Effects of isokinetic muscle strengthening on balance, proprioception, and physical function in bilateral knee osteoarthritis patients with moderate fall risk

Abstract

Objectives: This study aims to assess the effects of isokinetic quadriceps and hamstring strengthening exercises on balance, proprioception, and physical function in patients with moderate-to-severe knee osteoarthritis and moderate fall risk. Patients and methods: Between November 2011 and December 2012, a total of 39 participants (30 females, 9 males; mean age 61.7±8.6 years; range, 18 to 79 years) with Grade 2 or 3 knee osteoarthritis according to the Kellgren-Lawrence radiographic grading system and moderate risk of fall with active knee pain were included in this study. All participants received isokinetic quadriceps and hamstring strengthening exercises for six weeks. Pre-treatment quadriceps and hamstring muscle strength (peak torque and total work value) and quadriceps to hamstring muscle strength ratio at angular velocities of 60°/sec and 180°/sec, range of motion (ROM), average proprioceptive errors at 15-45° and 30-60°, the Berg Balance Scale (BBS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscale scores, the Visual Analog Scale (VAS) scores, and physical function tests results were compared with the post-treatment results. The correlations of pre-and post-treatment BBS and average proprioceptive error at 15-45° and 30-60° changes to other pre-and post-treatment clinical measurements changes were calculated. Results: Post-treatment quadriceps and hamstring muscle strength at angular velocities of 60°/sec and 180°/sec and quadriceps to hamstring muscle strength ratios at angular velocity of 60°/sec, ROM, average proprioceptive errors at 15-45° and 30-60°, BBS scores, WOMAC subscale scores, VAS scores, and physical function tests significantly improved compared to the pre-treatment results (p<0.001). Statistically significant correlations were found between the pre-and post-treatment BBS score changes and pre-and post-treatment VAS (p=0.015), WOMAC-Pain (p=0.017), WOMAC-Physical Function (p=0.005) scores and Timed Up and Go Test (p=0.036) scores. Conclusion: Inclusion of isokinetic quadriceps and hamstring strengthening exercises into the rehabilitation programs for the patients with knee osteoarthritis may improve the quality of life and contribute to the decreased risk of fall.

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“…Osteoarthritis (OA) is a major cause of musculoskeletal disability worldwide, which is associated with significant loss of work and a high socioeconomic burden ( 1 ). The prevalence of symptomatic OA is as high as 5-7% in the adult population worldwide ( 2 ). As one of the typical ‘wear and tear’ diseases, OA is primarily caused by articular cartilage damage or loss ( 3 , 4 ).…”

Wireless Motion Sensors—Useful in Assessing the Effectiveness of Physiotherapeutic Methods Used in Patients with Knee Osteoarthritis—Preliminary Report

“…The literature search yielded no studies citing the use of this parameter in relation to specific disease entities. We employed the described methods in clinical practice because OAK patients develop a number of undesirable anatomical changes that negatively affect the knee joint position sense [27,40,41] and cause pain [21,26] and functional deficits [2,3,7,12,30]. Therefore, based on available data from other studies [27,42], we determined that the treatment algorithm for OAK patients should include therapeutic procedures that improve joint position sense and overall function while reducing pain intensity.…”

“…Still, it is not known whether other therapy techniques, which do not necessarily require active patient participation and last less than four weeks in duration, could also have a significantly positive impact on knee JPS. This matter is crucial because, in the clinical practice, the time required to achieve the desired therapeutic outcome determines the overall therapeutic success, understood as a global function of the patient [30].…”

Potential Benefits of a Selective Region High-frequency Diathermy with Therapeutic Exercises on Older Persons with Degenerative Knee Osteoarthritis

“…This effect is especially more prominently reduced, as pain of the quadriceps muscle increases [39], hence, the improvement of this pain is important for enhancing balance. In addition, the increase of both quadriceps and hamstring muscle strength signi cantly enhances the dynamic balance and decreases the risk of falling [40], while the decrease of the hamstring muscle's exibility induces the imbalance of main muscles [41]. Physical balance can be, therefore, maintained only after the exibility of the hamstring muscles is enhanced.…”