Dataset Information

Baseline and longitudinal change in isometric muscle strength prior to radiographic progression in osteoarthritic and pre-osteoarthritic knees--data from the Osteoarthritis Initiative.

ABSTRACT: OBJECTIVE:To test whether cross-sectional or longitudinal measures of thigh muscle isometric strength differ between knees with and without subsequent radiographic progression of knee osteoarthritis (KOA), with particular focus on pre-osteoarthritic female knees (knees with risk factors but without definite radiographic KOA). METHODS:Of 4,796 Osteoarthritis Initiative participants, 2,835 knees with Kellgren Lawrence grade (KLG) 0-3 had central X-ray readings, annual quantitative joint space width (JSW) and isometric muscle strength measurements (Good strength chair). Separate slope analysis of covariance (ANCOVA) models were used to determine differences in strength between "progressor" and "non-progressor" knees, after adjusting for age, body mass index, and pain. RESULTS:466 participant knees exceeded the smallest detectable JSW change during each of two observation intervals (year 2?4 and year 1?3) and were classified as progressors (213 women, 253 men; 128 KLG0/1, 330 KLG2/3); 946 participant knees did not exceed this threshold in either interval and were classified as non-progressors (588 women, 358 from men; 288KLG0/1, 658KLG2/3). Female progressor knees, including those with KLG0/1, tended to have lower extensor and flexor strength at year 2 and at baseline than those without progression, but the difference was not significant after adjusting for confounders. No significant difference was observed in longitudinal change of muscle strength (baseline?year 2) prior to radiographic progression. No significant differences were found for muscle strength in men, and none for change in strength concomitant with progression. CONCLUSION:This study provides no strong evidence that (changes in) isometric muscle strength precedes or is associated with structural (radiographic) progression of KOA.

SUBMITTER: Eckstein F

PROVIDER: S-EPMC3624032 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Baseline and longitudinal change in isometric muscle strength prior to radiographic progression in osteoarthritic and pre-osteoarthritic knees--data from the Osteoarthritis Initiative.

Eckstein F F Hitzl W W Duryea J J Kent Kwoh C C Wirth W W

Osteoarthritis and cartilage 20130306 5

<h4>Objective</h4>To test whether cross-sectional or longitudinal measures of thigh muscle isometric strength differ between knees with and without subsequent radiographic progression of knee osteoarthritis (KOA), with particular focus on pre-osteoarthritic female knees (knees with risk factors but without definite radiographic KOA).<h4>Methods</h4>Of 4,796 Osteoarthritis Initiative participants, 2,835 knees with Kellgren Lawrence grade (KLG) 0-3 had central X-ray readings, annual quantitative j ...[more]

PMID: 23473978

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Project description:BackgroundMuscle force testing is one of the more common categories of diagnostic tests used in clinical practice. Clinicians have little evidence to guide interpretations of muscle force tests when pain is elicited during testing.ObjectiveThe purpose of this study was to examine the construct validity of isometric quadriceps muscle strength tests by determining whether the relationship between maximal isometric quadriceps muscle strength and functional status was influenced by pain during isometric testing.DesignA cross-sectional design was used.MethodsData from the Osteoarthritis Initiative were used to identify 1,344 people with unilateral knee pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale scores of 1 or higher on the involved side. Measurements of maximal isometric quadriceps strength and ratings of pain during isometric testing were collected. Outcome variables were WOMAC physical function subscale, 20-m walk test, 400-m walk test, and a repeated chair stand test. Multiple regression models were used to determine whether pain during testing modified or confounded the relationship between strength and functional status.ResultsPearson r correlations among the isometric quadriceps strength measures and the 4 outcome measures ranged from -.36 (95% confidence interval=-.41, -.31) for repeated chair stands to .36 (95% confidence interval=.31, .41) for the 20-m walk test. In the final analyses, neither effect modification nor confounding was found for the repeated chair stand test, the 20-m walk test, the 400-m walk test, or the WOMAC physical function subscale. Moderate or severe pain during testing was weakly associated with reduced strength, but mild pain was not.LimitationsThe disease spectrum was skewed toward mild or moderate symptoms, and the pain measurement scale used during muscle force testing was not ideal.ConclusionsGiven that the spectrum of the sample was skewed toward mild or moderate symptoms and disease, the data suggest that isometric quadriceps muscle strength tests maintain their relationship with self-report or performance-based disability measures even when pain is elicited during testing.

