Article

Objective: To test whether knee stabilization therapy, prior to
strength/functional training, may have added value in reducing activity
limitations only in patients with knee osteoarthritis who have knee instability
and (i) low upper leg muscle strength, (ii) impaired knee proprioception, (iii)
high knee laxity, or (iv) frequent episodes of knee instability. Design: Subgroup
analyses in a randomized controlled trial comparing 2 exercise programmes
(with/without knee stabilization therapy) (STABILITY; NTR1475). Patients:
Participants from the STABILITY-trial with clinical knee osteoarthritis and knee
instability (n = 159). Methods: Effect modification by upper leg muscle strength,
knee proprioception, knee laxity, and patient-reported knee instability were
determined using the interaction terms "treatment group*subgroup factor", with
the outcome measures WOMAC physical function (primary), numeric rating scale pain
and the Get up and Go test (secondary). Results: Effect modification by muscle
strength was found for the primary outcome (p = 0.01), indicating that patients
with greater muscle strength tend to benefit more from the experimental programme
with additional knee stabilization training, while patients with lower muscle
strength benefit more from the control programme. Conclusion: Knee stabilization
therapy may have added value in patients with instability and strong muscles.
Thus it may be beneficial if exercises target muscle strength prior to knee
stabilization.

Langue : ANGLAIS