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股四头肌力发展率与膝关节骨关节炎患者或高危人群的身体功能恶化相关:来自骨关节炎倡议的 36 个月随访数据。

Lower Quadriceps Rate of Force Development Is Associated With Worsening Physical Function in Adults With or at Risk for Knee Osteoarthritis: 36-Month Follow-Up Data From the Osteoarthritis Initiative.

机构信息

Department of Rehabilitation Medicine, The University of Kansas, Kansas City, KS; School of Public Health and Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei Province, China.

Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark.

出版信息

Arch Phys Med Rehabil. 2018 Jul;99(7):1352-1359. doi: 10.1016/j.apmr.2017.12.027. Epub 2018 Jan 31.

Abstract

OBJECTIVE

To determine the association between quadriceps rate of force development (RFD) and decline in self-reported physical function and objective measures of physical performance.

DESIGN

Longitudinal cohort study.

SETTING

Community-based sample from 4 urban areas.

PARTICIPANTS

Osteoarthritis Initiative participants with or at risk for knee osteoarthritis, who had no history of knee/hip replacement, knee injury, or rheumatoid arthritis (N=2630).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Quadriceps RFD (N/s) was measured during isometric strength testing. Worsening physical function was defined as the minimal clinically important difference for worsening self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale score, 20-m walk time, and repeated chair stand time over 36 months.

RESULTS

Compared with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an odds ratio (OR) of .68 (95% confidence interval [CI], .51-.92) after adjustment for age, sex, body mass index, depression, history of chronic diseases, and knee pain. In women, in comparison with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an adjusted OR of .57 (95% CI, .38-.86). This decreased risk did not reach statistical significance in men (OR, 0.81; 95% CI, 0.52-1.27). No statistically significant associations were detected between baseline RFD and walk or chair stand times.

CONCLUSIONS

Our results indicate that higher RFD is associated with decreased risk for worsening self-reported physical function but not with decreased risk for worsening of physical performance.

摘要

目的

确定股四头肌力量发展速率(RFD)与自我报告的身体功能下降和身体表现客观测量之间的关系。

设计

纵向队列研究。

地点

来自 4 个城市的社区样本。

参与者

有或有膝关节骨关节炎风险的骨关节炎倡议参与者,无膝关节/髋关节置换、膝关节损伤或类风湿关节炎史(N=2630)。

干预措施

不适用。

主要观察指标

在等速力量测试中测量股四头肌 RFD(N/s)。身体功能恶化定义为自我报告的西安大略和麦克马斯特大学骨关节炎指数(WOMAC)身体功能子量表评分、20 米步行时间和 36 个月内重复坐立时间恶化的最小临床重要差异。

结果

与 RFD 最慢三分位相比,最快三分位在 36 个月随访时 WOMAC 身体功能子量表评分恶化的风险较低,调整年龄、性别、体重指数、抑郁、慢性疾病史和膝关节疼痛后,比值比(OR)为 0.68(95%置信区间 [CI],0.51-0.92)。在女性中,与 RFD 最慢三分位相比,最快三分位在 36 个月随访时 WOMAC 身体功能子量表评分恶化的风险较低,调整后的 OR 为 0.57(95% CI,0.38-0.86)。在男性中,这种风险降低没有达到统计学意义(OR,0.81;95% CI,0.52-1.27)。在基线 RFD 与步行或坐立时间之间未检测到统计学显著相关性。

结论

我们的结果表明,较高的 RFD 与自我报告的身体功能恶化风险降低相关,但与身体表现恶化风险降低无关。

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