Project description:ObjectiveTo explore whether subregional laminar femorotibial cartilage spin-spin relaxation time (T2) is associated with subsequent radiographic progression and cartilage loss and/or whether one-year change in subregional laminar femorotibial cartilage T2 is associated with concurrent progression in knees with established radiographic OA (ROA).MethodsIn this case-control study, Osteoarthritis Initiative (OAI) knees with medial femorotibial progression were selected based on one-year loss in both quantitative cartilage thickness Magnetic resonance imaging (MRI) and radiographic joint space width (JSW). Non-progressor knees were matched by sex, Body mass index (BMI), baseline Kellgren-Lawrence-grade (2/3), and pain. Baseline and one-year follow-up superficial and deep cartilage T2 was analyzed in 16 femorotibial subregions using multi-echo spin-echo MRI.Results37 knees showed medial femorotibial progression whereas 37 matched controls had no medial or lateral compartment progression. No statistically significant baseline differences between progressor and non-progressor knees in medial femorotibial cartilage T2 were observed in the superficial (48.9 ± 3.0 ms; 95% CI: [47.9, 49.9] vs 47.8 ± 3.6 ms; 95% CI: [46.6, 49.0], P = 0.07) or deep cartilage layer (40.8 ± 3.6 ms; 95% CI: [39.5, 42.0] vs 40.1 ± 4.7 ms; 95% CI: [38.5, 41.6], P = 0.29). Concurrent T2 change was more pronounced in the deep than the superficial cartilage layer. In the medial femorotibial compartment (MFTC), longitudinal change was greater in the deep layer of progressor than non-progressor knees (1.8 ± 4.5 ms; 95% CI: [0.3, 3.3] vs -0.2 ± 1.9 ms; 95% CI: [-0.8, 0.5], P = 0.02), whereas no difference was observed in the superficial layer.ConclusionMedial compartment cartilage T2 did not appear to be a strong prognostic factor for subsequent structural progression in the same compartment of knees with established ROA, when appropriately controlling for covariates. Yet, deep layer T2 change in the medial compartment occurred concurrent with medial femorotibial progression.

Project description:OBJECTIVE:To determine whether thigh muscle strength predicts the risk of undergoing knee replacement surgery, independent of radiographic severity of osteoarthritis and pain. METHODS:Participants in the Osteoarthritis Initiative study who had received a knee replacement between the 12-month and 60-month follow-up visits (cases) were each matched with 1 control subject (who did not receive a knee replacement over 60 months) for age, sex, height, body mass index, baseline radiographic stage, and location of joint space narrowing. Isometric knee extensor and flexor strength was recorded biennially. The strength examination prior to knee replacement (?2 years) was termed time 0, that 2 years prior to time 0 was termed time -2, and that 4 years prior to time 0 was termed time -4. Muscle strength in patients and controls was compared using paired t-tests and conditional logistic regression analysis adjusted for pain. RESULTS:One hundred thirty-six participants (60% women, mean?±?SD age 65?±?9 years, body mass index 29?±?4 kg/m(2) ) received a knee replacement during follow-up, had strength data for at least time 0, and had a matched control. Knee extensor strength at time 0 (primary outcome measure) was significantly lower in female patients compared with controls (P < 0.001, pain-adjusted odds ratio [ORadj ] 1.72, 95% confidence interval 1.16-2.56), but no significant difference was observed in men. Results were similar for knee flexor strength at time 0 and for longitudinal change in extensor and flexor strength between time -2 and time 0. Thigh muscle strength at time -2 or time -4, or change between time -4 and time -2, did not predict the risk of undergoing knee replacement surgery in men or women. CONCLUSION:Thigh muscle strength predicted the risk of undergoing knee replacement surgery in women, but not in men. The results of this study may identify a window during which the risk of undergoing knee replacement surgery in women can be modified.

Project description:To examine whether the quantity of cartilage or semiquantitative scores actually differ in knees with mild radiographic osteoarthritis compared with knees without osteoarthritis.Framingham Osteoarthritis Study participants had knee tibiofemoral magnetic resonance imaging-based measurements of cartilage. Using three-dimensional FLASH-water excitation sequences, cartilage volume, thickness and subregional cartilage thickness were measured and cartilage scored semiquantitatively (using the whole-organ magnetic resonance imaging score; WORMS). Using weight-bearing radiographs, mild osteoarthritis was defined as Kellgren/Lawrence (K/L) grade 2 and non-osteoarthritis as K/L grade 0. Differences between osteoarthritis and non-osteoarthritis knees in median cartilage measurements were tested using the Wilcoxon rank sum test.Among 948 participants (one knee each), neither cartilage volume nor regional thickness were different in mild versus non-osteoarthritis knees. In mild osteoarthritis, cartilage erosions in focal areas were missed when cartilage was quantified over large regions such as the medial tibia. For some but not all subregions of cartilage, especially among men, cartilage thickness was lower (p<0.05) in mild osteoarthritis than non-osteoarthritis knees. Because semiquantitative scores captured focal erosions, median WORMS scores were higher in mild osteoarthritis than non-osteoarthritis (all p<0.05). In moderate/severe osteoarthritis (K/L grades 3 or 4), osteoarthritis knees had much lower cartilage thickness and higher WORMS scores than knees without osteoarthritis.In mild osteoarthritis, the focal loss of cartilage is missed by quantitative measures of cartilage volume or thickness over broad areas. Regional cartilage volume and thickness (eg, medial tibia) are not different in mild osteoarthritis versus non-osteoarthritis. Subregional thickness may be decreased in mild osteoarthritis. Semiquantitative scoring that assesses focal cartilage damage differentiates mild osteoarthritis from non-osteoarthritis.

Dataset Information

Baseline and longitudinal change in isometric muscle strength prior to radiographic progression in osteoarthritic and pre-osteoarthritic knees--data from the Osteoarthritis Initiative.

Publications

Baseline and longitudinal change in isometric muscle strength prior to radiographic progression in osteoarthritic and pre-osteoarthritic knees--data from the Osteoarthritis Initiative.

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