Sex Differences in Patients With Different Stages of Knee Osteoarthritis

• Published in: Archives of physical medicine and rehabilitation Vol. 95; no. 12; pp. 2376 - 2381
• Main Authors: Logerstedt, David S., PT, PhD, MPT, Zeni, Joseph, PT, PhD, Snyder-Mackler, Lynn, PT, ScD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2014
• Subjects: Activities of Daily Living; Aged; Cross-Sectional Studies; Disability Evaluation; Female; Gait; Humans; Knee; Male; Middle Aged; Muscle Strength; Osteoarthritis; Osteoarthritis, Knee - physiopathology; Patient outcome assessment; Physical Medicine and Rehabilitation; Quadriceps Muscle - physiopathology; Rehabilitation; Self Report; Sex; Sex Factors; Task Performance and Analysis; Walking; Knee; Patient outcome assessment; timed Up and Go; PCS; Physical Component Summary; SCT; Sex; MVIC; TUG; TKA; Medical Outcomes Study 36-Item Short-Form Health Survey; maximal voluntary isometric contraction; 6MWT; Knee Outcome Survey–Activities of Daily Living Scale; stair-climbing test; SF-36; 6-minute walk test; total knee arthroplasty; OA; KOS-ADLS; normalized maximal voluntary isometric contraction; Rehabilitation; Osteoarthritis; NMVIC
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2014.07.414

Abstract Objective To quantify the differences in physical impairments and in performance-based measures and patient-reported outcomes in men and women seeking nonoperative management of symptomatic moderate knee osteoarthritis (OA) and those with symptomatic end-stage knee OA scheduled for total knee arthroplasty compared with healthy controls. Design Cross-sectional analysis of individuals referred to physical therapy, community participants, and subjects from a 2-year longitudinal study. Setting University research department. Participants Cross-sectional analysis of participants (N=289) consisting of a moderate OA group (n=83), a severe OA group (n=143), and a healthy control group (n=63). Interventions Not applicable. Main Outcome Measures Quadriceps strength, timed Up and Go test, stair-climbing test, 6-minute walk test, Knee Outcome Survey–Activities of Daily Living Scale (KOS-ADLS), and Physical Component Summary (PCS) of the Medical Outcomes Study 36-Item Short-Form Health Survey. Results Women had worse scores than men for physical impairment and performance-based measures ( P <.001). In the moderate OA group, women had significantly lower KOS-ADLS ( P =.007) and PCS ( P =.026) scores than men, with no differences seen between sexes in the other 2 groups for patient-reported measures. Conclusions Differences between women and men with knee OA on physical impairments and performance-based measures are not echoed in the differences seen in patient-reported measures. These measures signal different domains of knee function in patients with knee OA and should be used as part of a comprehensive functional evaluation.