EC Orthopaedics

Background and Purpose: Knee pain and increasing difficulty in performing basic tasks such as kneeling or squatting can affect quality of life and cause disability. This study examined the ability in performing functional tasks in patients with different levels of knee joint pathology.

Methods: This was a cross-sectional comparative study. Patients with advanced osteoarthritis (OA) of the knee joint were compared with workers with an occupational knee injury and healthy volunteers. Subjects were asked to complete tall and full kneeling. Half kneeling compared general core stability between injured workers and the control group. Double knee squat documented depth and quality of weight-bearing knee flexion. Static and dynamic balance tests examined the neuromuscular integrity. All tests are reported to be valid clinical tests for functional assessment. All subjects provided consent and approval for use of human participants was obtained from the Research Ethics Board of the Sunnybrook Health Sciences Centre. Statistical differences examined group differences using Fisher’s Exact tests.

Results: Data of 30 subjects (10 in each group) were used for analysis. The OA group was older (74 years of age, p < 0.0001) without a statistically significant difference between injured workers and the control group (48 vs. 41, p = 0.23). The OA group showed inferior results in all functional tests (p values ranging from 0.02 to < 0.0001) with no statistically significant differences between workers and the control group in squatting, half kneeling or static balance tests. Statistically significant differences between workers and the control group was in full kneeling (p = 0.02), reaching forward while kneeling (p = 0.02), and clockwise dynamic test (p = 0.04) in favor of the control group.

Conclusion: The results of this study indicates deficiency in joint mobility, muscular strength and neuromuscular coordination in older patients with OA of the knee joint. Patients with work-related knee injuries appear to have a relatively well-preserved ability to perform majority of the functional tests. Administration of knee functional tests may help to diagnose those who would benefit from a more comprehensive rehabilitation program, focusing on mobility and neuromuscular coordination.

 Keywords: Functional Tests; Neuromuscular; Kneeling; Squatting; Compensable Injury

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