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Lower Quadriceps Rate of Force Development Is Associated With Worsening Physical Function in Adults With or at Risk for Knee Osteoarthritis: 36-Month Follow-Up Data From the Osteoarthritis Initiative
Authors:Bo Hu  Søren Thorgaard Skou  Barton L. Wise  Glenn N. Williams  Michael C. Nevitt  Neil A. Segal
Affiliation:1. Department of Rehabilitation Medicine, The University of Kansas, Kansas City, KS;2. School of Public Health and Hebei Province Key Laboratory of Occupational Health and Safety for Coal Industry, North China University of Science and Technology, Tangshan, Hebei Province, China;3. Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark;4. Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark;5. University of California, Davis School of Medicine, Sacramento, CA;6. Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, PA;g. Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA
Abstract:

Objective

To determine the association between quadriceps rate of force development (RFD) and decline in self-reported physical function and objective measures of physical performance.

Design

Longitudinal cohort study.

Setting

Community-based sample from 4 urban areas.

Participants

Osteoarthritis Initiative participants with or at risk for knee osteoarthritis, who had no history of knee/hip replacement, knee injury, or rheumatoid arthritis (N=2630).

Interventions

Not applicable.

Main Outcome Measures

Quadriceps RFD (N/s) was measured during isometric strength testing. Worsening physical function was defined as the minimal clinically important difference for worsening self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale score, 20-m walk time, and repeated chair stand time over 36 months.

Results

Compared with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an odds ratio (OR) of .68 (95% confidence interval [CI], .51–.92) after adjustment for age, sex, body mass index, depression, history of chronic diseases, and knee pain. In women, in comparison with the slowest tertile of RFD, the fastest tertile had a lower risk for worsening of WOMAC physical function subscale score at 36-month follow-up, with an adjusted OR of .57 (95% CI, .38–.86). This decreased risk did not reach statistical significance in men (OR, 0.81; 95% CI, 0.52–1.27). No statistically significant associations were detected between baseline RFD and walk or chair stand times.

Conclusions

Our results indicate that higher RFD is associated with decreased risk for worsening self-reported physical function but not with decreased risk for worsening of physical performance.
Keywords:Knee  Muscle Strength  Osteoarthritis  Quadriceps muscle  Rehabilitation  Sports Medicine  BMI  body mass index  CI  confidence interval  MCID  minimal clinically important difference  OA  osteoarthritis  OAI  Osteoarthritis Initiative  OR  odds ratio  RFD  rate of force development  RM  repetition maximum  WOMAC  Western Ontario and McMaster Universities Osteoarthritis Index
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