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INTRODUCTION: Regular assessment of motor impairments is crucial in people with haemophilic arthropathy (PwHA). This study aimed to determine if there are differences in 30-seconds sit-to-stand (30-STS) power and maximal voluntary isometric contraction (MVIC) of the knee extensors between PwHA and healthy control group (CG). The secondary aims were to investigate the correlation between 30-STS power and MVIC of knee extensors with clinical characteristics and to assess their effectiveness in identifying motor impairment in PwHA. METHODS: A cross-sectional study was conducted by collecting data from PwHA (n = 17) and a sedentary CG (n = 15). MVIC (torque) and 30-STS power were normalised to body mass. Correlation analysis and simple linear regression adjusted for age were used to assess the association between tests and clinical variables. Using z-scores derived from the mean and standard deviation of the CG, we compared the MVIC and the 30-STS power in PwHA. RESULTS: PwHA showed lower MVIC and 30-STS power compared to CG (p < .001; large effect size d > .8). Lower 30-STS power was associated with greater joint impairment and greater fear of movement, whereas MVIC showed no association with clinical variables. 30-STS power showed a lower z-score compared to MVIC (p < .001). In addition, 30-STS power detected 47% of PwHA with motor impairment compared to 0% for MVIC (p = .002). CONCLUSIONS: Our results suggest that 30-STS power may be more effective than knee extensors MVIC in detecting motor impairment in PwHA. Consequently, lower limb skeletal muscle power, rather than maximum knee extensor strength, appears to be more affected in PwHA.

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NOMBRE DE LA TECNOLOGÍA: Sistema endovascular Tack® (4 F) para la reparación de disecciones tras angioplastia transluminal percutánea en el tratamiento de enfermedad arterial periférica (EAP) por debajo de la rodilla. BREVE DESCRIPCIÓN DE LA TECNOLOGÍA: El sistema endovascular Tack® tiene como finalidad la reparación de disecciones arteriales periféricas, producidas tras una angioplastia transluminal percutánea, en el tratamiento de la isquemia crítica por EAP de los MMII a nivel infrapopliteo (3). Tack® (4 F) es el primer sistema endovascular disponible para el tratamiento focal de disecciones posteriores a angioplastia en arterias del sector infrapoplíteo (3). POBLACIÓN DIANA: La GPC de 2016 AHA/ACC (25) recomienda hacer revascularización quirúrgica o endovascular para disminuir tanto la mortalidad como la amputación del miembro, siempre que ésta sea viable. La técnica elegida para el tratamiento endovascular de CLTI está relacionada con la ubicación anatómica de las lesiones, las características de las lesiones y la experiencia de los profesionales encargados. En cualquier caso, según dicho documento, los pacientes con lesiones infrapoplíteas con comorbilidades, con lesiones de pequeña longitud y que no puedan disponer de material de vena safena autólogo deben ser considerados para el tratamiento endovascular. DESCRIPCIÓN DEL PROBLEMA DE SALUD AL QUE SE APLICA LA TECNOLOGÍA: El problema de salud al que se dirige esta

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OBJECTIVE: To compare the effects of moderate intensity running and cycling on markers of exercise-induced muscle damage in men. STUDY DESIGN: Randomized controlled trial. SETTING: Laboratory. PARTICIPANTS: Thirty volunteers were randomized in three groups [running (RG; n = 10), cycling (CG; n = 10) and control (CON; n = 10)] and were evaluated at baseline, post 24, 48 and 72 h of knee extensors' muscle damage protocol. CON performed passive recovery, while RG and CG performed active recovery immediately after the protocol, as well as 24 h and 48 h afterwards. MAIN OUTCOMES: (i) maximal voluntary isometric contraction (MVIC); (ii) delayed-onset muscle soreness (DOMS); (iii) plasma creatine kinase (CK) and lactate dehydrogenase (LDH) levels. RESULTS: No group-by-time interaction was found in any outcome evaluated (p > 0.05). All groups presented decreases in MVIC and increases in DOMS (p < 0.001), without differences in CK and LDH. Compared with CON, exercise groups presented likely beneficial effects for LDH, while only CG had a likely beneficial effect for DOMS. Lastly, CG presented likely/very likely beneficial effects for MVIC and DOMS compared to RG. CONCLUSION: Although the null hypothesis analysis did not find differences, the magnitude-based inference analysis suggested that moderate intensity cycling have likely beneficial effects on knee extensor muscle recovery after eccentric exercise protocol.

