Hall Michelle, Wrigley Tim V, Kasza Jessica, Dobson Fiona, Pua Yong Hao, Metcalf Ben R, Bennell Kim L
Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Melbourne, The University of Melbourne, VIC, Australia.
Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, Melbourne, The University of Melbourne, VIC, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, VIC, Australia.
Semin Arthritis Rheum. 2017 Feb;46(4):387-394. doi: 10.1016/j.semarthrit.2016.08.004. Epub 2016 Aug 16.
This study aimed to evaluate associations between strength of selected hip and knee muscles and self-reported physical function, and their clinical relevance, in men and women with hip osteoarthritis (OA).
Cross-sectional data from 195 participants with symptomatic hip OA were used. Peak isometric torque of hip extensors, flexors, and abductors, and knee extensors were measured, along with physical function using the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. Separate linear regressions in men and women were used to determine the association between strength and physical function accounting for age, pain, and radiographic disease severity. Subsequently, magnitudes of strength associated with estimates of minimal clinically important improvement (MCII) in physical function were estimated according to severity of difficulty with physical function.
For men, greater strength of the hip extensors, hip flexors and knee extensors were each associated with better physical function. For women, greater muscle strength of all tested muscles were each associated with better physical function. For men and women, increases in muscle strength between 17-32%, 133-223%, and 151-284% may be associated with estimates of MCII in physical function for those with mild, moderate, and severe physical dysfunction, respectively.
Greater isometric strength of specific hip and thigh muscle groups may be associated with better self-reported physical function in men and women. In people with mild physical dysfunction, an estimate of MCII in physical function may be associated with attainable increases in strength. However, in patients with more severe dysfunction, greater and perhaps unattainable strength increases may be associated with an estimate of MCII in physical function. Longitudinal studies are required to validate these observations.
本研究旨在评估髋关节骨关节炎（OA）男性和女性中，所选髋部和膝部肌肉力量与自我报告的身体功能之间的关联及其临床相关性。
使用来自195名有症状的髋关节OA参与者的横断面数据。测量髋部伸肌、屈肌和外展肌以及膝部伸肌的等长峰值扭矩，并使用西安大略和麦克马斯特大学骨关节炎指数问卷评估身体功能。对男性和女性分别进行线性回归，以确定力量与身体功能之间的关联，并考虑年龄、疼痛和放射学疾病严重程度。随后，根据身体功能困难程度的严重程度，估计与身体功能最小临床重要改善（MCII）估计值相关的力量大小。
对于男性，髋部伸肌、髋部屈肌和膝部伸肌力量越大，身体功能越好。对于女性，所有测试肌肉的力量越大，身体功能越好。对于男性和女性，肌肉力量分别增加17 - 32%、133 - 223%和151 - 284%，可能分别与轻度、中度和重度身体功能障碍者身体功能的MCII估计值相关。
特定髋部和大腿肌肉群更大的等长力量可能与男性和女性更好的自我报告身体功能相关。在轻度身体功能障碍者中，身体功能的MCII估计值可能与可实现的力量增加相关。然而，在功能障碍更严重的患者中，更大且可能无法实现的力量增加可能与身体功能的MCII估计值相关。需要纵向研究来验证这些观察结果。
