Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
The Effects of Hip Muscle Training on Knee Joint Loading in Medial Knee Osteoarthritis.
Daher1, Julia, Block2, Joel A., Wimmer1, Markus, Sumner1, Dale R., Thorp3, Laura E.
The purpose of this investigation was to analyze the effects of a focused hip muscle training program on knee joint loading in subjects with medial compartment knee OA. Specifically, we hypothesized that focused hip musculature training in individuals with mild to moderate knee OA would produce favorable changes in dynamic loading of the medial knee during walking, as evidenced by decreased external knee adduction moments.
To date, 12 subjects with mild to moderate medial compartment knee OA ranging in age from 3569 years of age completed the study protocol. Subjects underwent gait analysis at their self-selected normal walking speed and both the peak external knee adduction moment and the knee adduction angular impulse were calculated before and after participation in a 4-week supervised, physical therapy intervention targeted at the hip abductor musculature. Response to treatment was defined as a reduction in either parameter. Additionally, subjects wore an accelerometer-based activity monitor for 7 days after the baseline visit.
8 of the 12 subjects responded to therapy. For these subjects, the mean percent decreases in the peak external knee adduction moment were -9.6 ± 8.7% and -12.4 ± 7.7% for index and contralateral knees respectively. In the index and contralateral knees, the mean percent decreases in knee adduction angular impulse were -7.1 ± 3.8% and -22.0 ± 8.3% respectively. The magnitude of change in the responders was greater in the contralateral knee than in the index knee. The responders tended to be more active than the non-responders, though this difference was not significant. Nonetheless, when non-responders were included in the analysis, there were no significant changes in either peak adduction moment or adduction angular impulse.
The discrepancy between responders and non-responders is unexplained, though may relate to activity and/or adherence. While more subjects are needed to determine the efficacy of hip muscle training on joint loads in medial compartment knee OA, these preliminary results suggest hip muscle training may have use in prevention of contralateral disease development. It is possible that this type of intervention may be best suited for more active individuals.
To cite this abstract, please use the following information:
Daher, Julia, Block, Joel A., Wimmer, Markus, Sumner, Dale R., Thorp, Laura E.; The Effects of Hip Muscle Training on Knee Joint Loading in Medial Knee Osteoarthritis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :200