Abstract
Deficits in maximal and explosive knee extensor strength, which are usually assessed with unilateral tasks, are substantial in patients with knee osteoarthritis (KOA). The aim of this study was to investigate the clinical relevance of unilateral vs. bilateral tasks for assessing knee extensor strength in patients with KOA. This was achieved primarily by comparing unilateral and bilateral inter-limb strength asymmetries and secondarily by examining the relationship between unilaterally and bilaterally measured strength, and performance-based and self-reported function. Twenty-four patients with unilateral KOA (mean age: 65 ± 7 years) performed isometric gradual and explosive maximal voluntary contractions to assess, respectively their maximal and explosive strength. Performance-based and self-reported function were also evaluated with standard functional tests and questionnaires, respectively. Inter-limb asymmetries of maximal and explosive strength did not differ significantly between unilateral (mean asymmetry: 26 ± 15%) and bilateral tasks (22 ± 21%). In the same way, the relationships between knee extensor strength—measured either unilaterally or bilaterally—and performance-based or self-reported function were not influenced by the type of task. In conclusion, it does not seem to make a difference in terms of clinical relevance whether maximal and explosive knee extensor strength are evaluated with unilateral or bilateral tasks in KOA patients.
Highlights
It does not seem to make a difference in terms of clinical relevance whether maximal and explosive knee extensor strength are evaluated with unilateral or bilateral tasks in knee osteoarthritis (KOA) patients
maximal voluntary contractions (MVC) torque and rate of torque development (RTD) values compared to the uninvolved side (p < 0.001)
Inter-limb asymmetries did not differ significantly between unilateral and bilateral tasks (p > 0.05), and no differences were observed between the different strength outcomes (p > 0.05)
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Knee osteoarthritis (KOA) is the most frequent musculoskeletal condition in older individuals [1]. KOA has a global prevalence of 23% among individuals aged > 40 years (~654 million individuals had KOA worldwide in 2020) and a pooled global incidence of 203 per 10,000 person-years in individuals aged > 20 years [2]. Patients with KOA are characterized by low levels of physical functioning in comparison to age- and sexmatched controls [3] due to a combination of joint pain, stiffness, and lower limb muscle weakness [3,4]. Knee extensor strength is universally considered to be an important determinant of physical function in subjects with KOA [5]
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