Recent Injury, Severe Radiographic Change, and Lower Quadriceps Strength Increase Risk of Knee Pain Exacerbation During Walking: A Within-Person Knee-Matched Study.

Abstract

OBJECTIVE:

To examine the associations of knee injury, radiographic osteoarthritis severity, and quadriceps strength with knee pain exacerbation during walking.

DESIGN:

Within-person knee-matched case-control study.

METHODS:

Participants from the Osteoarthritis Initiative who completed a 20-m walking test at the 24-month visit were included. Pain exacerbation was defined as an increase in pain intensity of 1 or more on a numeric rating scale (0 as no pain and 10 as the worst imaginable pain) while completing the 20-m walking test. We used conditional logistic regression to assess the relation of recent knee injury, Kellgren-Lawrence (KL) grade, and quadriceps strength to unilateral knee pain exacerbation during walking.

RESULTS:

We included 277 people who experienced unilateral knee pain exacerbation during the walking test. Recent knee injury was associated with pain exacerbation during walking, with an odds ratio of 3.4 (95% confidence interval [CI]: 1.3, 9.2). Compared with knees with a KL grade of 0, the odds ratios of pain exacerbation during walking were 1.3 (95% CI: 0.7, 2.7), 3.3 (95% CI: 1.5, 7.1), and 8.1 (95% CI: 3.1, 21.1) for knees with KL grades of 2, 3, and 4, respectively. Painful knees with a deficit in quadriceps strength of greater than or equal to 4% had a 1.4-fold (95% CI: 1.0, 1.9) higher risk of pain exacerbation during walking than their pain-free counterparts.

CONCLUSION:

Recent knee injury, more severe radiographic osteoarthritis, and lower quadriceps strength were associated with an increased risk of knee pain exacerbation during walking. J Orthop Sports Phys Ther 2021;51(6):298-304. Epub 10 May 2021. doi:10.2519/jospt.2021.9735.

• Authors: Qiang Liu, Zhikun Li, Manuela Ferreira, Barton Wise, David J Hunter, Ke Tao, Jianhao Lin, Yuqing Zhang
• Journal: The Journal of orthopaedic and sports physical therapy (J Orthop Sports Phys Ther) Vol. 51 Issue 6 Pg. 298-304 (06 2021) ISSN: 1938-1344 [Electronic] United States
• PMID: 33971732 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Arthralgia (diagnostic imaging, physiopathology)
• Case-Control Studies
• Female
• Humans
• Knee Injuries (diagnostic imaging, physiopathology)
• Longitudinal Studies
• Male
• Middle Aged
• Muscle Strength (physiology)
• Osteoarthritis, Knee (diagnostic imaging, physiopathology)
• Quadriceps Muscle (physiopathology)
• Radiography
• Walk Test
• Walking (physiology)