Introduction: Osteoarthritis (OA) is the most common musculoskeletal disorder among the elderly population. Quadriceps muscle weakness is one of the biological factors that may contribute to knee pain. There was only limited evidence that higher quadriceps strength may improve knee pain. This study investigates whether quadriceps strengthening improves pain, joint stability, and quality of life (QOL) in OA patients.
Materials and methodology: Prospective study was done among the outpatients visiting the orthopaedic department, Velammal Medical College Hospital & Research Institute, Madurai, Tamil Nadu, India. The study period is between 1st October 2020 and 1st January 2021. We had 340 OA knee patients in the age-group <65 years who met the inclusion criteria as the study participants. Patients were randomly assigned to two groups A and B by card method. Group A is the case group, and group B is the control group. The patients allocated in the case group underwent isometric exercise (isometric hip adduction, isometric quadriceps exercise, and straight leg raise exercise) along with pharmacotherapy and lifestyle modification advices. The control group only had pharmacotherapy and lifestyle modification advices. The Knee Injury and Osteoarthritis Outcome Scale (KOOS) scale was used to measure the outcome.
Results: Unpaired t-test was used to compare between two groups, reduction in pain intensity (0.001**), improvement in QOL (0.001**), and improvement in joint stability (0.001**) in the isometric exercise group at the end of the 8th week were significantly greater than those of the control group (p < 0.05).
Conclusion: The 8-week isometric quadriceps exercise program showed beneficial effects on pain, QOL, and joint stability in patients with OA of the knee.
Sharma MK, Swami HM, Bhatia V, et al. An epidemiological study of correlates of osteo-arthritis in geriatric population of UT Chandigarh. Indian J Community Med 2007;32(1):77–78. DOI: 10.4103/0970-0218.53414
Lee J, Chang RW, Ehrlich-Jones L, et al. Sedentary behavior and physical function: objective evidence from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 2015;67(3):366–373. DOI: 10.1002/acr.22432
Hurley MV. The role of muscle weakness in the pathogenesis of osteoarthritis. Rheum Dis Clin North Am 1999;25(2):283–298. DOI: 10.1016/s0889-857x(05)70068-5
Segal NA, Torner JC, Felson D, et al. Effect of thigh strength on incident radiographic and symptomatic knee osteoarthritis in a longitudinal cohort. Arthritis Rheum 2009;61(9):1210–1217. DOI: 10.1002/art.24541
Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008;16(2):137–162. DOI: 1016/j.joca.2007.12.013
Roos EM, Roos H, Lohmander LS et al. Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 1998;28(2):88–96. DOI: 10.2519/jospt.19220.127.116.11
Messier SP, Legault C, Loeser RF, et al. Does high weight loss in older adults with knee osteoarthritis affect bone-on-bone joint loads and muscle forces during walking? Osteoarthritis Cartilage 2011;19(3):272–280. DOI: 10.1016/j.joca.2010.11.010
Ettinger WH Jr, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA 1997;277(1):25–31. DOI: 10.1001/jama.1997.03540250033028
Deyle GD, Henderson NE, Matekel RL, et al. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A randomized, controlled trial. Ann Intern Med 2000;132(3):173–181. DOI: 10.7326/0003-4819-132-3-200002010-00002
Falconer J, Hayes KW, Chang RW. Effect of ultrasound on mobility in osteoarthritis of the knee. A randomized clinical trial. Arthritis Care Res 1992;5(1):29–35. DOI: 10.1002/art.1790050108
Fisher NM, Gresham G, Pendergast DR. Effects of a quantitative progressive rehabilitation program applied unilaterally to the osteoarthritic knee. Arch Phys Med Rehabil 1993;74(12):1319–1326. DOI: 10.1016/0003-9993(93)90087-q