Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits

Aderson Loureiro,Maria Constantinou,Rod Barrett,Laura E Diamond,Belinda Beck

doi:10.1186/s12891-018-2230-4

Abstract

BackgroundIndividuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. However, the extent and pattern of muscle weakness, including any between-limb asymmetries, in early stages of the disease are unclear. This study compared hip and knee muscle strength and volumes between individuals with mild-to-moderate symptomatic and radiographic hip OA and a healthy control group.MethodsNineteen individuals with mild-to-moderate symptomatic and radiographic hip OA (n = 12 unilateral; n = 7 bilateral) and 23 age-matched, healthy controls without radiographic hip OA or hip pain participated. Isometric strength of the hip and knee flexors and extensors, and hip abductors and adductors were measured. Hip and thigh muscle volumes were measured from lower limb magnetic resonance images. A full-factorial, two-way General Linear Model was used to assess differences between groups and between limbs.ResultsParticipants in the hip OA group demonstrated significantly lower knee flexor, knee extensor, hip flexor, hip extensor and hip abductor strength compared to controls and had significantly lower volume of the adductor, hamstring and quadriceps groups, and gluteus maximus and gluteus minimus muscles, but not tensor fasciae latae or gluteus medius muscles. There were no between-limb strength differences or volume differences within either group.ConclusionsAtrophic, bilateral hip and knee muscle weakness is a feature of individuals with mild-to-moderate hip OA. Early interventions to target muscle weakness and prevent the development of strength asymmetries that are characteristic of advanced hip OA appear warranted.

Highlights

Individuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA and control groups than males (hip OA)
Deficits in hip abduction and internal rotation strength of the affected leg compared to healthy controls were noted and suggest that muscle weakness could be a feature of earlier stages of the disease than previously reported
Participants in the hip OA group had a higher Body mass index (BMI) than participants in the control group (p < 0.01) (Table 1)

Summary

Introduction

Individuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. Deficits in hip abduction and internal rotation strength of the affected leg compared to healthy controls were noted and suggest that muscle weakness could be a feature of earlier stages of the disease than previously reported. It remains unclear whether muscle weakness and atrophy that precede advanced stages of the disease extend beyond the abductor muscle group of the affected leg to other prime movers (i.e. quadriceps, hamstrings, adductors) within the most affected leg or the contralateral leg. An improved understanding of whether muscle weakness and atrophy in mild-to-moderate hip OA is generalized or specific to certain muscles or muscle groups in the lower extremity is required to appropriately inform and optimise management programs

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