Tevald Michael A, Murray Amanda, Luc Brittney A, Lai Kafai, Sohn David, Pietrosimone Brian
Department of Rehabilitation Sciences, University of Toledo, 2801 W. Bancroft Street, MS #119, Toledo, OH 43606-3390, USA.
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 209 Fetzer Hall, CB#8700, Chapel Hill, NC 27599-8700, USA.
Knee. 2016 Jan;23(1):57-62. doi: 10.1016/j.knee.2015.06.006. Epub 2015 Jun 30.
To investigate the clinical importance of hip abductor (HA) strength in people with knee osteoarthritis (OA), the purposes of this study were to 1) compare the association of HA strength and physical function to that of knee extensor (KE) strength and physical function, and 2) determine the reliability of the assessment of HA strength using a hand-held dynamometer.
Thirty-five individuals [58 years standard deviation 10 years old] with knee osteoarthritis participated. Physical function was assessed with performance-based [Get-Up and Go (GUG), stair climb and descent (SC), and five times chair rise (CR)] and self-reported (WOMAC function) measures. The relationship between strength and function was assessed using bivariate correlation and hierarchical multiple regression models. Reliability across sessions was assessed in 25 subjects.
In the bivariate models, both KE and HA strength were both significantly associated with performance-based measures of function, but not WOMAC function. After controlling for anthropometric factors and KE strength in the hierarchical models, HA made significant independent contributions to the prediction of GUG and SC, but not CR or WOMAC function. The reliability of HA strength was excellent (ICC2, 3=0.94; 95% CI=0.86-0.97), while the minimum detectable change (MDC95) was 0.29Nm/kg (95% CI=0.23-0.41).
HA strength can be reliably measured and is closely associated with functional performance in people with knee OA.
These results provide preliminary evidence suggesting that HA strength may be an important rehabilitation target for the conservative management of knee OA.
为了研究髋外展肌（HA）力量在膝骨关节炎（OA）患者中的临床重要性，本研究的目的是：1）比较HA力量与身体功能之间的关联以及膝伸肌（KE）力量与身体功能之间的关联；2）确定使用手持测力计评估HA力量的可靠性。
35名[平均年龄58岁，标准差10岁]膝骨关节炎患者参与研究。通过基于表现的测量方法[起身行走（GUG）、上下楼梯（SC）和五次从椅子上起身（CR）]以及自我报告的测量方法（WOMAC功能量表）评估身体功能。使用双变量相关性和分层多元回归模型评估力量与功能之间的关系。对25名受试者评估了不同测试环节间的可靠性。
在双变量模型中，KE和HA力量均与基于表现的功能测量显著相关，但与WOMAC功能无关。在分层模型中，在控制了人体测量因素和KE力量后，HA对GUG和SC的预测有显著的独立贡献，但对CR或WOMAC功能无显著贡献。HA力量的可靠性极佳（组内相关系数ICC2,3 = 0.94；95%置信区间 = 0.86 - 0.97），而最小可检测变化（MDC95）为0.29 Nm/kg（95%置信区间 = 0.23 - 0.41）。
HA力量可以可靠地测量，并且与膝OA患者的功能表现密切相关。
这些结果提供了初步证据，表明HA力量可能是膝OA保守治疗的一个重要康复目标。
