Alshahrani Mastour Saeed, Reddy Ravi Shankar
Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia.
Diagnostics (Basel). 2023 Oct 1;13(19):3110. doi: 10.3390/diagnostics13193110.
Bilateral knee osteoarthritis (OA) poses significant challenges to individuals' functional abilities, including quadriceps strength, postural stability, and pain perception. Understanding the complex relationships among these factors is crucial for enhancing knee OA management strategies. The primary objective of this research is to evaluate and draw comparisons between the strength of the quadriceps and the level of postural stability in two distinct groups: individuals afflicted with bilateral knee OA and those who are healthy. Furthermore, the study seeks to examine the potential correlation between the strength of the quadriceps and the level of postural stability in individuals with knee OA. In addition to this, an investigation into the potential mediating effect of pain on the relationship between these physiological factors will also be conducted. A total of 95 participants with bilateral knee OA and 95 healthy controls were recruited. Quadriceps strength was assessed using dynamometry and postural stability was evaluated through anterior-posterior and medial-lateral sway measurements along with the ellipse area using a force plate. Pain levels were measured using the Visual Analog Scale (VAS). Mediation analysis was employed to explore the role of pain in mediating the relationship between quadriceps strength and postural stability. Statistical analyses included t-tests, Pearson correlation coefficients, and mediation analysis. Knee OA participants exhibited significantly lower quadriceps strength (1.08 Nm/kg ± 0.54) compared to controls (1.54 Nm/kg ± 0.57, < 0.001). They also demonstrated compromised postural stability with increased anterior-posterior sway (9.86 mm ± 3.017 vs. 2.98 mm ± 1.12, < 0.001), medial-lateral sway (7.87 mm ± 2.23 vs. 3.12 mm ± 1.34, < 0.001), and larger ellipse area (935.75 mm ± 172.56 vs. 436.19 mm ± 135.48, < 0.001). Negative correlations were observed between quadriceps strength and postural stability variables (r = from -0.43 to -0.51, < 0.001). Pain significantly mediated the relationship between quadriceps strength and postural stability variables ( < 0.05). This study highlights the associations between quadriceps strength, postural stability, and pain mediation in individuals with bilateral knee OA. Our findings emphasize the need for targeted interventions addressing quadriceps weakness and compromised postural stability. Additionally, the mediation effect of pain underscores the complexity of these relationships, offering insights for more effective management strategies.
双侧膝关节骨关节炎（OA）对个体的功能能力构成重大挑战，包括股四头肌力量、姿势稳定性和疼痛感知。了解这些因素之间的复杂关系对于加强膝关节OA管理策略至关重要。本研究的主要目的是评估并比较两个不同组别的股四头肌力量和姿势稳定水平：患有双侧膝关节OA的个体和健康个体。此外，该研究旨在探讨膝关节OA患者股四头肌力量与姿势稳定水平之间的潜在相关性。除此之外，还将对疼痛在这些生理因素之间关系中的潜在中介作用进行调查。总共招募了95名双侧膝关节OA患者和95名健康对照者。使用测力计评估股四头肌力量，并通过使用测力板测量前后和内外侧摆动以及椭圆面积来评估姿势稳定性。使用视觉模拟量表（VAS）测量疼痛水平。采用中介分析来探讨疼痛在股四头肌力量与姿势稳定性之间关系中的作用。统计分析包括t检验、Pearson相关系数和中介分析。与对照组（1.54 Nm/kg±0.57，<0.001）相比，膝关节OA患者的股四头肌力量显著更低（1.08 Nm/kg±0.54）。他们还表现出姿势稳定性受损，前后摆动增加（9.86 mm±3.017对2.98 mm±1.12，<0.001），内外侧摆动增加（7.87 mm±2.23对3.12 mm±1.34，<0.001），以及椭圆面积更大（935.75 mm±172.56对436.19 mm±135.48，<0.001）。在股四头肌力量与姿势稳定性变量之间观察到负相关（r = -0.43至-0.51，<0.001）。疼痛显著中介了股四头肌力量与姿势稳定性变量之间的关系（<0.05）。本研究强调了双侧膝关节OA患者股四头肌力量、姿势稳定性和疼痛中介之间的关联。我们的研究结果强调了针对股四头肌无力和姿势稳定性受损进行有针对性干预的必要性。此外，疼痛的中介作用凸显了这些关系的复杂性，为更有效的管理策略提供了见解。
