Patients with early-stage knee osteoarthritis and knee pain have decreased hip abductor muscle strength while descending stairs

Goo

et al. 2021

JPR

Background: Knee osteoarthritis (OA) is a degenerative disease of the joint cartilage with no definite treatment in the early stage. Several previous review studies have shown that alternative medical treatments, including acupuncture, moxibustion, and herbal medicines, are effective in improving the symptoms of the disease and the patient's quality of life. However, no systematic review study has shown the effectiveness of the combination of conventional and alternative therapies. Therefore, the aim of our study is to determine the most effective combination therapies and to provide evidence for the effectiveness and safety of integrated therapies. This article describes the protocol for the methods that will be applied in our systematic review. Methods: We will conduct an electronic search of nine databases: PubMed, Embase, Cochrane, Google Scholar (first 100 articles), four Korean databases (KoreaMed, Korean

Section: Discussionmentioning

confidence: 99%

Traditional Korean Medicine as Collaborating Treatments with Conventional Treatments for Knee Osteoarthritis: A Protocol for a Systematic Review and Meta-Analysis

Goo

et al. 2021

JPR

Evidence-Based Complementary and Alternative Medicine

“…Meta-analysis revealed that KOA patients may adopt kinematic and kinetic alterations during stair climbing, such as increasing hip/trunk flexion angle [ 34 ]. Early-stage KOA patients with knee pain may decrease their hip abductor muscle strength when negotiating stairs [ 35 ]. The results showed that there were little remarkable differences in hip angle and moments between the two groups.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Electroacupuncture on Dynamic Balance during Stair Climbing for Elderly Patients with Knee Osteoarthritis

Hou

Wang

et al. 2020

Background. Poor balance is one of the risk factors for falls in patients with knee osteoarthritis (KOA), which is related to the symptoms. Electroacupuncture (EA) is one of the traditional Chinese conservative methods commonly used to improve the symptoms in patients with KOA. Objective. To assess whether EA increases the dynamic balance during stair negotiation among patients with KOA. Methods. A total of 40 KOA patients were assigned to two groups randomly (true electroacupuncture vs. mock electroacupuncture). Acupoints around the knee were selected in the true electroacupuncture (TEA) group with electrical stimulation (2 Hz). In the mock electroacupuncture (MEA) group, about 2 cm next to the above acupoints, the needles were inserted superficially without electrical stimulation. All the participants received 11 sessions of stimulation treatment in three weeks. The primary outcome was margin of stability (MOS). Secondary outcomes included hip kinematics and kinetics as well as pain. Results. There was no significant difference between the two groups for self-reported pain (p=0.585). During ascent, there was no difference between groups in MOS value in both directions, which was the anterior-posterior (A/P) direction and medial-lateral (M/L) direction at initial contact and toe-off as well as the midstance in the gait cycle, and no difference for the hip kinematics and kinetics between the groups was detected (p>0.05). For descent, at the toe-off event, the TEA group was more unstable as compared to the MEA group in the A/P direction (p=0.029) but not in the M/L direction, and the hip showed a larger internal rotator moment (p=0.049); at the midstance, the TEA group showed a lower abductor moment than the MEA group (p=0.003). Conclusions. Based on the assessment results from the chosen patients with KOA, the TEA did not demonstrate a significant effect in improving the dynamic balance during stair negotiation in comparison with the MEA. This finding does not support EA as a conservative treatment to improve the dynamic balance in such patients.

“…[14][15][16] Additional findings of increased pelvic motion during stair descent 17 are suggested to reflect compensation for reduced knee flexion in order to reach the next step down and to avoid pain. 18 An inverse association has also been found between pelvic motion and knee extension strength. 17 Reduced knee extension strength, a known predictor for functional decline, 19 is a common finding in knee OA, 20 particularly the ability to produce maximal voluntary eccentric force.…”

Section: Introductionmentioning

confidence: 97%

Factors associated with self‐rated difficulty to descend stairs in persons with knee osteoarthritis

Stensdotter

Vårbakken

Roeleveld

2021

PM&R

Background: Difficulty descending stairs is common in persons with knee osteoarthritis (OA). Clinically, it is important to know if and how this is explained by objectively measured difficulty to descend stairs, muscle weakness, pain, fear of movement, or knee joint status.Objective: To identify the potential of these factors to explain self-reported difficulty descending stairs. Design: Cross sectional, case-control. Setting: Hospital outpatient and physiotherapy clinic. Participants: Twenty-eight men and women with knee OA (age 62.2 SD 5.9 years) and 31 controls (age 50.0 SD 8.5 years). Intervention: Not applicable. Main outcome measures: Using multivariate statistics, group comparisons were made for lower extremity kinematics (incorporating hip, knee, and ankle angles) and stance time in stair descent and lower extremity muscle strength. Then, a stepwise linear regression analysis was performed within the OA group to explain self-reported difficulties in stair descent where pain, kinesiophobia, radiographic signs, and outcomes that differed from controls for stair-descent kinematics and muscle strength were independent variables. Results: Multivariate statistics showed that the OA group displayed different allover lower extremity kinematics (F 8,42 = 2.44 p = .029, η 2 = 0.32) and a longer stance time (F 3,50 = 6.46; p = .001, η 2 = 0.28) in stair descent and lower muscle strength (F 7,47 = 2.39; p = .035, η 2 = 0.26) compared to controls. Regression analysis within the OA group to explain self-rated difficulties to descend stairs showed that the strongest association with kinesiophobia (ß = 0.607, p = .001) that combined with pain last week and radiographic signs explained almost 100% (ß = 0.972). Stair descent kinematics and strength variables that differed between groups did not explain self-rated difficulties to descend stairs. Conclusion: Kinesiophobia and pain rather than stair-descent kinematics and reduced muscle-strength explained self-rated difficulties in stair descent in the OA group.