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BACKGROUND: Chronic kidney disease is a systemic disease affecting not only renal function, but also endocrine, cardiovascular, and skeletal muscle systems, with broad impact on functionality. Therefore, the assessment of body composition, peripheral muscle function, and exercise tolerance is also of great importance in this population. In addition, the development of reliable strategies that use feasible tools in clinical practice is of great importance in the functional diagnosis, clinical management and prescription of physical activity. OBJECTIVE: To assess the relationship between phase angle and peak torque of knee extensors with the performance in six-minute step test of patients with chronic kidney disease undergoing haemodialysis. METHODS: Observational and cross-sectional study at Haemodialysis Centre of Sírio-Libanês Hospital. The evaluations took place 3 days before the haemodialysis sessions. On the first day, patients underwent anthropometric evaluation and biochemical tests (lactate, urea, creatinine, albumin, ferritin and growth factor similar to insulin type 1 [IGF1]). On the second day, performed electrical bioimpedance and exercise tolerance assessed using the six-minute step test. On the last day, the evaluation of knee extensor muscles strength using isokinetic dynamometry was performed. RESULTS: Eighteen subjects were included, with a mean age of 62.3 ± 17.6 years. A positive linear correlation was observed between the phase angle, derived from the electrical bioimpedance, and the performance in six-minute step test in these patients. It was also possible to observe a linear correlation between phase angle and IGF1, handgrip strength, peak torque of knee extensors and quality of life questionnaire. The peak torque of knee extensors also presented a linear correlation with IGF1, the performance in six-minute step test and mal-nutrition and inflammation score. CONCLUSION: Phase angle and peak torque of knee extensors were correlated with the performance in six-minute step test. Therefore, the phase angle seems to be an important marker of reduced peripheral muscle function and exercise tolerance in haemodialysis patients.

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Aim: This study was performed to assess the effect of the phonophoretic application of a nanoemulsion incorporating glucosamine and chondroitin sulfate (NANO-CG) associated with kinesiotherapy on the reduction of pain and stiffness in knee chondropathy. Materials & methods: NANO-CG was tested in vitro and in vivo prior to being applied in a randomized and controlled clinical trial. Results: Cell viability and hen's egg test-chorionallantonic membrane tests indicated the NANO-CG is safe for topical application. Permeation tests showed NANO-CG enhances drug permeation through the skin. There was no statistical significance between treated groups in this preliminary study, however, pain reduction and complete recovery of articular cartilage were observed in some patients treated with NANO-CG. Conclusion: We demonstrate that NANO-CG may be a promising candidate for the therapy of knee chondropathy.

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PURPOSE: Bradykinesia and muscle weaknesses are common symptoms of Parkinson's Disease (PD) and are associated with impaired functional performance, increased risk of falls, and reduced quality of life. Recent studies have pointed to progressive resistance training (PRT) as an effective method to control and reduce these symptoms, increasing possibilities to treat the disease. However, few studies have focused on assessing the PRT effects in the short-term. Therefore, the present study aimed to assess the short-term PRT effects on people with PD, in order to offer new parameters for a better understanding of its effects, so as an adequation and PRT use as a complementary therapy. PATIENTS AND METHODS: Forty individuals diagnosed with PD from stage 1 to 3 on the Hoehn and Yahr scale took part on the study and were allocated into 2 groups; Training Group (TG) performed a 9-week RT program twice a week, and the Control Group (CG) attended disease lectures. Bradykinesia UPDRS subscale (BSS), knee extensors isokinetic strength, Ten Meters Walk Test (TMW), Timed Up&Go Test (TUG) and 30-Second Chair Stand (T30) were measured before and after the intervention period. Statistical significance was set at p ≤ 0.05. RESULTS: Significant time was noted by the group interaction for all functional tests (TUG, T30, and TWM; all p < 0.01) and BSS (p < 0.01). Post hoc analyses revealed that these differences were driven by significant improvements in these dependent variables (all p < 0.01) while the CG remained unchanged (all p > 0.05). Moreover, TUG, T30, TWM, and BSS were significantly different between TG and CG in the post-training assessments (all p < 0.01). Isokinetic muscle strength was slightly increased in the TG (2.4%) and decreased in the CG (-2.2%), but statistical analyses did not reach significance for interaction but only a trend (p = 0.12). CONCLUSION: The results indicate that 9 weeks of PRT reduces bradykinesia and improves functional performance in patients with mild to moderate PD. These findings reinforce this mode of exercise as an important component of public health promotion programs for PD.

