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Lower Limb Strength Asymmetry is Associated With Stair Ambulatory Pain in Individuals With or at Risk for Knee
Carson Halliwell1,2,3, Ryan Matthews1, Anne Doan1
1School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, B3H 4R2, Canada.
Objective:
To determine whether self-reported pain during stair ambulation was associated with inter-limb strength asymmetry and hamstring-quadriceps ratios (HQR).
Design:
4086 participants with or at risk for tibiofemoral knee osteoarthritis were selected from the Osteoarthritis Initiative. Participants were grouped by self-reported pain severity during stair ambulation; right limb pain (RPG), left limb pain (LPG), or equal pain bilaterally (EPG). One-way analyses of covariance tested between-groups differences in knee extensor and flexor strength, symmetry index (SI) and bilateral HQR.
Results:
RPG participants had significantly lower right knee extensor (P<0.001) and flexor (P<0.001) strength, and knee extensor (P<0.001) and flexor (P<0.001) SI, compared to the EPG. LPG participants had significantly lower left knee extensor (P<0.001) and flexor (P<0.001) strength, and significantly higher extensor (P<0.001) and flexor (P<0.001) SI, compared to the EPG. No significant differences in HQR were observed in the RPG (P=0.820; P=0.743) or LPG (P=0.11; P=0.601), when compared to the EPG.
Conclusion:
Self-reported knee pain during stair ambulation was significantly associated with ipsilateral strength deficits and muscle strength asymmetry. These findings suggest that asymmetrical self-reported knee pain may be related to underlying strength imbalances in individuals with knee osteoarthritis and warrant further investigation regarding its potential clinical relevance.
