Effect of baseline quadriceps activation on changes in quadriceps strength after exercise therapy in subjects with knee osteoarthritis.
OBJECTIVE
To examine whether pretreatment magnitude of quadriceps activation (QA) helps predict changes in quadriceps strength after exercise therapy in subjects with knee osteoarthritis (OA). We hypothesized that subjects with lower magnitudes of QA (greater failure of muscle activation) would have smaller gains in strength compared with those with higher magnitudes of QA following exercise therapy.


METHODS
One hundred eleven subjects with knee OA (70 women) participated. Baseline measures included demographic information, quadriceps muscle strength, and QA using a burst-superimposition isometric torque test. Following baseline testing, subjects underwent a 6-week supervised exercise program designed to improve strength, range of motion, balance and agility, and physical function. On completion of the program, quadriceps strength and QA were reassessed. Multiple regression analysis was used to determine whether baseline QA predicted quadriceps strength scores at the 2-month followup.


RESULTS
Bivariate correlations demonstrated that baseline QA was significantly associated with quadriceps strength at baseline (rho = 0.30, P < 0.01) and 2-month followup (rho = 0.23, P = 0.01). Greater magnitude of baseline QA correlated with higher strength. While controlling for baseline quadriceps strength and type of exercise therapy, the level of QA did not predict quadriceps strength at the 2-month followup (beta = -0.04, P = 0.18).


CONCLUSIONS
Baseline QA did not predict changes in quadriceps strength following exercise therapy. Measurement of QA using the central activation ratio method does not appear to be helpful in identifying subjects with knee OA who will have difficulty improving quadriceps strength with exercise therapy.
Scopaz
Kristen A
KA
University of Pittsburgh, Pittsburgh, PA, USA.
Piva
Sara R
SR
Gil
Alexandra B
AB
Woollard
Jason D
JD
Oddis
Chester V
CV
Fitzgerald
G Kelley
GK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D052097:Quadriceps Muscle / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D012044:Regression Analysis; D019415:Torque; D016896:Treatment Outcome