Department of Sports Medicine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
Sports Medicine Center, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 6 West Sec, Chia-Pu Road, Putz city, Chiayi, 613, Taiwan.
BMC Geriatr. 2018 Oct 17;18(1):245. doi: 10.1186/s12877-018-0932-y.
Patients with knee osteoarthritis (OA) were reported to have quadriceps weakness, and impaired proprioception, both related to pain and swelling. It is unclear whether pain alone a causal factor to above findings over the knee joint. The purpose of this study was to assess the effects of knee pain alone on the quadriceps strength, proprioception and dynamic balance in subjects with bilateral knee OA without joint swelling.
Fourty females with mean age of 68.3 years were involved in this cross-sectional study. The inclusion criteria were bilateral knee OA without joint swelling, with a visual analogue pain scale difference (> 1) between each knee. Patients all underwent assessment of the isokinetic strength of knee muscles, knee proprioceptive acuity, and dynamic balance.
Patients' more painful knee had weaker isokinetic quadriceps strength than less painful knee at both 60 °/s and 180 °/s (p = 0.01, p = 0.01, respectively). There were no differences in proprioceptive acuity between both knees in all three knee positions. Meanwhile, there was a significant difference in the dynamic balance index measurement between both knees (more painful versus less painful: 3.88 ± 1.15 vs. 3.30 ± 1.00, p = 0.01). Quadriceps strength was associated with dynamic balance stability (60 °/s, r = - 0.578, p < 0.01; 180 °/s, r = - 0.439, p < 0.01).
For patients with knee OA, the more painful knee was associated with weaker quadriceps and poor balance ability. To improve lower limb function and balance stability of the older persons having knee OA, physicians should take the optimal pain management strategy.
膝骨关节炎（OA）患者被报道存在股四头肌无力和本体感觉受损，这两者均与疼痛和肿胀有关。目前尚不清楚疼痛本身是否是膝关节以上发现的因果因素。本研究旨在评估膝关节单纯疼痛对双侧膝骨关节炎且无关节肿胀患者的股四头肌力量、本体感觉和动态平衡的影响。
本横断面研究共纳入 40 名平均年龄为 68.3 岁的女性。纳入标准为双侧膝骨关节炎且无关节肿胀，每侧膝关节的视觉模拟疼痛评分差值（>1）。所有患者均接受了膝关节肌肉等速力量、膝关节本体感觉敏锐度和动态平衡评估。
在 60°/s 和 180°/s 时，患者较痛的膝关节的等速股四头肌力量均弱于较不痛的膝关节（p=0.01，p=0.01）。在所有三个膝关节位置，两侧膝关节的本体感觉敏锐度均无差异。同时，两侧膝关节的动态平衡指数测量值存在显著差异（较痛膝关节：3.88±1.15；较不痛膝关节：3.30±1.00，p=0.01）。股四头肌力量与动态平衡稳定性相关（60°/s，r=-0.578，p<0.01；180°/s，r=-0.439，p<0.01）。
对于膝骨关节炎患者，较痛的膝关节与股四头肌无力和平衡能力较差相关。为改善膝骨关节炎老年患者的下肢功能和平衡稳定性，医生应采取最佳的疼痛管理策略。
