title: Is Pain in One Knee Associated with Isometric Muscle Strength in the Contralateral Limb?: Data From the Osteoarthritis Initiative.
abstract: OBJECTIVE
  Knee pain and muscle weakness confer risk for knee osteoarthritis incidence and progression. The purpose of this study was to determine whether unilateral knee pain influences contralateral thigh muscle strength.
  
  
  METHODS
  Of 4796 Osteoarthritis Initiative participants, 224 (mean ± SD age, 63.9 ± 8.9 yrs) cases could be matched to a control. Cases were defined as having unilateral knee pain (numerical rating scale, ≥ 4/10; ≥infrequent pain) and one pain-free knee (numerical rating scale, 0-1; ≤infrequent pain; Western Ontario and McMaster Universities Arthritis Index, ≤ 1). Controls were defined as having bilaterally pain-free knees (numerical rating scale, 0-1; ≤infrequent pain; Western Ontario and McMaster Universities Arthritis Index, ≤ 1). Maximal isometric muscle strength (N) was compared between limbs in participants with unilateral pain (cases) as well as between pain-free limbs of cases and controls.
  
  
  RESULTS
  Knee extensor/flexor strength in pain-free limbs of the cases was lower than that in bilaterally pain-free controls (-5.5%/-8.4%; P = 0.043/P = 0.022). Within the cases, maximum extensor/flexor strength was significantly lower in the painful limb than in the pain-free limb (-6.3%/4.1%; P < 0.0001/P = 0.015).
  
  
  CONCLUSIONS
  These results suggest that strength in limbs without knee pain is associated with the pain status of the contralateral knee. The strength difference between unilateral pain-free cases and matched bilateral pain-free controls was similar to that between limbs in persons with unilateral knee pain. Lower strength caused by contralateral knee pain might be centrally mediated.
authors.affiliation: From the Institute of Anatomy, Paracelsus Medical University, Department Salzburg, Austria (ES-K, WW, AR, SC, FE); Department of Orthopaedics & Rehabilitation, University of Iowa, Iowa City, Iowa (NAG); and Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas (NAS).
authors.forename: Eva
authors.initials: E
authors.lastname: Steidle-Kloc
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wirth
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Glass
authors.forename: Anja
authors.initials: A
authors.lastname: Ruhdorfer
authors.forename: Sebastian
authors.initials: S
authors.lastname: Cotofana
authors.forename: Felix
authors.initials: F
authors.lastname: Eckstein
authors.forename: Neil A
authors.initials: NA
authors.lastname: Segal
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000503:physiopathology*; D013848:Thigh / Q000503:physiopathology*