Bilateral Knee Strength Asymmetry and Functional Performance in Older Women With Osteoarthritis

NCT07261540 | Completed DMC

• 1 other identifier: KOSTU-25-OA-02
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

Osteoarthritis (OA) is a degenerative joint disease that primarily affects the knees and becomes more prevalent with age. In individuals over 50, particularly those with bilateral knee osteoarthritis, it leads to chronic pain, limited mobility, and functional decline. This condition worsens due to muscle strength imbalances, especially in the quadriceps and hamstrings. These imbalances are triggered by pain, joint instability, and cartilage damage, which negatively impact muscle strength and coordination. In women, these asymmetries are more pronounced, increasing the risk of functional decline. Recent studies highlight the significant role of strength asymmetry in functional limitations, affecting balance, gait, and daily activities. This study aims to investigate the impact of bilateral quadriceps and hamstring strength asymmetries on dynamic balance, gait efficiency, and functional mobility in older women with bilateral knee osteoarthritis. The study aims to examine the effects of bilateral strength asymmetries in the knee extensors and flexors on dynamic balance, gait efficiency, and overall mobility in older women with bilateral knee osteoarthritis. We hypothesize that greater strength asymmetry will be associated with impaired dynamic balance, reduced gait efficiency, and decreased functional mobility.

Conditions

Knee Osteoarthristis; Postmenopausal Women; Functional Performance; Isokinetic Test; Muscle Strenght

Keywords

knee osteoarthristis; Postmenopausal women; muscle strenght; isokinetic test; Functional Performance

Outcome Measures

Primary Outcomes (2)

• Isokinetic Strength Testing

  Bilateral knee strength asymmetry was assessed using a Biodex System 4 Pro isokinetic dynamometer (Biodex Medical Systems, USA). Participants were securely positioned, and knee extensor and flexor strength were measured at angular velocities of 120°/s and 180°/s. Each participant performed five maximal concentric contractions per limb, with the highest peak torque values recorded. Higher asymmetry values indicated greater strength imbalances between limbs

  From enrollment to the end of evaluation in 1 hour

• Functional Mobility

  The 30-second Sit-to-Stand test was used to assess lower limb functional strength and endurance. Participants were instructed to stand up and sit down as many times as possible in 30 seconds from a standard chair (seat height: 46 cm) without using their arms. The total number of completed repetitions was recorded. A lower Sit-to-Stand score indicates reduced quadriceps endurance, decreased functional independence, and a higher fall risk in older adults.

  From enrollment to the end of evaluation in 1 hour

Secondary Outcomes (3)

• Pain Assessment

  From enrollment to the end of evaluation in 1 hour

• Dynamic Balance Measurement

  From enrollment to the end of evaluation in 1 hour

• Gait Speed

  From enrollment to the end of evaluation in 1 hour

Study Arms (1)

Study Group

Patients with bilateral knee osteoarthritis who met the inclusion criteria underwent a single laboratory assessment involving isokinetic strength testing, pain evaluation, dynamic balance assessment, and functional mobility tests. Isokinetic strength testing was performed on both knees of the patients.All assessments took 1 hour in total for each patient.

Other: Isokinetic Strength Testing

Interventions

Isokinetic Strength Testing OTHER

Bilateral knee strength asymmetry was assessed using a Biodex System 4 Pro isokinetic dynamometer (Biodex Medical Systems, USA). Participants were securely positioned, and knee extensor and flexor strength were measured at angular velocities of 120°/s and 180°/s. Each participant performed five maximal concentric contractions per limb, with the highest peak torque values recorded.

Also known as: Pain Assessment, Dynamic Balance Measurement, Functional Mobility, Gait Speed

Study Group

Eligibility Criteria

• Age: 50 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This cross-sectional observational study investigates the impact of bilateral isokinetic strength asymmetry on dynamic balance and gait speed in women with bilateral knee osteoarthritis. Participants were recruited from Inonu University Faculty of Medicine Research Hospital Physical Therapy and Rehabilitation Department with eligibility determined based on clinical and radiographic assessments.

You may qualify if:

• women gender
• aged 50 years or older
• diagnosed with bilateral knee osteoarthritis (Kellgren-Lawrence grade II-III),
• capable of independent walking without assistive devices.

You may not qualify if:

• severe knee osteoarthritis requiring total knee arthroplasty
• neurological conditions affecting gait or balance
• severe musculoskeletal disorders
• uncontrolled systemic diseases
• cognitive impairments (Mini-Mental State Examination \< 24)

Sponsors & Collaborators

• Kocaeli Sağlık ve Teknoloji Üniversitesi: lead

Study Sites (1)

Kocaeli Health and Technology University

Kocaeli, Turkey (Türkiye)

Location

MeSH Terms

Interventions

Walking Speed

Intervention Hierarchy (Ancestors)

Gait; Physical Examination; Diagnostic Techniques and Procedures; Diagnosis; Walking; Locomotion; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Sema Aktürk, MD Professor

  Inonu University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Asisstant Professor

Study Record Dates

• First Submitted: November 22, 2025
• First Posted: December 3, 2025
• Study Start: April 1, 2025
• Primary Completion: May 5, 2025
• Study Completion: June 1, 2025
• Last Updated: December 3, 2025

Record last verified: 2025-05

Locations

TU (1)