Quadriceps Strength as a Predictor of Knee Osteoarthritis Progression
Notice bibliographique
Résumé
Objective To determine whether quadriceps strength is associated with tibiofemoral osteoarthritis progression in persons with knee osteoarthritis. The association was examined particularly in malaligned knees and high-laxity knees. Design Cohort study. Setting Academic medical center in Chicago, Illinois. Participants Participants for a natural history study (Mechanical Factors in Arthritis of the Knee) were recruited through periodicals, organizations, and medical center referrals. Inclusion criteria were osteophyte presence in 1 or both knees and difficulty with ≥2 items in the Western Ontario and McMaster University osteoarthritis index physical function scale. Exclusion criteria were corticosteroid injection within 3 months, inflammatory arthritis, comorbidity in the lower limb, and replacement or planned replacement of the arthritic knee(s). Of 237 participants, 230 were followed for 18 months, and 171 (mean age, 64 years; 74% women) who did not have advanced osteoarthritis at baseline (Kellgren and Lawrence grade 4) were included in the analysis (328 knees). Assessment of risk factors Baseline measurements were obtained for both knees. Isokinetic quadriceps strength (maximal torque during movement) was assessed by means of a computer-driven isokinetic dynamometer. Alignment was measured on a single anterior radiograph of both lower extremities. A knee was considered malaligned if the angle of the intersection of the line between the centers of the femoral head and inter-condylar notch and the line between the centers of the ankle talus and tibial spines was 5° or more. High varus-valgus laxity (the sum of varus and valgus rotation for each knee measured at the foot) was defined as knees in the highest tertile (≥5.75°). Main outcome measures The main outcome measure was tibiofemoral osteoarthritis progression (an increase in the grade of joint space narrowing) determined radiographically at baseline and 18 months. Main results The predicted probability of arthritis progression, after adjustment for baseline age, body mass index, disease severity, and physical activity, was slightly greater in knees with greater quadriceps strength (>47.3 ft-lb) compared with lesser quadriceps strength (0.153 vs. 0.098; P = 0.09). In logistic regression, strength was associated with an increase in predicted probability of disease progression in malaligned knees (n = 78; high strength, 0.406. vs. low strength, 0.187; P = 0.03), but not in neutrally aligned knees (n = 250; P > 0.2). High strength in the knees with high laxity (≥5.75°; n = 110) and in knees with the greatest laxity (≥6.75°; n = 70) was associated with a greater probability of arthritis progression (P = 0.05 and P = 0.003, respectively). Conclusions Quadriceps strength was not found to be beneficial in reducing the progression of tibiofemoral knee osteoarthritis in older adults. Quadriceps strength was predictive of more severe arthritis progression in malaligned knees and in knees with high laxity.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».