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Structural severity, phase angle, and quadriceps strength among patients with knee osteoarthritis: the SPSS-OK study

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Abstract

Introduction/objectives

The associations between severity of knee osteoarthritis (KOA) and phase angle (PhA) and between PhA and quadriceps strength in patients with KOA are unclear. This study examined (1) whether the structural severity of KOA affects PhA and (2) whether PhA affects quadriceps strength in patients with KOA.

Method

Data of 1093 patients with KOA, obtained from Screening for People Suffering Sarcopenia in the Orthopedic cohort of Kobe study, were analyzed. PhA was determined by bioimpedance. Quadriceps strength was measured using a handheld dynamometer. Structural severity of KOA was determined using Kellgren-Lawrence radiographic grading scale. A series of general linear models were fitted to estimate the magnitude of differences in PhA by differences in KOA severity and quadriceps strength by differences in PhA.

Results

The mean age of the patients was 72.8 years, and 78% were women. Increasing KOA severity was associated with decreasing PhA, especially in men. In women, only grade 4 KOA was associated with a decrease in PhA (P for interaction = 0.048). PhA per leg was positively associated with quadriceps strength per leg, independent of age, sex, leg muscle mass, pain, and KOA severity (mean difference per 1° increase = 7.54 Nm, 95% confidence interval = 5.51–9.57 Nm). The association between PhA and quadriceps strength differed neither by sex nor by KOA severity (P for interaction = 0.133 and 0.185, respectively).

Conclusions

PhA decreased with increasing KOA severity, and increasing PhA was associated with increasing quadriceps strength. Clinicians should, therefore, evaluate PhA to assess quadriceps strength in patients with KOA.

Key Points

• PhA gradually decreased with increasing severity of KOA, especially in men.

• Increasing PhA was associated with increasing quadriceps strength.

• Clinicians should focus on increasing muscle mass and PhA.

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Acknowledgments

The authors greatly thank the following research assistants and medical staff members for their assistance in collecting the clinical information used in this study: Takehiro Kaga, Tomohiro Oka, Yoriko Tamura, Hiroshi Nishi, Yuichi Isaji, Yutaka Sato, Tomohiro Takagi, Kaho Shibata, Maho Wakai, Chisato Shindoh, Kenta Hirose, Takuma Ota, Tatsuya Arita, Yuuki Ikawa, Tsuyoshi Fukui, Riuji Nakagawa, Taisuke Hayashida, Shuto Fujii, Keisuke Yoneya, Kazuaki Mori (Anshin Hospital, Kobe), and Lisa Shimokawa (Fukushima Medical University Hospital, Fukushima city, Fukushima).

Availability of data and material

The datasets generated during and/or analyzed during the present study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Funding

This study was supported by JSPS KAKENHI (Grant Number: JP15K16518). The JSPS had no role in this study except for funding.

Author information

Authors and Affiliations

  1. Anshin Hospital, Kobe, Japan

    Osamu Wada & Kiyonori Mizuno

  2. Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Noriaki Kurita

  3. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan

    Noriaki Kurita

  4. Center for Innovative Research for Communities and Clinical Excellence (CiRC(2)LE), Fukushima Medical University, Fukushima, Japan

    Noriaki Kurita

  5. Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan

    Minoru Yamada

Authors
  1. Osamu Wada
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  2. Noriaki Kurita
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  3. Minoru Yamada
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  4. Kiyonori Mizuno
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Contributions

Research idea and study design: OW, NK; data acquisition: OW, KM; data analysis and interpretation: OW, NK, MY, KM; statistical analysis: NK; supervision or mentorship: NK, MY, KM. Each author contributed important intellectual content during article drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Noriaki Kurita.

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Ethical approval

The study was approved by the local institutional review board (no. 57, January 26, 2017) and by the Research Ethics Committee of Fukushima Medical University School of Medicine (no. 2850, September 28, 2016).

Consent to participate

Informed consent for the present study was not mandatory according to the “ethical guidelines for medical and health research involving human subjects” in Japan.

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Wada, O., Kurita, N., Yamada, M. et al. Structural severity, phase angle, and quadriceps strength among patients with knee osteoarthritis: the SPSS-OK study. Clin Rheumatol 39, 3049–3056 (2020). https://doi.org/10.1007/s10067-020-05056-w

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  • DOI: https://doi.org/10.1007/s10067-020-05056-w

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