Do not concentrate on single muscles

A thorough understanding of the many muscle limitations caused by arthritis should enable us to create rehabilitation and exercise regimens for people with knee arthritis that are more effective.

⇒Quadriceps muscle strength

Quadriceps strength deficiency is well-documented in several literary works. In a previously published article, it was noted that the quadriceps strength losses ranged from 11 to 56% when compared to healthy controls. When evaluating eccentric strength, a study article reports a 76% disadvantage.

Functional impairments are significantly impacted by this, particularly loss of eccentric strength deficits. For instance, rising up from the floor, standing up from a chair, and climbing and descending steps

⇒Inhibition of the quadriceps

The two primary causes of knee arthritis are atrophy and muscular inhibition. Patients with knee arthritis have been observed to have a 12% atrophy (decrease in cross sectional area) of the quadriceps. Loss of strength is unquestionably influenced by this atrophy.

Furthermore, although the precise process is yet unclear, there are a few possible causes for the altered muscular contraction, which may be brought on by changes in the afferent discharge of knee receptors. Joint laxity, effusion, discomfort, inflammation, and degenerative changes in joint structures might all affect this.

Lower Extremity Strength Deficits, according to literature there have been several studies on the impairment of muscles reported.Strength deficits in the muscles include a 4–38% reduction in hamstring strength, a 16% reduction in hip extension strength, a 26-40% reduction in hip flexion strength, a 20–43% reduction in internal rotation strength, a 22–24% reduction in abduction strength, and a 26% reduction in adduction strength.Additionally, it has been shown that the quadriceps strength of the contralateral leg is 16–26% lower than that of healthy controls. Both limbs should be thoroughly inspected.

Although the cause of the mysterious contralateral deficiency is unclear, it may once again be interpreted as the patient progressively losing strength overall.

⇒Clinical Implications

1. Quadriceps strength is reduced in those with knee arthritis.
2. Muscle atrophy and a lack of activation are the causes of weakness.
3. dysfunction of the hamstring and hip muscles
4. Deficits in both strength and activation, but the side that is affected more severely
   Strength is a crucial component of functional activities.
5. Knee arthritis development is predicted by a lack of strength.

Summary of the suggestions made by Roddy et al, which we have stated as:

Strengthening and aerobic exercise may help patients with knee and hip osteoarthritis to lessen pain and improve function.
Enhance strength and proprioception, which may slow the course of osteoarthritis. Adherence, however, is the key factor in predicting the long-term effects of exercise.

In addition to these suggestions, we would advise adding the following guidelines to the creation of rehabilitation and exercise programmes for arthritis sufferers:

Because muscular imbalance contributes to osteoarthritis, we place a strong focus on lower extremity strengthening exercises, particularly those that target quadriceps strength increasing hip muscle strength. The region with the most severe muscular impairment should get special attention. Exercise on both sides should work. Exercise should focus on muscle control, dynamic stabilisation, and strength training increase mobility.
Implementing an appropriate workout prescription that lessens particular muscle limitation, mobility issues, and movement impairments. Knee arthritis is linked to muscular weakness, muscle imbalances, and muscle limitations. When dealing with someone who has knee arthritis, keep in mind these conclusions and suggestions.

References:

Zhang W, Doherty M, Roddy E, et al. The MOVE consensus offers suggestions based on data about the value of exercise in the treatment of hip or knee osteoarthritis. Oxford Rheumatology.2004 Sep 7;44(1):67–73 in 2005 Jan.
Ali H Alnahdi and others. Muscle Impairments in People With Osteoarthritis of the Knee American Orthopaedic Sports Medicine Society June 19 2012