Research Evidence in Practice on Knee Osteoarthritis & Hip Muscle Weakness - Nursing Assignment Help

Assignment Task

Hinman, Hunt, Creaby et al., (2010) research article statesknee osteoarthritis (OA) sometimes develops in older people causing pain, disability, and muscle weakness. Researchers found that weakness of hip muscles could correlate with knee OA, affecting their functions, and leading to developing a disease in the medial tibiofemoral of the knee. In this condition, strengthening exercises can help alleviate pain in the knee. However, it is not known whether the medial knee OA group or asymptomatic control group determines hip muscle weakness. Researchers aim to evaluate the strength of hip muscles in individuals with symptomatic medial knee OA, as it is considered that individuals with this condition show more weakness in their hip muscles compared to asymptomatic individuals.

From the community, 89 knee OA participants and 23 control participants above 50 years old were recruited. Participants needed to have at least one OA knee with pain level >3 on a numerical rating scale, whereas the control participants cannot show symptoms of pain in the hip, knee, or back for ≤6 months. Inclusion criteria required were medial compartment joint space narrowing and knee alignment <182o on a semi-flexed posteroanterior radiograph.

Measurements that were undertaken were muscle strength and OA-related knee pain and physical dysfunction test. In muscle strength, all hip muscles (abductors/adductors, internal/external rotators, flexors/extensors) were measured from the maximal effort test using the formula ‘Torque (Nm) x Resistance lever arm (m)’, to work out strength relative to body mass (Nm/kg) using a hand-held dynamometer (HHD). The abduction/adduction HHDs were placed distally on the medial and lateral femoral, the flexion HHDs placed proximally on the patella, and internal/external rotation HHDs placed proximally on malleoli. A force transducer and transducer inclinometer were used for hip extension. This test has shown reliable results in determing the strength of hip musculatures in both symptomatic and asymptomatic participants.

Data were collected from a baseline assessment clinical trial where knee OA participants assessed their hip strength. Symptomatic and asymptomatic participants undertook a strength test where all hip movements were measured. Three trials of maximal effort were done, with 5 seconds duration and 15 seconds rest, where the maximum force output (N) converted to torque (Nm). The formula ‘Torque (Nm) x Resistance lever arm (m)’ were utilized to get the strength to body mass results. Adduction/abduction were measured in the supine position, stabilizing the pelvis and contralateral extremity, using the HHD distally to the medial and lateral femoral. Flexion and internal/external rotation were also measured in a supine position, but with the knees and hips flexed at 90 o with the HHD placed proximally to both the patella and malleoli,respectively. Hip extension participants were stabilized in the supine position with extremities supported by a padded cuff and raised off the plinth. A force transducer was used along with the transducer inclinometer, where the participants' hip flexed ~20 o perpendicular to the force transducer.

This study reveals that hip musculature is weaker in people with knee OA than those with asymptomatic control. Researchers found that gait patterns are developed in individuals with knee OA, which could result in hip muscle weakness. This reinforces the fact that participants with knee OA depict hip muscle weakness which supports the hypothesis, and it is shown that hip strengthening exercises can strengthen and improve pain and physical function.

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