Does the Q - H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?
Remi Fujita, Yasumoto Matsui, Atsushi Harada and 6 others
PMID 28174444WHAT IT FOUND
Lower knee extension strength and a smaller gap between knee extension and flexion strength were linked to more pain in 78 women with knee osteoarthritis.
The hamstring-to-quadriceps ratio was not.
Key findings
01In 78 women with knee osteoarthritis, higher knee extension strength was significantly associated with lower pain scores during level ground walking and stair climbing in the dominant leg.
02The hamstring-to-quadriceps ratio was not significantly correlated with knee pain during any daily activity in either leg.
03Q-H was significantly correlated with knee pain during walking and stair climbing in both legs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot show that weak muscles cause pain or that strengthening reduces pain. It included only Japanese women with knee osteoarthritis, so it may not apply to men, other populations, or people with different knee problems. It did not account for other factors that can affect knee pain, such as knee alignment and inflammation. The paper labels the study case-control in one place but describes cross-sectional correlations in another, and no treatment was tested. Strength was measured with a prototype instrument, although the paper reported good reliability and correlations with an isokinetic dynamometer.
The easy way to misread this
Do not read this as proof that quadriceps training will reduce knee pain. The study measured associations at one time point and did not give anyone a training programme.