Skip to main content
Top
Published in: Archives of Osteoporosis 1/2017

01-12-2017 | Short Communication

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

Authors: Pazit Levinger, Rezaul Begg, Kerrie M Sanders, Hanatsu Nagano, Calum Downie, Aaron Petersen, Alan Hayes, Flavia Cicuttini

Published in: Archives of Osteoporosis | Issue 1/2017

Login to get access

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.
Literature
1.
go back to reference 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 19:1082–1089CrossRefPubMed 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 19:1082–1089CrossRefPubMed
2.
go back to reference 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 9:17–25CrossRef 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 9:17–25CrossRef
3.
go back to reference 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 4:84–99PubMedPubMedCentral 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 4:84–99PubMedPubMedCentral
4.
go back to reference 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 48:106–112CrossRefPubMed 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 48:106–112CrossRefPubMed
5.
go back to reference 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 100:185–192CrossRefPubMed 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 100:185–192CrossRefPubMed
6.
go back to reference Dirks-Naylor AJ, Lennon-Edwards S (2011) The effects of vitamin D on skeletal muscle function and cellular signaling. J Steroid Biochem Mol Biol 125:159–168CrossRefPubMed Dirks-Naylor AJ, Lennon-Edwards S (2011) The effects of vitamin D on skeletal muscle function and cellular signaling. J Steroid Biochem Mol Biol 125:159–168CrossRefPubMed
7.
go back to reference 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 73:581–587CrossRef 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 73:581–587CrossRef
8.
go back to reference Vaishya R, Vijay V, Hussaini SM, Agarwal AK (2017) Association of vitamin D and knee osteoarthritis—a review. Apollo Medicine 14:3–7CrossRef Vaishya R, Vijay V, Hussaini SM, Agarwal AK (2017) Association of vitamin D and knee osteoarthritis—a review. Apollo Medicine 14:3–7CrossRef
9.
go back to reference 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 60:1381–1389CrossRefPubMed 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 60:1381–1389CrossRefPubMed
10.
go back to reference 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 52:1323–1334CrossRef 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 52:1323–1334CrossRef
11.
go back to reference 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 2:466–474CrossRefPubMedPubMedCentral 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 2:466–474CrossRefPubMedPubMedCentral
12.
go back to reference 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 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.
go back to reference 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 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.
go back to reference 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 29:1039–1049CrossRefPubMed 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 29:1039–1049CrossRefPubMed
15.
go back to reference 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 16:67–77CrossRefPubMed 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 16:67–77CrossRefPubMed
16.
go back to reference 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 15:1833–1840PubMed 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 15:1833–1840PubMed
17.
go back to reference 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 15:230–237CrossRefPubMed 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 15:230–237CrossRefPubMed
18.
go back to reference 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 56:129–136CrossRefPubMed 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 56:129–136CrossRefPubMed
19.
go back to reference Heidari B, Heidari P, Hajian-Tilaki K (2011) Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop 35:1627–1631CrossRefPubMed Heidari B, Heidari P, Hajian-Tilaki K (2011) Association between serum vitamin D deficiency and knee osteoarthritis. Int Orthop 35:1627–1631CrossRefPubMed
20.
go back to reference 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 23:981–989CrossRefPubMed 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 23:981–989CrossRefPubMed
24.
go back to reference 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 56:3626–3633CrossRefPubMed 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 56:3626–3633CrossRefPubMed
25.
go back to reference 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 196:686–687CrossRefPubMed 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 196:686–687CrossRefPubMed
Metadata
Title
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
Authors
Pazit Levinger
Rezaul Begg
Kerrie M Sanders
Hanatsu Nagano
Calum Downie
Aaron Petersen
Alan Hayes
Flavia Cicuttini
Publication date
01-12-2017
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-017-0378-4

Other articles of this Issue 1/2017

Archives of Osteoporosis 1/2017 Go to the issue