Knee Extensor and Flexor Torque Variability During Maximal Strength Testing and Change in Knee Pain and Physical Function at 60-Mo Follow-Up: The Multicenter Osteoarthritis Study (MOST).
Allison Schroeder, Na Wang, David T Felson and 3 others
PMID 32932359WHAT IT FOUND
In adults with or at risk of knee OA, inconsistent hamstring strength predicted worsening pain and function over 5 years, even after accounting for peak strength.
Inconsistent quadriceps strength did not. Screening for hamstring variability may identify patients at higher risk of decline.
Key findings
01Higher baseline knee flexor torque variability was associated with worsening pain and physical function, and this association persisted after adjusting for baseline maximum flexor torque.
02Baseline peak knee extensor torque variability was not associated with worsening pain, physical function, or physical performance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is an observational study, so it shows a link but does not prove that reducing hamstring variability will prevent pain or decline. Isokinetic testing is a laboratory measure and may not fully replicate how muscles work during daily functional activities. Pain and function were assessed only at baseline and 5-year follow-up, missing any episodic changes in between. Only the left leg was tested, which may not represent the bilateral or right-side status of all patients.
Declared interests
The study was funded by the NIH. The text states it is an NIH-funded longitudinal observational study but does not report specific author conflicts of interest or commercial funding.
The easy way to misread this
Do not assume that measuring quadriceps variability is unnecessary for all patients. This study only examined variability during maximal efforts; previous research cited in the text found that variability during sub-maximal efforts was associated with OA progression. Additionally, do not interpret this as evidence that hamstring training prevents decline, as the study did not test an intervention.