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BACKGROUND: Studies evaluating kinematics lead to different conclusions, not all changes appear in all assessed tasks and in all subgroups of patients with patellofemoral pain (PFP). The inconsistencies between studies could be reduced if we knew which task separates patients best from healthy controls. RESEARCH QUESTION: Identify which functional task, between gait, forward step down (FSD), lateral step down (LSD), stair ascent and descent and propulsion and landing phase of the single leg hop test (SLHT), differentiates the three-dimensional kinematics of women with patellofemoral pain from asymptomatic women. METHODS: This cross-sectional study evaluated thirty-five PFP and thirty-five asymptomatic women during the execution of the following tasks: gait, FSD, LSD, stair ascent and descent and the propulsion and landing phase of single leg hop test. Frontal, sagittal and transverse plane angles of the trunk, pelvis and hip, frontal and sagittal plane angles of the knee, ankle dorsiflexion, foot progression angle and hindfoot eversion were analyzed through the Movement Deviation Profile (MDP). To compare the groups, the multivariate analysis with Bonferroni post hoc test were used, with a significance level of p < 0.01. To identify which task presented the most difference between the groups, the Z-score of the mean MDP was calculated. RESULTS: For all tasks, the groups presented significant differences. According to the Z-score, the groups got farther apart considering the MDP for each task in the following order: LSD (7.97), FSD (7.62), landing phase of SLHT (3.43), gait (2.85), propulsion phase of SLHT (1.64), descending stairs (1.63) and ascending stairs (1.00). SIGNIFICANCE: We suggest that step down tests should be included in the assessment of PFP patients, since these tests most differentiate the kinematics of women with and without PFP. Identifying the tasks with the highest sensitivity to detect the kinematic differences is expected to improve clinical decision-making.

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Chronic obstructive pulmonary disease (COPD) is characterized by dyspnea, as well as musculoskeletal and systemic manifestations. Photobiomodulation therapy (PBMT) with use of low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) is an electrophysical intervention that has been found to minimize or delay muscle fatigue. The aim of this study was to evaluate the acute effect of PBMT with combined use of lasers diodes, light-emitting diodes (LEDs), magnetic field on muscle performance, exercise tolerance, and metabolic variables during the 6-minute stepper test (6MST) in patients with COPD. Twenty-one patients with COPD (FEV1 46.3% predicted) completed the 6MST protocol over 2 weeks, with one session per week. PBMT/magnetic field or placebo (PL) was performed before each 6MST (17 sites on each lower limb, with a dose of 30 J per site, using a cluster of 12 diodes 4 × 905 nm super-pulsed laser diodes, 4 × 875 nm infrared LEDs, and 4 × 640 nm red LEDs; Multi Radiance Medical™, Solon, OH, USA). Patients were randomized into two groups before the test according to the treatment they would receive. Assessments were performed before the start of each protocol. The primary outcomes were oxygen uptake and number of steps, and the secondary outcome was perceived exertion (dyspnea and fatigue in the lower limbs). PBMT/magnetic field applied before 6MST significantly increased the number of steps during the cardiopulmonary exercise test when compared to the results with placebo (129.8 ± 10.6 vs 116.1 ± 11.5, p = 0.000). PBMT/magnetic field treatment also led to a lower score for the perception of breathlessness (3.0 [1.0-7.0] vs 4.0 [2.0-8.0], p = 0.000) and lower limb fatigue (2.0 [0.0-5.0] vs 4.0 [0.0-7.0], p = 0.001) compared to that with placebo treatment. This study showed that the combined application of PBMT and magnetic field increased the number of steps during the 6MST and decreased the sensation of dyspnea and lower limb fatigue in patients with COPD.

