School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
Department of Kinesiology, University of Waterloo, Room 1052, Burt Matthews Hall, 200 University Ave, Waterloo, ON, N2L 3G1, Canada.
Clin Rheumatol. 2018 Feb;37(2):495-504. doi: 10.1007/s10067-017-3903-3. Epub 2017 Nov 10.
This study examined the extent to which baseline measures of quadriceps strength, quadriceps power, knee pain and self-efficacy for functional tasks, and their interactions, predicted 2-year changes in mobility performance (walking, stair ascent, stair descent) in women with knee osteoarthritis. We hypothesized that lesser strength, power and self-efficacy, and higher pain at baseline would each be independently associated with reduced mobility over 2 years, and each of pain and self-efficacy would interact with strength and power in predicting 2-year change in stair-climbing performance. This was a longitudinal, observational study of women with clinical knee osteoarthritis. At baseline and follow-up, mobility was assessed with the Six-Minute Walk Test, and stair ascent and descent tasks. Quadriceps strength and power, knee pain, and self-efficacy for functional tasks were also collected at baseline. Multiple linear regression examined the extent to which 2-year changes in mobility performances were predicted by baseline strength, power, pain, and self-efficacy, after adjusting for covariates. Data were analyzed for 37 women with knee osteoarthritis over 2 years. Lower baseline self-efficacy predicted decreased walking (β = 1.783; p = 0.030) and stair ascent (β = -0.054; p < 0.001) performances over 2 years. Higher baseline pain intensity/frequency predicted decreased walking performance (β = 1.526; p = 0.002). Lower quadriceps strength (β = 0.051; p = 0.015) and power (β = 0.022; p = 0.022) interacted with lesser self-efficacy to predict worsening stair ascent performance. Strategies to sustain or improve mobility in women with knee osteoarthritis must focus on controlling pain and boosting self-efficacy. In those with worse self-efficacy, developing knee muscle capacity is an important target.
本研究旨在探讨基线股四头肌力量、股四头肌力量、膝关节疼痛和功能任务自我效能及其相互作用,在多大程度上预测膝关节骨关节炎女性 2 年移动性能(行走、上楼梯、下楼梯)的变化。我们假设基线时力量、力量和自我效能较低,疼痛较高,与 2 年内移动能力下降有关,疼痛和自我效能中的每一个都会与力量和力量相互作用预测 2 年爬楼梯能力的变化。这是一项对有临床膝关节骨关节炎的女性进行的纵向观察研究。在基线和随访时,使用六分钟步行测试和上楼梯和下楼梯任务评估移动能力。还在基线时收集了股四头肌力量和力量、膝关节疼痛和功能任务的自我效能。在调整了协变量后,多元线性回归分析了 2 年内移动表现变化在多大程度上由基线力量、力量、疼痛和自我效能来预测。对 37 名患有膝关节骨关节炎的女性进行了 2 年的数据分析。较低的基线自我效能预测行走(β=1.783;p=0.030)和上楼梯(β=-0.054;p<0.001)表现在 2 年内下降。较高的基线疼痛强度/频率预测行走表现下降(β=1.526;p=0.002)。较低的股四头肌力量(β=0.051;p=0.015)和力量(β=0.022;p=0.022)与较低的自我效能相互作用,预测上楼梯表现恶化。在膝关节骨关节炎女性中维持或改善移动性的策略必须侧重于控制疼痛和提高自我效能。对于那些自我效能较低的人来说,发展膝关节肌肉能力是一个重要的目标。