The Relationship Between Knee Osteoarthritis Severity, Muscle Strength, Proprioception, and Quality of Life

Abstract

Aim: This study aimed to investigate the relationship between knee osteoarthritis (OA) severity and key clinical factors such as muscle strength, proprioception, and quality of life (QoL) in individuals with bilateral knee OA. Material and Method: A cross-sectional observational study was conducted with 40 participants diagnosed with bilateral knee OA. Isometric quadriceps and hamstring muscle strength were measured using a hand-held dynamometer. Proprioception was assessed using a digital inclinometer during knee flexion at 30° and 60°. Osteoarthritis severity was determined using the Kellgren-Lawrence classification and the Lequesne Algofunctional Knee Index, while QoL and functional status were evaluated using the WOMAC Index. Results: As OA severity increased, significant increases were observed in WOMAC pain, stiffness, and physical function scores, indicating worse outcomes in QoL (p<0.005). Proprioception was notably impaired at 60° of knee flexion in the non-dominant leg as OA grade increased. At the same time, no significant muscle strength decline in the quadriceps and hamstrings was observed across OA grades (p>0.005). Conclusion: OA severity is closely associated with worse QoL outcomes, particularly in pain and physical function, but not consistently with muscle strength. These findings highlight the need for tailored rehabilitation programs that focus on improving proprioception and pain management in OA patients.

Keywords

• Osteoarthritis severity
• grade
• knee proprioception
• life quality
• WOMAC
• knee muscle strength

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