Abstract
OBJECTIVES:To analyze the effects of motor learning on knee extension-flexion isokinetic performance in knee osteoarthritis patients.METHODS:One hundred and thirty-six middle-aged and older sedentary individuals (111 women, 64.3±9.9 years) with knee osteoarthritis (130 patients with bilateral) and who had never performed isokinetic testing underwent two bilateral knee extension-flexion (concentric-concentric) isokinetic evaluations (5 repetitions) at 60°/sec. The tests were first performed on the dominant leg with 2 min of recovery between test, and following a standardized warm-up that included 3 submaximal isokinetic repetitions. The same procedure was repeated on the non-dominant leg. The peak torque, peak torque adjusted for the body weight, total work, coefficient of variation and agonist/antagonist ratio were compared between tests.RESULTS:Patients showed significant improvements in test 2 compared to test 1, including higher levels of peak torque, peak torque adjusted for body weight and total work, as well as lower coefficients of variation. The agonist/antagonist relationship did not significantly change between tests. No significant differences were found between the right and left legs for all variables.CONCLUSION:The results suggest that performing two tests with a short recovery (2 min) between them could be used to reduce motor learning effects on clinical isokinetic testing of the knee joint in knee osteoarthritis patients.
Highlights
Osteoarthritis (OA) of the knee is a highly prevalent agerelated clinical condition that is associated with joint pain, decreased physical functioning and independence, and loss of muscle strength and power [1,2,3,4]
Studies analyzing the reliability of isokinetic testing in older subjects have shown intraclass correlation coefficients (ICCs) that vary from 0.29 to 0.99 [11,12,13,14], suggesting that it may not be reliable in this population
Because of the limited joint painrelated muscular performance commonly found in knee OA patients [7, 16], the use of two isokinetic assessments with a short period of recovery between tests (2 min) would not have a motor learning effect in the present study
Summary
Osteoarthritis (OA) of the knee is a highly prevalent agerelated clinical condition that is associated with joint pain, decreased physical functioning and independence, and loss of muscle strength and power [1,2,3,4]. Muscle strength plays an important protective role in the progression of knee OA [5,6,7], and it is inversely associated with physical function in this population [2, 3, 8]. The poor motor performance ability commonly found in older individuals is a possible explanation for the large variation in ICC, which should be considered in isokinetic dynamometry protocols for older subjects [9, 11, 15]. It has been suggested that the use of a singlesession isokinetic testing protocol, as commonly used in young individuals, may not be adequate for older people [11,12,13]
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