Recent injury, severe radiographic change, and lower quadriceps strength increase risk of knee pain exacerbation during walking: A within-person knee-matched study

Qiang Liu, Zhikun Li, Manuela Ferreira, Barton Wise, David J. Hunter, Ke Tao, Jianhao Lin, Yuqing Zhang

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To examine the associations of knee injury, radiographic osteoarthritis severity, and quadriceps strength with knee pain exacerbation during walking. DESIGN: Within-person knee-matched case-control study. METHODS: Participants from the Osteoarthritis Initiative who completed a 20-m walking test at the 24-month visit were included. Pain exacerbation was defined as an increase in pain intensity of 1 or more on a numeric rating scale (0 as no pain and 10 as the worst imaginable pain) while completing the 20-m walking test. We used conditional logistic regression to assess the relation of recent knee injury, Kellgren-Lawrence (KL) grade, and quadriceps strength to unilateral knee pain exacerbation during walking. RESULTS: We included 277 people who experienced unilateral knee pain exacerbation during the walking test. Recent knee injury was associated with pain exacerbation during walking, with an odds ratio of 3.4 (95% confidence interval [CI]: 1.3, 9.2). Compared with knees with a KL grade of 0, the odds ratios of pain exacerbation during walking were 1.3 (95% CI: 0.7, 2.7), 3.3 (95% CI: 1.5, 7.1), and 8.1 (95% CI: 3.1, 21.1) for knees with KL grades of 2, 3, and 4, respectively. Painful knees with a deficit in quadriceps strength of greater than or equal to 4% had a 1.4-fold (95% CI: 1.0, 1.9) higher risk of pain exacerbation during walking than their pain-free counterparts. CONCLUSION: Recent knee injury, more severe radiographic osteoarthritis, and lower quadriceps strength were associated with an increased risk of knee pain exacerbation during walking.

Original languageEnglish (US)
Pages (from-to)298-303
Number of pages6
JournalJournal of Orthopaedic and Sports Physical Therapy
Volume51
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • Disability
  • Muscle strength
  • Osteoarthritis
  • Pain
  • Risk factors

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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