Huang Chun-Hao, Segal Neil A, Felson David T, Sherman David A, Lewis Cara L, Bacon Kathryn L, Lynch John, Lewis Cora E, Stefanik Joshua
C.H. Huang, PhD, Northeastern University, Department of Physical Therapy, Movement & Rehabilitation Sciences, Boston, MA; Georgia State University, Department of Kinesiology and Health, Atlanta, GA.
N.A. Segal, MD, University of Kansas Medical Center, Department of Physical Medicine & Rehabilitation, Kansas, KS; University of Iowa, Department of Epidemiology, Iowa, IA.
J Rheumatol. 2025 Sep 15. doi: 10.3899/jrheum.2025-0621.
Knee extensor power declines rapidly with aging and may contribute to knee pain. We evaluated the relationship between knee extensor power and changes in knee pain over 2 years in adults with or at risk for knee osteoarthritis (OA).
We used data from the Multicenter Osteoarthritis Study. Knee extensor power was measured at baseline using isotonic contractions at 40% of one-repetition maximum. Pain severity (Western Ontario and McMaster Universities Osteoarthritis Index; WOMAC) and frequent knee pain (FKP; pain on most days in the past 30 days) were assessed at baseline, 8, 16, and 24 months in each knee. We examined the association between baseline sex-specific quartiles of knee extensor power and two outcomes-worsening WOMAC pain and incident FKP-using logistic regression with generalized estimating equations to account for within-subject correlations between knees.
Compared to the strongest quartile, the weakest quartile of knee extensor power had 1.35 (95% CI: 0.98-1.86; p for linear trend = 0.04) times the odds of worsening knee pain severity and 1.93 (95% CI: 1.22-3.05; p for linear trend < 0.05) times the odds of incident FKP.
Lower knee extensor power may be a risk factor for both worsening knee pain severity and the development of frequent knee pain in adults with or at risk for knee OA. Interventions targeting knee extensor power may reduce the risk for incident and progressive knee pain.
膝关节伸肌力量会随着年龄增长而迅速下降,这可能会导致膝关节疼痛。我们评估了膝关节伸肌力量与膝关节骨关节炎(OA)患者或有患膝关节OA风险的成年人在2年内膝关节疼痛变化之间的关系。
我们使用了多中心骨关节炎研究的数据。在基线时,通过等张收缩以一次重复最大值的40%来测量膝关节伸肌力量。在基线、8个月、16个月和24个月时,对每个膝关节评估疼痛严重程度(西安大略和麦克马斯特大学骨关节炎指数;WOMAC)和频繁膝关节疼痛(FKP;过去30天中大多数日子疼痛)。我们使用广义估计方程的逻辑回归来检验膝关节伸肌力量按性别划分的基线四分位数与两个结果(WOMAC疼痛加重和新发FKP)之间的关联,以考虑膝关节之间的受试者内相关性。
与最强的四分位数相比,膝关节伸肌力量最弱的四分位数出现膝关节疼痛严重程度加重的几率是其1.35倍(95%置信区间:0.98 - 1.86;线性趋势p = 0.04),新发FKP的几率是其1.93倍(95%置信区间:1.22 - 3.05;线性趋势p < 0.05)。
较低的膝关节伸肌力量可能是膝关节OA患者或有患膝关节OA风险的成年人膝关节疼痛严重程度加重和频繁膝关节疼痛发生的危险因素。针对膝关节伸肌力量的干预措施可能会降低新发和进行性膝关节疼痛的风险。