Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee.

OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee

OBJECTIVES: To evaluate the difference in isokinetic strength of hip muscles between patients with knee osteoarthritis (OA) and matched healthy controls, and to establish the correlation between this isokinetic strength and pain and function in patients with knee OA. METHODS: 25 patients with a diagnosis of unilateral knee OA, 25 patients with bilateral knee OA, and 50 matched controls were evaluated using the visual analog scale for pain, knee Lequesne index, Western Ontario and McMaster Universities questionnaire and an isokinetic test. RESULTS: The groups were matched for age, gender and body mass index. The results of the isokinetic test revealed lower peak torque of the hip in patients with OA of the knee than in the control group for all movements studied. Strong correlations were found between the peak torque, visual analog scale and function. CONCLUSIONS: Patients with OA of the knee exhibit lower isokinetic strength in the hip muscles than healthy control subjects. Strengthening the muscles surrounding the hip joint may help to decrease pain in people with knee OA. Some correlations between pain/function and peak torque were found.

Energy expenditure during cane-assisted gait in patients with knee osteoarthritis

OBJECTIVE: To compare the energy expenditure in patients with unilateral knee osteoarthritis while walking with canes of different lengths. METHODS: A quasi-experimental study (single-group) was carried out on thirty patients with unilateral knee osteoarthritis. An adjustable aluminum cane was used, and three different cane lengths were determined for each subject: C1 - length from the floor to the greater trochanter; C2 - length from the floor to the distal wrist crease; and C3 - length obtained by the formula: height x 0.45 + 0.87 m. Resting and walking heart rates were measured with a Polar hear rate meter. Walking speed was calculated by the time required for the patient to walk 10 m. Gait energy cost was estimated using the physiological cost index, and results were compared. RESULTS: The sample consisted of 25 women and five men (average age of 68 years). Statistically significant differences in physiological cost index measurements were observed between unassisted walking and assisted walking with a cane of any length (p<0.001), as well as between walking with a C2-length cane and unassisted walking, and walking with a C1-length cane and walking with a C3-length cane (p=0.001; p = 0.037; p=0.001; respectively). CONCLUSION: These data demonstrate that small alterations in the length of canes used for weight-bearing ambulation in patients with unilateral knee osteoarthritis increase the energy expenditure measured by the physiological cost index during walking. Further studies are needed for a more precise quantification of the increase in energy expenditure during cane-assisted gait and an assessment of the effectiveness of cane use in relieving pain and improving function in patients with knee osteoarthritis.

Qualidade de vida em pacientes com fraturas por osteoporose: adaptação cultural, reprodutibilidade e validação do Osteoporosis Assessment Questionnaire / Quality of life in patients with osteoporosis fractures: cultural adaptation, applicability and validity of the Osteoporosis Assessment Questionnaire

Objetivo: A proposta deste estudo foi traduzir para o português o OPAQ (Osteoporosis Assessment Questionnaire) e avaliar sua reprodutibilidade e validade. Pacientes e métodos: O OPAQ foi traduzido para o português. A primeira versão foi retraduzida para o inglês por um professor de língua inglesa. Essa versão foi comparada com a versão original e uma segunda versão em português foi gerada. O OPAQ foi aplicado a 30 pacientes com osteoporose lombar sem fraturas, acompanhadas no ambulatório da Disciplina de Reumatologia, Unifesp/EPM, de janeiro de 1995 a abril de 1997. As questões não aplicáveis foram modificadas e o OPAQ modificado foi aplicado novamente. A versão final em português foi então definida. A reprodutibilidade da versão em português do OPAQ foi testada em 30 pacientes ambulatoriais com osteoporose. O questionário foi aplicado três vezes às pacientes. As pacientes também foram clinicamente avaliadas usando-se HAQ (Health Assessment Questionnaire), FIQ (Fybromialgia Impact Questionnaire) e escala numérica de dor (NRS). A densidade óssea da coluna e o número de fraturas foram avaliados em todas as pacientes. Resultados: A média de idade foi 69 anos (54-89 anos) e a média do número de fraturas foi de 2,72 mais ou menos 1,68. Vinte e uma pacientes (70 por cento) tinham mais que uma fratura vertebral. Todos os componentes, com exceção do humor (c16), apresentaram coeficiente estatisticamente significante para reprodutibilidade. O escore mais elevado foi observado no medo de cair (6,70). A correlação entre os componentes do OPAQ e o número de fraturas, densidade óssea e escore z não foi estatisticamente significante. Conclusões: O OPAQ é um instrumento reprodutível e válido. Outros aspectos, que não densidade ósssea e número de fraturas, têm influência importante na qualidade de vida dos pacientes com osteoporose e fraturas