Test-retest reliability of quadriceps muscle function outcomes in patients with knee osteoarthritis

Quadriceps muscle weakness and the underlying neuromuscular deficits have been increasingly studied over the last few years in patients with knee osteoarthritis, but the applied methodologies have never been validated for this specific population. The aim of this study was to investigate test-retest reliability of several quadriceps muscle function outcomes in patients with knee osteoarthritis both before and after knee arthroplasty surgery. Ten preoperative and 20 postoperative patients participated in two identical testing sessions. A series of voluntary and/or electrically stimulated contractions of the involved quadriceps with concomitant torque and electromyographic recordings were used to characterize muscle strength, muscle activation and muscle contraction properties. Vastus lateralis morphology (thickness and fascicle pennation angle) was also assessed using ultrasonography. Overall, good reliability scores were observed for the majority of the 13 assessed variables (nine variables with intraclass correlation coefficients >0.75, 12 variables with coefficients of variation <15%). The most reliable testing protocol for patients with knee osteoarthritis would entail the assessment of (1) isometric maximal voluntary torque for evaluating muscle strength, with (2) simultaneous vastus lateralis electromyographic activity for evaluating muscle activation, (3) potentiated (resting) doublet peak torque for evaluating muscle contractility, and (4) vastus lateralis thickness for evaluating muscle size.