Group of Physiotherapy of the Ageing Process, Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag no. 5, 46010 Valencia, Spain.
Group of Physiotherapy of the Ageing Process, Social and Healthcare Strategies, Departament de Fisioteràpia, Universitat de València, Calle Gascó Oliag no. 5, 46010 Valencia, Spain; Hospital Universitari i Politècnic La Fe, València, Spain.
Knee. 2020 Dec;27(6):1795-1800. doi: 10.1016/j.knee.2020.09.021. Epub 2020 Nov 13.
Loss of knee extensor strength in individuals with knee osteoarthritis (KOA) may induce inter-limb strength asymmetries and alter functionality. The aims were to analyse whether the condition of the uninvolved knee (advanced to severe KOA or no affection) may induce different degrees of knee extensor strength asymmetry in individuals with KOA and to study whether functionality may differ in cases of unilateral or bilateral KOA.
Sixty-eight subjects with advance-to-severe KOA were categorized into two groups (unilateral or bilateral KOA). The knee extensor strength ratio (KESR), and self-reported and performance-based functionality were analysed and compared. Sex and age were independent factors. One- and two-way analysis of variance assessed for significant between-group differences (95% confidence interval (CI)).
Participants with unilateral KOA presented with 20% knee extensor strength asymmetry. The mean difference with the bilateral KOA group in terms of Knee Extensors Strength Ratio was 0.2 (95% CI 0-0.3; P = 0.021), of the Oxford Knee Scale score was 4.2 (95% CI 3.4-5.1; P = 0.037), and of the Timed Up and Go was 1.3 s (95% CI 0.5-2.2; P > 0.05). There were significant sex and age interactions (P < 0.05).
Individuals with unilateral or bilateral KOA present with different degrees of knee extensor strength asymmetry. The non-affected knee seems to help to better develop functional tasks in cases of unilateral condition. The findings may help the design of tailored strengthening interventions in which each knee condition in individuals with KOA should be considered.
膝骨关节炎（KOA）患者的膝关节伸肌力量丧失可能导致肢体间力量不对称，并改变其功能。本研究旨在分析未受累膝关节（进展至重度 KOA 或无病变）是否会引起 KOA 患者不同程度的膝关节伸肌力量不对称，并研究单侧或双侧 KOA 患者的功能是否存在差异。
将 68 例进展至重度 KOA 的患者分为两组（单侧或双侧 KOA）。分析并比较了膝关节伸肌力量比（KESR）以及自我报告和基于表现的功能。性别和年龄是独立因素。使用单因素和双因素方差分析评估组间差异的显著性（95%置信区间（CI））。
单侧 KOA 患者的膝关节伸肌力量出现 20%的不对称。在膝关节伸肌力量比方面，双侧 KOA 组与单侧 KOA 组的平均差值为 0.2（95%CI 0-0.3；P=0.021），在牛津膝关节量表评分方面的差值为 4.2（95%CI 3.4-5.1；P=0.037），在计时起立行走测试方面的差值为 1.3 秒（95%CI 0.5-2.2；P>0.05）。存在显著的性别和年龄交互作用（P<0.05）。
单侧或双侧 KOA 患者存在不同程度的膝关节伸肌力量不对称。在单侧情况下，未受累的膝关节似乎有助于更好地完成功能任务。这些发现有助于设计针对个体化的强化干预措施，应考虑 KOA 患者中每个膝关节的状况。
