The Affectivity of Knee and Hip Muscle Strengthening Exercise to Improve Muscle Strength, Balance, Pain, and Functional Activity of People with Osteoarthritis
Keywords:knee osteoarthritis, strengthening exercise, pain, muscle strength, balance, functional activity
Introduction. Osteoarthritis is a common condition that affects elderly people, especially knee osteoarthritis.
It can cause pain, muscle weakness, imbalance and low functional activity of elderly people. Knee
osteoarthritis not only affects muscles in the knee joint area but also those in the hip joint. To improve
symptoms of knee osteoarthritis, strengthening exercise is often conducted only on muscles in the knee
joint area, but not muscles in the hip area. This study aimed to compare the effect of strengthening exercise
conducted in knee joint muscles only with the strengthening exercise in both knee and hip muscles on pain,
strength, balance and functional activity.
Method. A pre- and posttest design was chosen as the design of this study. Two groups were formed in
this study. Group 1 received strengthening exercise on knee joint muscles only and Group 2 received
strengthening exercise on knee joint and hip joint muscles. This study was conducted in Prima Physio Clinic
for Group 1 and Tajuddin Chalid Hospital, Makassar for Group 2. On each group, there were 10 subjects
with osteoarthritis. The strengthening exercise was conducted for 3 times a week for 4 weeks. The outcome
measure used was numeric pain rating scale (NPRS), manual muscle strength (MMT), Berg balance scale
(BBS) and Western Ontario McMaster (WOMAC). Manual muscle strength was measured in all major
muscles of the joints: iliopsoas, gluteus, tensor fascia lata, quadriceps and hamstring.
Results. The statistical analysis was conducted using Wilcoxon and Mann Whitney tests. In group 1 analysis,
pain, balance, functional activity, and all major muscle strengths were found to be a statistically significant
difference between baseline and 4 weeks post-exercise. In group 2 analysis, pain, muscle strength, balance,
and functional activity were found to be a statistically significant difference (p<0.05). The comparison
between the two groups showed statistically significant differences in all muscle group strength except
for hamstring. Pain, balance, functional activity and hamstring strength were not statistically significantly
different between the groups.
Conclusion. From the results, we concluded that the strengthening program for both knee and hip muscles
is recommended than only to the affected joint muscles.