Volume 7, Issue 3 (2022)                   IJMPP 2022, 7(3): 741-749 | Back to browse issues page

Research code: 78942
Ethics code: IR.MODARES.REC.1398.094


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Hosseini I, Najafi Ashtiani M N, Bahrpeyma F. Correlation between the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Scores and the Stability Metrics in Patients with Knee Osteoarthritis. IJMPP. 2022; 7 (3) :741-749
URL: http://ijmpp.modares.ac.ir/article-32-60103-en.html
1- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran , mnashtiani@modares.ac.ir
Abstract:   (144 Views)
Aims: The aim of the present study was to assess the correlation between the stability metrics related to the center of pressure excursion measurements and the WOMAC questionnaire scores.
Method and Materials: Fourteen patients with moderate knee osteoarthritis and fourteen healthy age-matched individuals were participated to stand with open and closed eyes, and on firm and rocking support on a force platform. The WOMAC questionnaire was obtained from the patient group. One-way ANOVA was utilized to determine the effects of knee osteoarthritis, vision, and support on postural stability metrics. Spearman’s correlation was also used to indicate the correlation between the stability metrics and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) sub scores.
Findings: The anterior-posterior variability of the center of pressure was significantly greater in patients (2.7 mm, p=.003). Elimination of the visual feedback and the rocking support affected the sway area and the AP (p<.001), and the ML variability (p<.024). The pain subscore of the WOMAC questionnaire was negatively and strongly correlated to the AP total mean velocity (open-eyes: r=-.466, closed-eyes: r=-.779). The pain was positively and strongly correlated to the AP variability (open-eyes: r=.796, closed-eyes: r=.744). Patients with knee osteoarthritis showed more postural instabilities.
Conclusion: The instability in the anterior-posterior was more eminent than in the lateral direction. The pain was the most role-playing factor in the destabilization of the posture among the patients with knee osteoarthritis but may be disregarded in physically-difficult conditions of standing.
Full-Text [PDF 439 kb]   (31 Downloads)    
Article Type: Original Research | Subject: Musculoskeletal Pain Prevention
Received: 2022/03/7 | Accepted: 2022/03/14 | Published: 2022/06/9

