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The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study

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Abstract

Summary

The association between vitamin D and muscle function associated with balance recovery and falls in people with knee osteoarthritis is unclear. Those with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.

Purpose

Low vitamin D status in people with knee osteoarthritis (OA) is often reported to be associated with increased pain and locomotor dysfunction. However, despite the growing evidence of the effect of vitamin D on the pathogenesis of knee OA, its role remains conflicting. Importantly, muscle function is important for knee joint health; however, the association between vitamin D levels and muscle function associated with balance recovery and falls is unclear. This study investigated the effect of circulating 25-hydroxyvitamin D (25 (OH) D) on pain, quadriceps strength, lower limb muscle mass and knee power function during balance recovery in people with knee OA.

Methods

Twenty-four participants with clinical symptoms of knee OA (68.6 ± 6.2 years) participated in the study. Serum levels of 25 (OH) D were assessed and participants were classified as follows: vitamin D insufficiency ≤ 50 nmol/L and vitamin D sufficiency > 50 nmol/L. The groups were compared on knee function during balance recovery tasks, lower limb strength and muscle mass as well as perceived pain and function.

Results

Seven patients (29.1%) were classified as vitamin D-insufficient. Vitamin D insufficiency was associated with reduced knee muscle function during the balance recovery task, increased pain (Western Ontario and McMasters University Osteoarthritis Index (WOMAC) subscore), dysfunction (WOMAC subscore) and total WOMAC score (p < 0.05).

Conclusion

People with knee OA with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.

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References

  1. Levinger P, Menz HB, Wee E, Feller JA, Bartlett JR, Bergman NR (2011) Physiological risk factors for falls in people with knee osteoarthritis before and early after knee replacement surgery. Knee Surg Sports Traumatol Arthrosc 19:1082–1089

    Article  PubMed  Google Scholar 

  2. Levinger P, Wallman S, Hill K (2012) Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk, and effectiveness of exercise interventions. Eur Rev Aging Phys Act 9:17–25

    Article  Google Scholar 

  3. Takacs J, Carpenter MG, Garland SJ, Hunt MA (2013) The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control. Aging Dis 4:84–99

    PubMed  PubMed Central  Google Scholar 

  4. Levinger P, Nagano H, Downie C, Hayes A, Sanders KM, Cicuttini F et al (2016) Biomechanical balance response during induced falls under dual task conditions in people with knee osteoarthritis. Gait Posture 48:106–112

    Article  PubMed  Google Scholar 

  5. Jackson C, Gaugris S, Sen SS, Hosking D (2007) The effect of cholecalciferol (vitamin D3) on the risk of fall and fracture: a meta-analysis. QJM 100:185–192

    Article  CAS  PubMed  Google Scholar 

  6. Dirks-Naylor AJ, Lennon-Edwards S (2011) The effects of vitamin D on skeletal muscle function and cellular signaling. J Steroid Biochem Mol Biol 125:159–168

    Article  CAS  PubMed  Google Scholar 

  7. Scott D, Blizzard L, Fell J, Ding C, Winzenberg T, Jones G (2010) A prospective study of the associations between 25-hydroxy-vitamin D, sarcopenia progression and physical activity in older adults. Clin Endocrinol 73:581–587

    Article  CAS  Google Scholar 

  8. Vaishya R, Vijay V, Hussaini SM, Agarwal AK (2017) Association of vitamin D and knee osteoarthritis—a review. Apollo Medicine 14:3–7

    Article  Google Scholar 

  9. Ding C, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G (2009) Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study. Arthritis Rheum 60:1381–1389

    Article  PubMed  Google Scholar 

  10. Cao Y, Winzenberg T, Nguo K, Lin J, Jones G, Ding C (2013) Association between serum levels of 25-hydroxyvitamin D and osteoarthritis: a systematic review. Rheumatol 52:1323–1334

    Article  CAS  Google Scholar 

  11. Barker T, Henriksen VT, Rogers VE, Aguirre D, Trawick RH, Lynn Rasmussen G et al (2014) Vitamin D deficiency associates with gamma-tocopherol and quadriceps weakness but not inflammatory cytokines in subjects with knee osteoarthritis. Redox Biol 2:466–474

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Alkan G, Akgol G (2017) Do vitamin D levels affect the clinical prognoses of patients with knee osteoarthritis? J Back Musculoskelet Rehabil 30:897–901

  13. Brennan-Speranza TC, Mor D, Mason RS, Bartlett JR, Duque G, Levinger I et al. (2017) Skeletal muscle vitamin D in patients with end stage osteoarthritis of the knee. J Steroid Biochem Mol Biol 173:180–184

  14. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049

    Article  CAS  PubMed  Google Scholar 

  15. Barbat-Artigas S, Rolland Y, Zamboni M, Aubertin-Leheudre M (2012) How to assess functional status: a new muscle quality index. J Nutr Health Aging 16:67–77

    Article  CAS  PubMed  Google Scholar 

  16. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840

    CAS  PubMed  Google Scholar 

  17. Bergink AP, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA et al (2009) Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: the Rotterdam study. J Clin Rheumatol 15:230–237

    Article  PubMed  Google Scholar 

  18. Felson DT, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A et al (2007) Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies. Arthritis Rheum 56:129–136

    Article  CAS  PubMed  Google Scholar 

  19. Heidari B, Heidari P, Hajian-Tilaki K (2011) Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop 35:1627–1631

    Article  PubMed  Google Scholar 

  20. Menant JC, Close JC, Delbaere K, Sturnieks DL, Trollor J, Sachdev PS et al (2012) Relationships between serum vitamin D levels, neuromuscular and neuropsychological function and falls in older men and women. Osteoporos Int 23:981–989

    Article  CAS  PubMed  Google Scholar 

  21. Alnahdi AH, Zeni JA, Snyder-Mackler L (2012) Muscle impairments in patients with knee osteoarthritis. Sports Health 4:284–292

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lee JY, Han K, McAlindon TE, Park YG, Park SH (2016) Lower leg muscle mass relates to knee pain in patients with knee osteoarthritis. Int J Rheum Dis. https://doi.org/10.1111/1756-185X.12896

  23. Boland R (1986) Role of vitamin D in skeletal muscle function. Endocr Rev 7:434–448

    Article  CAS  PubMed  Google Scholar 

  24. Fink B, Egl M, Singer J, Fuerst M, Bubenheim M, Neuen-Jacob E (2007) Morphologic changes in the vastus medialis muscle in patients with osteoarthritis of the knee. Arthritis Rheum 56:3626–3633

    Article  PubMed  Google Scholar 

  25. Nowson CA, McGrath JJ, Ebeling PR, Haikerwal A, Daly RM, Sanders KM et al (2012) Vitamin D and health in adults in Australia and New Zealand: a position statement. Med J Aust 196:686–687

    Article  PubMed  Google Scholar 

  26. Hussain S, Singh A, Akhtar M, Najmi AK (2017) Vitamin D supplementation for the management of knee osteoarthritis: a systematic review of randomized controlled trials. Rheumatol Int. https://doi.org/10.1007/s00296-017-3719-0

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Acknowledgements

This study was funded through the Australian Government’s Collaborative Research Network.

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Correspondence to Pazit Levinger.

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Levinger, P., Begg, R., Sanders, K.M. et al. The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study. Arch Osteoporos 12, 83 (2017). https://doi.org/10.1007/s11657-017-0378-4

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  • DOI: https://doi.org/10.1007/s11657-017-0378-4

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