Pain and its relationship with muscle strength and proprioception in knee OA: Results of an 8-week home exercise pilot study

N. Shakoor (1), S. Furmanov (1), D.E. Nelson (2), Y. Li (3), J.A. Block (1)

(1) Section of Rheumatology, Rush Medical College of Rush University Medical Center, Chicago, IL, USA;
(2) Department of Nursing, Rush Medical College of Rush University Medical Center, Chicago, IL,USA;
(3) Rush Institute for Healthy Aging, Rush Medical College of Rush University Medical Center, Chicago, IL, USA

Abstract
Muscle strength and proprioception deficits have been recognized in knee OA. Pain is the symptomatic hallmark of knee OA. Indirect evidence suggests that muscle strength and proprioception deficits may be interrelated and that pain may have a confounding influence on the measurement of these factors in knee OA. However, these relationships have never been clearly evaluated. Therefore, the purpose of this investigation was to investigate relationships between pain, muscle strength, and proprioception in subjects with knee OA before and after an 8-week home exercise program. This study evaluated thirty-eight subjects with knee OA. Subjects were taught standard quadriceps strengthening exercises that were to be performed daily at home. Pain, muscle strength, and proprioceptive function were measured at baseline and after 8 weeks of therapy. Significant improvements in pain (42%, p<0.001) and quadriceps muscle strength (30%, p<0.001) were noted. Significant indirect associations were observed between pain and both muscle strength (rho=-0.39, p=0.01) and proprioceptive acuity (rho=-0.35, p=0.03) at baseline. Changes in pain were directly associated with changes in muscle strength (rho=0.45, p=0.005) and proprioceptive acuity (rho=0.41, p=0.01) with exercise. The association of pain with both muscle strength and proprioception should prompt future studies to consider and adjust for the influence of pain on neuromuscular factors in knee OA.

Keywords: Osteoarthritis, Exercise, Pain, Muscle Strength, Proprioception