References
1. Sharma L, Pai Y-C. Impaired proprioception and osteoarthritis. Curr Opin Rheumatol. 1997;9(3):253-8. [DOI:10.1097/00002281-199705000-00013]
2. Hirata RP, Jørgensen TS, Rosager S, ArendtNielsen L, Bliddal H, Henriksen M, et al. Altered visual and feet proprioceptive feedbacks during quiet standing increase postural sway in patients with severe knee osteoarthritis. PloS one. 2013;8(8):e71253. [DOI:10.1371/journal.pone.0071253]
3. Tanaka R, Hirohama K, Ozawa J. Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study. Braz J Phys Ther. 2019;23(3):266-72. [DOI:10.1016/j.bjpt.2018.08.011]
4. Ö ztürk Ö , Bombacı H, Keçeci T, Algun ZC. Effects of additional action observation to an exercise program in patients with chronic pain due to knee osteoarthritis: A randomized-controlled trial. Musculoskelet Sci Pract. 2021;52:102334. [DOI:10.1016/j.msksp.2021.102334]
5. Hinman R, Bennell K, Metcalf B, Crossley K. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology. 2002;41(12):1388-94. [DOI:10.1093/rheumatology/41.12.1388]
6. Turcot K, Sagawa Jr Y, Hoffmeyer P, Suvà D, Armand S. Multi-joint postural behavior in patients with knee osteoarthritis. Knee. 2015;22(6):517-21. [DOI:10.1016/j.knee.2014.09.001]
7. Pirayeh N, Shaterzadeh-Yazdi M-J, Negahban H, Mehravar M, Mostafaee N, Saki-Malehi A. Examining the diagnostic accuracy of static postural stability measures in differentiating among knee osteoarthritis patients with mild and moderate to severe radiographic signs. Gait Posture. 2018;64. [DOI:10.1016/j.gaitpost.2018.04.049]
8. Hassan B, Mockett S, Doherty M. Static postural sway, proprioception, and maximal voluntary quadriceps contraction in patients with knee osteoarthritis and normal control subjects. Ann Rheum Dis. 2001;60(6):612-8. [DOI:10.1136/ard.60.6.612]
9. Sanchez-Ramirez D, van der Leeden M, Knol D, van der Esch M, Roorda L, Verschueren S, et al. Association of postural control with muscle strength, proprioception, self-reported knee instability and activity limitations in patients with knee osteoarthritis. J Rehabil Med. 2013;45(2):192-7. [DOI:10.2340/16501977-1087]
10. Amano T, Tanaka S, Ito H, Morikawa S, Uchida S. Quantifying walking ability in Japanese patients with knee osteoarthritis: Standard values derived from a multicenter study. J Orthop Sci. 2018;23(6):1027-31. [DOI:10.1016/j.jos.2018.07.015]
11. Bellamy N, Kirwan J, Boers M, Brooks P, Strand V, Tugwell P, et al. Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. J Rheumatol. 1997;24(4):799-802.
12. Turcot K, Armand S, Fritschy D, Hoffmeyer P, Suvà D. Sit-to-stand alterations in advanced knee osteoarthritis. Gait Posture. 2012;36(1):68-72. [DOI:10.1016/j.gaitpost.2012.01.005]
13. Duffell LD, Gulati V, Southgate DF, McGregor AH. Measuring body weight distribution during sit-to-stand in patients with early knee osteoarthritis. Gait Posture. 2013;38(4):745-50. [DOI:10.1016/j.gaitpost.2013.03.015]
14. Anan M, Shinkoda K, Suzuki K, Yagi M, Ibara T, Kito N. Do patients with knee osteoarthritis perform sit-to-stand motion efficiently? Gait Posture. 2015;41(2):488-92. [DOI:10.1016/j.gaitpost.2014.11.015]
15. Debi R, Mor A, Segal G, Segal O, Agar G, Debbi E, et al. Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations. Disabil Rehabil. 2011;33(13-14):1103-9. [DOI:10.3109/09638288.2010.520805]
16. Hosseini I, Ashtiani MN, Bahrpeyma F. Postural Stability in Patients with Moderate Knee Osteoarthritis: Roles of Visual Feedback and Dynamic Perturbations. J Rehabil Sci Res. 2021;8(4).
17. Jorge JG, Dionisio VC. Biomechanical analysis during single-leg squat in individuals with knee osteoarthritis. Knee. 2021;28:362-70. [DOI:10.1016/j.knee.2020.12.031]
18. Petrella M, Gramani-Say K, Serrão PRMdS, Lessi GC, Barela JA, Carvalho RdP, et al. Measuring postural control during mini-squat posture in men with early knee osteoarthritis. Human Mov Sci. 2017;52:108-16. [DOI:10.1016/j.humov.2017.01.011]
19. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 ;15(12):1833-40.
20. Eftekhar-Sadat B, Niknejad-Hosseyni SH, Babaei-Ghazani A, Toopchizadeh V, Sadeghi H. Reliability and validity of Persian version of Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis. J Res Clin Med. 2015;3(3):170-7. [DOI:10.15171/jarcm.2015.027]
21. Higuchi T. Approach to an irregular time series on the basis of the fractal theory. Phys D: Nonlinear Phenom. 1988;31(2):277-83. [DOI:10.1016/0167-2789(88)90081-4]
22. Appiah-Kubi KO, Wright W. Vestibular training promotes adaptation of multisensory integration in postural control. Gait Posture. 2019;73:215- 20. [DOI:10.1016/j.gaitpost.2019.07.197]
23. Taglietti M, Bela LFD, Dias JM, Pelegrinelli ARM, Nogueira JF, Júnior JPB, et al. Postural sway, balance confidence, and fear of falling in women with knee osteoarthritis in comparison to matched controls. PM&R. 2017;9(8):774-80. [DOI:10.1016/j.pmrj.2016.11.003]
24. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(suppl_2):ii7-ii11. [DOI:10.1093/ageing/afl077]
25. van Beers RJ. Motor learning is optimally tuned to the properties of motor noise. Neuron. 2009;63(3):406-17. [DOI:10.1016/j.neuron.2009.06.025]
26. Brucini M, Duranti R, Galletti R, Pantaleo T, Zucchi PL. Pain thresholds and electromyographic features of periarticular muscles in patients with osteoarthritis of the knee. Pain. 1981;10(1):57-66. [DOI:10.1016/0304-3959(81)90045-2]
27. Masui T, Hasegawa Y, Yamaguchi J, Kanoh T, Ishiguro N, Suzuki S. Increasing postural sway in ruralcommunity-dwelling elderly persons with knee osteoarthritis. J Orthop Sci. 2006;11(4):353-8. [DOI:10.1007/s00776-006-1034-9]
28. Lyytinen T, Liikavainio T, Bragge T, Hakkarainen M, Karjalainen PA, Arokoski JP. Postural control and thigh muscle activity in men with knee osteoarthritis. J Electromyogr Kinesiol. 2010;20(6):1066-74. [DOI:10.1016/j.jelekin.2010.05.005]
29. Truszczyńska-Baszak A, Dadura E, Drzał-Grabiec J, Tarnowski A. Static balance assessment in patients with severe osteoarthritis of the knee. Knee. 2020;27(5):1349-56. [DOI:10.1016/j.knee.2020.06.014]
30. Ivanenko YP, Levik YS, Talis V, Gurfinkel V. Human equilibrium on unstable support: the importance of feet-support interaction. Neurosci Lett. 1997;235(3):109-12. [DOI:10.1016/S0304-3940(97)00721-0]
31. Oliaei S, Ashtiani MN, Azma K, Saidi S, Azghani MR. Effects of postural and cognitive difficulty levels on the standing of healthy young males on an unstable platform. Acta Neurobiol Exp. 2018;78:60-8. [DOI:10.21307/ane-2018-006]
32. Duffell LD, Southgate DF, Gulati V, McGregor AH. Balance and gait adaptations in patients with early knee osteoarthritis. Gait Posture. 2014;39(4):1057-61. [DOI:10.1016/j.gaitpost.2014.01.005]
33. Ashtiani MN, Azghani Mr. Nonlinear dynamics analysis of the human balance control subjected to physical and sensory perturbations. Acta Neurobiol Exp. 2017;77:168-75. [DOI:10.21307/ane-2017-049]
34. Robon MJ, Perell KL, Fang M, Guererro E. The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain. Clin Biomech. 2000;15(7):522-7. [DOI:10.1016/S0268-0033(00)00007-3]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.