Abstract
BackgroundThe assessment of improvement or maintenance of joint health in healthy subjects is a great challenge. The aim of the study was the evaluation of a joint stress test to assess joint discomfort in subjects with activity-related knee joint discomfort (ArJD).ResultsForty-five subjects were recruited to perform the single-leg-step-down (SLSD) test (15 subjects per group). Subjects with ArJD of the knee (age 22–62 years) were compared to healthy subjects (age 24–59 years) with no knee joint discomfort during daily life sporting activity and to subjects with mild-to-moderate osteoarthritis of the knee joint (OA, Kellgren score 2–3, age 42–64 years). The subjects performed the SLSD test with two different protocols: (I) standardization for knee joint discomfort; (II) standardization for load on the knee joint. In addition, range of motion (ROM), reach test, acute pain at rest and after a single-leg squat and knee injury, and osteoarthritis outcome score (KOOS) were assessed.In OA and ArJD subjects, knee joint discomfort could be reproducibly induced in a short time interval of less than 10 min (200 steps). In healthy subjects, no pain was recorded. A clear differentiation between study groups was observed with the SLSD test (maximal step number) as well as KOOS questionnaire, ROM, and reach test. In addition, a moderate to good intra-class correlation was shown for the investigated outcomes.ConclusionsThese results suggest the SLSD test is a reliable tool for the assessment of knee joint health function in ArJD and OA subjects to study the improvements in their activities. Further, this model can be used as a stress model in intervention studies to study the impact of stress on knee joint health function.
Highlights
The assessment of improvement or maintenance of joint health in healthy subjects is a great challenge
Stress-related joint pain can be caused by anatomical weaknesses, mechanical overload, or unstable joints as a result of earlier ligament injuries
Joint Stress Test/Single-Leg-Step-Down Test The single-leg-step-down (SLSD) test is an unilaterally performed test used in literature as a functional performance test in patients with patellofemoral pain syndrome [12]
Summary
The assessment of improvement or maintenance of joint health in healthy subjects is a great challenge. Joint discomfort and joint overload are a common problem in daily life of athletes, and in daily life of recreationally active people These symptoms can limit mobility and flexibility in healthy people without diagnosed joint diseases, like osteoarthritis (OA) or rheumatoid arthritis. Stress-related joint pain can be caused by anatomical weaknesses (e.g., unequal leg length, bandy legs, small patella), mechanical overload, or unstable joints as a result of earlier ligament injuries. In such cases, the homeostasis of cartilage building and cartilage degradation processes loses balance under load and discomfort occurs for a certain period. These conditions and symptoms occur long before manifestation of a disease like osteoarthritis [4, 5]
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