OA). More information is needed to determine whether targeting muscle power is a useful adjunct to strengthening for people with knee OA.
The purpose of this study was to identify the predictive ability of knee extensor strength and knee extensor power in the performance of physical tasks in adults with knee OA.
This study used a cross-sectional design.
Fifty-five participants with clinical knee OA were included (43 women; mean [SD] age=60.9 [6.9] years). Dependent variables were: timed stair ascent, timed stair descent, and the Six-Minute Walk Test (6MWT). Independent variables were: peak knee extensor strength and mean peak knee extensor power. Covariates were: age, body mass index, and self-efficacy. Multiple regression analyses were run for each dependent variable with just covariates, then a second model including strength, and then a third model including power. The R(2) values were compared between models.
Power explained greater variance than strength in all models. Over and above the covariates, power explained an additional 6% of the variance in the 6MWT, increasing the R(2) value from .33 to .39; 8% in the stair ascent test, increasing the R(2) value from .52 to .60; and 3% in the stair descent test, increasing the R(2) value from .44 to .47.
The sample demonstrated very good mobility and muscle function scores and may not be indicative of those with severe knee OA.
In adults with knee OA, knee extensor power was a stronger determinant of walking and stair performance when compared with knee extensor strength. Clinicians should consider these results when advising patients on exercise to maintain or improve mobility.
股四头肌强化训练是膝骨关节炎(OA)常见的康复锻炼方式。对于膝OA患者而言,确定针对肌肉力量是否是强化训练的有益辅助手段,还需要更多信息。
本研究旨在确定膝伸肌力量和膝伸肌功率对膝OA成年患者身体任务表现的预测能力。
本研究采用横断面设计。
纳入55例临床诊断为膝OA的参与者(43名女性;平均[标准差]年龄=60.9[6.9]岁)。因变量为:定时上楼梯、定时下楼梯和六分钟步行试验(6MWT)。自变量为:膝伸肌峰值力量和膝伸肌平均峰值功率。协变量为:年龄、体重指数和自我效能感。对每个因变量分别进行仅包含协变量的多元回归分析,然后是包含力量的第二个模型,接着是包含功率的第三个模型。比较各模型之间的R²值。
在所有模型中,功率比力量解释的方差更大。在协变量之外,功率在6MWT中额外解释了6%的方差,使R²值从0.33增加到0.39;在上楼梯试验中为8%,使R²值从0.52增加到0.60;在下楼梯试验中为3%,使R²值从0.44增加到0.47。
该样本表现出非常好的活动能力和肌肉功能评分,可能无法代表重度膝OA患者。
在膝OA成年患者中,与膝伸肌力量相比,膝伸肌功率是步行和上下楼梯表现的更强决定因素。临床医生在为患者提供关于维持或改善活动能力的运动建议时应考虑这些结果。