双侧膝骨关节炎女性中肌肉力量与姿势稳定性在客观和主观功能中的不同作用
Distinct Roles of Muscle Strength and Postural Stability in Objective and Subjective Function in Women with Bilateral Knee Osteoarthritis.
摘要(中文译文)
膝骨关节炎（OA）显著损害身体功能和生活质量，在女性中尤为明显。尽管肌肉力量和姿势稳定性已知会影响功能结局，但在控制年龄、体质指数（BMI）和疼痛后，二者各自的独立贡献仍不明确。本研究旨在探讨双侧膝骨关节炎女性中，下肢肌肉力量与姿势稳定性对功能状态的差异化作用，功能状态通过基于表现的功能测试和患者报告结局两方面进行评估。本研究纳入64例双侧膝骨关节炎女性（平均年龄：55.71 ± 5.99岁）。下肢肌肉力量采用五次坐立试验评估，姿势稳定性采用Biodex平衡系统评估。基于表现的功能采用六分钟步行试验（6MWT）和爬楼梯试验（SCT）测量，自我报告功能采用WOMAC功能亚量表（WOMAC-F）评估。在控制年龄、BMI和疼痛的条件下进行分层线性回归分析。肌肉力量是基于表现结局的最强独立预测因子，对SCT（β = 0.330， = 0.005）和6MWT（β = -0.409， = 0.001）均有显著贡献。在6MWT模型中，纳入肌肉力量后，年龄和BMI的效应变得不显著，提示其起中介作用。相比之下，自我报告功能（WOMAC-F）主要与疼痛（β = 0.385， = 0.001）和姿势稳定性（β = 0.243， = 0.040）相关，而肌肉力量未见显著贡献。肌肉力量是客观功能表现的主要决定因素，而疼痛和姿势稳定性对感知功能受限的影响更大。这些发现揭示了实际表现与患者报告功能之间的分离现象。康复策略应优先进行力量训练以改善身体表现，同时兼顾疼痛和平衡以提升患者的感知功能。
Abstract
Knee osteoarthritis (OA) significantly impairs physical function and quality of life, particularly in women. Although muscle strength and postural stability are known to influence functional outcomes, their independent contributions after controlling for age, body mass index (BMI), and pain remain unclear. This study aimed to investigate the differential roles of lower extremity muscle strength and postural stability on functional status, evaluated through both performance-based tests and patient-reported outcomes, in women with bilateral knee OA. Sixty-four women with bilateral knee OA (mean age: 55.71 ± 5.99 years) were included in this study. Lower extremity muscle strength was assessed using the five-times sit-to-stand test, and postural stability was evaluated with the Biodex Balance System. Performance-based function was measured using the Six-Minute Walk Test (6MWT) and the stair climbing test (SCT), while self-reported function was assessed using the WOMAC function subscale (WOMAC-F). Hierarchical linear regression analyses were conducted, controlling for age, BMI, and pain. Muscle strength emerged as the strongest independent predictor of performance-based outcomes, significantly contributing to both SCT (β = 0.330, = 0.005) and 6MWT (β = -0.409, = 0.001). In the 6MWT model, the effects of age and BMI became non-significant after the inclusion of muscle strength, indicating a mediating role. In contrast, self-reported function (WOMAC-F) was primarily associated with pain (β = 0.385, = 0.001) and postural stability (β = 0.243, = 0.040), while muscle strength showed no significant contribution. Muscle strength is the primary determinant of objective functional performance, whereas pain and postural stability are more influential in shaping perceived functional limitations. These findings highlight a dissociation between actual performance and patient-reported function. Rehabilitation strategies should prioritize strength training to improve physical performance, while also addressing pain and balance to enhance patients' perceived function.
如何引用
AMA
Kubra Alpay, Sefa Yildirim, Elif Durgut, Ahmet Usen. Distinct Roles of Muscle Strength and Postural Stability in Objective and Subjective Function in Women with Bilateral Knee Osteoarthritis.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14131880.
APA
Kubra Alpay, Sefa Yildirim, Elif Durgut, Ahmet Usen (2026). Distinct Roles of Muscle Strength and Postural Stability in Objective and Subjective Function in Women with Bilateral Knee Osteoarthritis.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14131880
GB/T 7714
Kubra Alpay, Sefa Yildirim, Elif Durgut, Ahmet Usen. Distinct Roles of Muscle Strength and Postural Stability in Objective and Subjective Function in Women with Bilateral Knee Osteoarthritis.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14131880.
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