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OBJECTIVES: This study had three aims: (1) to evaluate the relationships between the paretic knee extensor muscle strength and global lower-limb strength in individuals who had suffered a sub-acute/chronic stroke, (2) to determine whether global lower-limb strength, sex, body mass index, or age could predict knee extensor muscle strength, and 3) to investigate whether the results obtained via a Modified Sphygmomanometer Test (MST) would be similar to those obtained using a hand-held dynamometer. METHODS: This was a cross-sectional study, performed at a research laboratory, at participants' homes, or at outpatient clinics. Forty-two individuals with a sub-acute stroke and 45 individuals with a chronic stroke participated. Maximum isometric strength of the paretic lower-limb muscles (i.e. hip, knee, and ankle flexors/extensors, hip abductors) was measured using the MST and a hand-held dynamometer. RESULTS: Significant and high correlation coefficients were found between knee extensor muscle strength and global lower-limb strength as measured by the combined strength values of 6 lower limb muscle groups in individuals with sub-acute (0.81≤r≤0.88; p<0.05) and chronic (0.82≤r≤0.85; p<0.05) stroke. Step-wise multiple regression analysis revealed that only global lower-limb strength was retained in the model and accounted for 66-78% and 67-72% (p<0.001) of the variance in knee extensor muscle strength at the sub-acute and chronic phases post-stroke, respectively. The results obtained via the MST were similar to those obtained using the hand-held dynamometer. CONCLUSION: Paretic knee extensor muscles strength, assessed using a MST or a hand-held dynamometer, indicates global lower-limb strength in individuals with a sub-acute or chronic stroke.

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Aim: Surface electromyography (sEMG) has been established as a safe non-invasive method to investigate neuromuscular function. However, the use of this instrument to assess lower limbs of transfemoral amputees still presents a lack of standardization in its methods of signal acquisition and processing. The aim of this study was to review the current state of sEMG utilization to assess transfemoral amputees, the procedures adopted for the acquisition and the functional findings. Methods: This is a literature review. Five electronic databases were searched to find the studies: All relevant information of each study was extracted and registered. Methodological quality was evaluated using a customized checklist. Results: Eight studies followed the inclusion criteria and were included in this paper. Four studies did not reach more than 80% of the quality checklist, few studies fully described the methodology applied. The muscles assessed were similar in all studies, electrodes placement was determined by different criteria. Conclusion: This paper demonstrates that a few studies have used this method to assess this population and the main variable aspect is concerned to the placement of the electrodes. More researches are needed to better understand the neuromuscular behavior of amputees by using sEMG and assist future researches to develop more reproducible and reliable studies.(AU)

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BACKGROUND: Kinesiotaping (KT) has been commonly used in clinical setting. However, beneficial KT effects have not been proved yet. OBJECTIVE: We aimed to verify the effects of KT in knee extensor torque in children with CP. METHODS: We evaluated three children diagnosed as spastic CP, classified as level I, II and III, according with GMFCS. Knee extensor peak torque was analyzed by isokinetic evaluation (Biodex Multi Joint System). The test was performed at 60°/s in the concentric passive mode and the children performed maximal contractions. Children with CP were evaluated with and without KT under rectus femoris. RESULTS: After KT application, knee peak torque of the affected limb increased in children with CP. CONCLUSION: KT may increase muscle strength in children with CP.

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BACKGROUND: Increased external knee abduction moment has been proposed as a risk factor for patellofemoral pain. This alteration is thought to be associated with elevated patellofemoral joint reaction force and stress, however these relationships remain poorly explored. Therefore, this study aimed at comparing knee abduction moment parameters (peak, rate of moment development and impulse), patellofemoral joint reaction force and stress of women with patellofemoral pain and pain-free controls during stair descent; and investigating the relationship among these variables with self-reported pain. METHODS: Kinetic data was obtained by inverse-dynamics equations and a previously reported algorithmic model was used to determine patellofemoral joint reaction force and stress. Participants' worst pain in the last month and pain level during stair descent were evaluated using a visual analogue scale. FINDINGS: Women with patellofemoral pain presented higher peak, rate of moment development and impulse of the external knee abduction moment, patellofemoral joint reaction force and stress (p = 0.005 to 0.04, effect size = 0.52 to 0.96) during stair descent than pain-free controls. Only knee abduction moment impulse presented positive moderate correlations with worst pain level in the last month (r = 0.53, p < 000.1), pain level during stair descent (r = 0.33, p = 0.042), patellofemoral joint reaction force (r = 0.65, p < 000.1) and stress (r = 0.58, p < 000.1). INTERPRETATION: These findings indicate that strategies aimed at decreasing external knee abduction moment impulse could reduce the load over the patellofemoral joint and improve pain of women with patellofemoral pain.

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The anterolateral structures of the knee have recently garnered considerable interest regarding their role in rotatory knee instability related to anterior cruciate ligament tears. Isolated anterior cruciate ligament reconstruction may not always restore rotatory stability of the knee. In these patients, additional procedures, such as lateral reconstruction or tenodesis, may be indicated. The anatomy of the anterolateral structures of the knee has been well described. Histologic and anatomic studies have reported conflicting findings regarding the presence of a discrete ligament. The biomechanical role of the anterolateral capsule in restraining internal tibial rotation has been described as negligible. The existing body of research on the anterolateral knee structures provides insight into the composition of the anterolateral complex of the knee.

