The British Journal of Rheumatology, Vol 37, 1181-1187, Copyright © 1998 by British Society for Rheumatology
MV Hurley and DL Scott
OBJECTIVE: Quadriceps sensorimotor dysfunction may be important in the
pathogenesis of knee osteoarthritis (OA) and a determinant of disability.
Exercise regimes can increase quadriceps strength, but whether this
improves proprioception and reduces disability is uncertain. Moreover,
research regimes involve protracted treatment which is clinically
impracticable. METHODS: We compared quadriceps sensorimotor function and
disability in 60 patients with knee OA, before and after an exercise
regime, with a control group (n = 37) who did not exercise. RESULTS:
Exercise improved quadriceps strength (mean change, 95% CI; 73 N, 26-19 N),
voluntary activation (14%, 5-20%), knee joint position sense (0.6 degrees,
0.1-1.8 degrees), and reduced the Lequesne Index (3.5, 0.5-4) and aggregate
time of four activities of daily living (8.4 s, 0.2-16.7 s). At 6 month
follow-up, these improvements were maintained. The parameters of the
control group were unchanged. CONCLUSIONS: These results substantiate the
association between quadriceps sensorimotor dysfunction and disability,
emphasizing the importance of quadriceps exercise in the management of knee
OA. The regimen is relatively brief and clinically practicable, but could
be adapted to make it more cost effective.
ORIGINAL PAPERS
Improvements in quadriceps sensorimotor function and disability of patients with knee osteoarthritis following a clinically practicable exercise regime
Physiotherapy Division, School of Biomedical Sciences, King's College, London.
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