The impact of knee osteoarthritis on rehabilitation outcomes in hemiparetic stroke patients.

Abstract

To investigate the effects of knee osteoarthritis (OA) on activities of daily living and motor and functional improvement in stroke patients with hemiparesis. This prospective case-controlled study included 60 inpatients (44 women, 16 men; mean age 66.1 ± 7.6 years, range 51-79 years) with hemiparesis after stroke. Main outcome measures included the Brunnstrom motor recovery stages of the lower extremity, Functional Ambulation Category (FAC), Barthel index, knee pain as assessed by a VAS, and radiographic severity of knee OA based on the Kellgren-Lawrence (K/L) criteria. Between improvements in FAC score and time since stroke , Barthel score, knee pain at rest, K/L radiological grade revealed weak but significant correlations (r: 0.254-0.393) (p< 0.05). Regression analysis revealed that time since stroke, knee pain at rest and radiologically knee osteoarthritis had a significant effect on the improvement in ambulation level (r=0.134, p=0.001; r=0.137, p<0.05; r=-0.007, p< 0.05; respectively). The present study shows that knee OA had a negative effect on ambulation levels in hemiplegic patients after stroke. Thus, knee pain at rest and knee osteoarthritis could be evaluated as a functional outcome factor for the improvement of the ambulation levels within stroke patients.