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BACKGROUND: Patellofemoral pain is a very common musculoskeletal condition. In the last years, evidence regarding this disease increased exponentially. Although widely investigated, this problem still frustrates patients and clinicians for having an unfavorable prognosis. Some gaps still exist in the understanding and managing of patellofemoral pain. Numerous cross-sectional association studies show an association between gluteus muscular strength and dynamic knee valgus in patients with patellofemoral pain. In spite of this biological plausibility, many evidences challenge the direct relationship between these factors. Recent studies have concluded that women with patellofemoral pain show muscular weakness of the hip based on the cross-sectional studies, however prospective studies indicate that hip weakness cannot be considered a risk for development of patellofemoral pain. In addition, some clinical trials have demonstrated that strength training of the gluteal muscles promotes significant improvement in symptoms but not alter the kinematics of the patients with patellofemoral pain. These findings cast doubt on whether the cause of this condition is really being treated, whether all individuals suffering from patellofemoral pain present dynamic knee valgus or if this is a disturbance present in only a subgroup of patients and whether the strengthening of the hip musculature is an option to consider for prevention of patellofemoral pain. CONCLUSION: Certainly, more studies should be conducted to clarify the influence of mechanical patterns on this condition, but with the existing evidence so far, the importance given to these issues in the evaluation and clinical decision on treatment of these patients seems questionable. Therefore, this masterclass explores the understanding about patellofemoral pain, highlighting mainly the importance of muscular strength and dynamic knee valgus, as well as other possible factors that must be consider during the evaluation and the decision making in these patients.

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INTRODUCTION: This study evaluates the complexity of force and surface electromyography (sEMG) during knee extension and flexion at low-level isometric contractions in individuals with different degrees of diabetic peripheral neuropathy (DPN). METHODS: Ten control and 38 diabetic participants performed isometric contractions at 10%, 20%, and 30% of maximal voluntary contraction. Knee force and multichannel sEMG from vastus lateralis (VL) and biceps femoris were acquired. The SD of force and sample entropy (SaEn) of both force and sEMG were computed. RESULTS: Participants with moderate DPN demonstrated high force-SD and low force-SaEn. Severely affected participants showed low SaEn in VL at all force levels. DISCUSSION: DPN affects the complexity of the neuromuscular system at the knee for the extension task during low-level isometric contractions, with participants in the later stages of the disease (moderate and severe) demonstrating most of the changes. Muscle Nerve 57: 112-121, 2018.

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OBJECTIVE: To compare knee isokinetic performance six months after reconstruction of the anterior cruciate ligament using grafts from either the patellar tendon or the hamstrings among patients who underwent the same rehabilitation protocol. METHODS: Thirty-four patients were evaluated (17 with grafts from the patellar tendon and 17 with grafts from the hamstrings). Operated and non-operated knees were compared with regards to the variables of peak torque, work and the hamstring/quadriceps relationship at velocities of 60º/s and 180º/s and power of 180º/s after six months of surgery. RESULTS: The patients with ACL reconstruction using the patellar tendon (BPTB) showed quadriceps deficits for all variables, but the flexor musculature was balanced. In the hamstring group, both the extensors and the flexors showed deficits for the variables analyzed, except for hamstring power at 180º/s. CONCLUSION: Patients in the patellar tendon group had a greater quadriceps deficit compared with those in the hamstrings group. Patients in the hamstrings group had a greater muscular deficit in the flexor mechanism compared with the contralateral knee. An unbalanced H/Q ratio was observed regardless of graft type, but this was more evident in the BPTB group.

