ABSTRACT

Background: Osteoarthritis can affect the knee joint most frequently. Muscle imbalance and physical activity limitation are present in early as well as in the moderate degree of knee osteoarthritis.This study aimedto find the effect of knee pain on muscle imbalance and physical limitation in patients with bilateral knee osteoarthritis.

Methodology: A comparative cross-sectional study was conducted at Khyber teaching hospital and Northwest General Hospital, Peshawar. The inclusion criteria were: both gender aged between 50-65 years according to American College of Rheumatology criteria., known patient of bilateral knee osteoarthritis with grade II or greater(Kellgren Lawrence grading scale), pain in both Knees (greater than or equal to 1) on numeric pain rating scale (The differences of pain greater than 1 point on NPRS between both knees). A total of 70 subjects having bilateral knee osteoarthritis were recruited via purposive sampling. The data was collected on the numeric pain rating scale, modified belt stabilizer hand-held dynamometer, active knee extension test, and WOMAC Urdu version questionnaire. The measurements were taken from both knees of each individual to make a comparison. At the same time, the quadriceps muscle strength, hamstring length, and physical limitation were measured.

Results: The mean age of the participants was 55.25± 4.90. The median (IQR) of quadriceps muscle strength in a more painful knee was 0.53 (0.36) while in a less painful knee was 1.35 (0.34). There was a significant difference between the quadriceps strength in a more painful knee and a less painful knee (P<0.01). The Hamstring length of the more painful knee with respect to the median (IQR) was 29.00 (2.00) and the less painful knee was 11.00 (6.00) which shows a significant difference in hamstring length between more and less painful knees (P<0.01). Similarly, there was a significant difference in WOMAC scores between less painful and more painful knees (P<0.01).

Conclusion: This study found that in individuals with bilateral knee osteoarthritis, knee pain was associated with muscle imbalance and physical limitation. Furthermore, A more painful knee had more weak quadriceps muscles, hamstring tightness, and physical limitations.