Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of System Design Engineering, Keio University, Yokohama, Japan.
Clin Rheumatol. 2018 Nov;37(11):3115-3123. doi: 10.1007/s10067-018-4229-5. Epub 2018 Aug 8.
This study aimed to develop a self-questionnaire index relevant to lower limb functional assessment reflecting clinical symptoms and activity restrictions associated with activities of daily living (ADL) for patients with knee osteoarthritis. This cross-sectional study enrolled patients with knee osteoarthritis (Kellgren/Lawrence grade ≥ 1). Participants evaluated clinical symptoms and activity restrictions using self-reported questionnaires. Radiographic evaluation, knee joint range of motion (ROM), and lower limb muscle strength were assessed. Associations between clinical symptoms, activity restrictions, and knee and hip joint function were evaluated using multiple and logistic regression analysis. Overall, 142 participants were included in the final analysis. Patients with knee pain while rising from a chair had lower knee and hip extension strength (knee extension β = - 0.28; 95% confidence interval (CI), - 0.41 to - 0.14; P < 0.0001; hip extension β = - 0.26; 95% CI, - 0.42 to - 0.08; P = 0.0034), and restricted knee extension ROM (odds ratio [OR] = 2.17; 95% CI, 1.02-4.63; P = 0.041). Patients with knee pain during stair climbing, turning or who were unable to stand on one leg without external support had reduced hip abduction muscle strength (β = - 0.17; 95% CI, - 0.27 to - 0.07; P = 0.0008). Patients with knee pain while rising from a chair or stepping showed more severe knee joint degeneration on radiographic evaluation (OR = 3.26; 95% CI, 1.11-10.91; P = 0.03). The self-questionnaire index reflected clinical symptoms and activity restrictions associated with ADL and was significantly associated with lower limb function in individuals with knee osteoarthritis.
本研究旨在开发一个与膝关节骨关节炎患者下肢功能评估相关的自我问卷指标，该指标反映了与日常生活活动（ADL）相关的临床症状和活动受限。这是一项横断面研究，纳入了膝关节骨关节炎（Kellgren/Lawrence 分级≥1 级）患者。参与者使用自我报告问卷评估临床症状和活动受限。进行放射学评估、膝关节活动范围（ROM）和下肢肌肉力量评估。使用多元和逻辑回归分析评估临床症状、活动受限与膝关节和髋关节功能之间的关系。共有 142 名参与者纳入最终分析。从椅子上起身时膝盖疼痛的患者膝关节和髋关节伸展力量较弱（膝关节伸展β= -0.28；95%置信区间（CI），-0.41 至 -0.14；P<0.0001；髋关节伸展β= -0.26；95%CI，-0.42 至 -0.08；P=0.0034），膝关节伸展 ROM 受限（比值比（OR）=2.17；95%CI，1.02-4.63；P=0.041）。在爬楼梯、转弯或无法单腿站立而无外部支撑时膝盖疼痛的患者髋关节外展肌肉力量减弱（β= -0.17；95%CI，-0.27 至 -0.07；P=0.0008）。从椅子上起身或跨步时膝盖疼痛的患者在放射学评估中显示出更严重的膝关节退变（OR=3.26；95%CI，1.11-10.91；P=0.03）。自我问卷指标反映了与 ADL 相关的临床症状和活动受限，与膝关节骨关节炎患者的下肢功能显著相关。