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BACKGROUND: Muscle force estimation could advance the comprehension of the neuromuscular strategies that diabetic patients adopt to preserve walking ability, which guarantees their independence as they deal with their neural and muscular impairments due to diabetes and neuropathy. In this study, the lower limb's muscle force distribution during gait was estimated and compared in diabetic patients with and without polyneuropathy. METHODS: Thirty individuals were evaluated in a cross-sectional study, equally divided among controls (CG) and diabetic patients with (DNG) and without (DG) polyneuropathy. The acquired ground reaction forces and kinematic data were used as input variables for a scaled musculoskeletal model in the OpenSim software. The maximum isometric force of the ankle extensors and flexors was reduced in the model of DNG by 30% and 20%, respectively. The muscle force was calculated using static optimization, and peak forces were compared among groups (flexors and extensors of hip, knee, and ankle; ankle evertors; and hip abductors) using MANOVAs, followed by univariate ANOVAs and Newman-Keuls post-hoc tests (p < 0.05). RESULTS: From the middle to late stance phase, DG showed a lower soleus muscle peak force compared to the CG (p=0.024) and the DNG showed lower forces in the gastrocnemius medialis compared to the DG (p=0.037). At the terminal swing phase, the semitendinosus and semimembranosus peak forces showed lower values in the DG compared to the CG and DNG. At the late stance, the DNG showed a higher peak force in the biceps short head, semimembranosus, and semitendinosus compared to the CG and DG. CONCLUSION: Peak forces of ankle (flexors, extensors, and evertors), knee (flexors and extensors), and hip abductors distinguished DNG from DG, and both of those from CG. Both diabetic groups showed alterations in the force production of the ankle extensors with reductions in the forces of soleus (DG) and gastrocnemius medialis (DNG) seen in both diabetic groups, but only DNG showed an increase in the hamstrings (knee flexor) at push-off. A therapeutic approach focused on preserving the functionality of the knee muscles is a promising strategy, even if the ankle dorsiflexors and plantarflexors are included in the resistance training.

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BACKGROUND: Shortwave diathermy (SWD) and microwave diathermy (MWD) are frequently used by physical therapists to treat musculoskeletal conditions. The therapeutic benefits are usually associated with an increase in tissue temperature; however, there is no consensus on the changes in blood flow. OBJECTIVES: 1) To evaluate the behavior of temperature and arterial blood flow after the application of SWD and MWD to the lower limb of healthy women aged 18-30 and 2) to assess whether changes in limb positioning can influence SWD response. METHOD: Among the subjects analyzed, 40 women were eligible to participate in the trial and were randomly allocated to the SWD group or the MWD group. Each group received 20min of diathermy. After receiving the interventions, all patients crossed over to the other group, but the devices were detuned (sham). SWD was applied to the posterior compartment of the thigh and leg, with the knee in 0° and 90° of flexion, and the MWD applied to the posterior thigh. Skin temperature evaluation (digital infrared thermography) and assessment of blood flow velocity (Doppler ultrasound) were performed immediately before and 10 and 20min after the application. RESULTS: Arterial blood flow increased after SWD diathermy (vs. Sham), but not after MWD diathermy. SWD promoted skin heating at the end of therapy in all areas analyzed, remaining above baseline even 20min after the end of the application. MWD diathermy promoted skin heating in the posterior thigh, reflecting a rise in the temperature of the popliteal fossa area that remained for 10min after the end of the application. CONCLUSION: The increase in arterial blood flow velocity depends on the size of the heating area, since it was only observed in the application of the SWD. However, after 20min of application, the position of the lower leg did not affect the heating.

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BACKGROUND: Secondary hyperalgesia in individuals with less severe levels of knee osteoarthritis remains unclear. The objective of this study was to measure the pressure pain threshold of individuals with mild or moderate knee osteoarthritis and compare with no osteoarthritis. METHODS: Ten healthy controls and 30 individuals with mild or moderate knee osteoarthritis divided into two groups (unilateral and bilateral involvement) were included. Dermatomes in lumbar levels (L1, L2, L3, L4 and L5) and sacral level (S1 and S2), myotomes (vastus medialis, vastus lateralis, rectus femoris, adductor longus, tibialis anterior, peroneus longus, iliacus, quadratus lumborum, and popliteus muscles), and sclerotomes in lumbar levels (L1-L2, L2-L3, L3-L4, L4-L5 supraspinous ligaments), over the L5-S1 and S1-S2 sacral areas, pes anserinus bursae, and at the patellar tendon pressure pain threshold were assessed and compared between individuals with and without knee osteoarthritis. RESULTS: Knee osteoarthritis groups (unilateral and bilateral) reported lower pressure pain threshold compared to the control group in most areas (dermatomes, myotomes, and sclerotomes). There were no between group differences in the supra-spinous ligaments and over the L5-S1 and S1-S2 sacral areas of the sclerotomes. No difference was seen between knee osteoarthritis. CONCLUSION: These findings suggest that individuals with mild to moderate knee osteoarthritis had primary and secondary hyperalgesia, independent of unilateral or bilateral involvement. These results suggest that the pain have to be an assertive focus in the clinical practice, independent of the level of severity or involvement of knee osteoarthritis.

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