Participants were recruited from February 2009 to March 2011 Participants were recruited from February 2009 to March 2011 regular referral from rheumatologists or rehabilitation physicians from our rehabilitation center. Participants’ eligibility was first assessed by screening questionnaire and telephone screening by the researcher, and subsequently by physical examination by a rheumatologist, rehabilitation physician and assessor. All participants provided written informed consent.
Inclusion criteria were (1) diagnosis of knee OA according to clinical American College of Rheumatology (ACR) criteria ,(2)age between 40 and 75 years, and (3) presence of self-reported and/or biomechanically assessed knee instability. Self-reported knee instability was defined as at least one episode of buckling, shifting or giving way of the knee in the past 3 months, reported by the patient Biomechanically assessed knee instability was defined as the presence of muscle weakness (i.e., bodyweight-adjusted isokinetic hamstrings strength 0.80 Nm/kg for men or 0.55 Nm/kg for women) in combination with presence of (1) impaired proprioceptive accuracy (i.e., score 4.3 ) and/or (2) high passive varuse-valgus laxity (i.e., score 4.6 for men or 7.7For women).Mean scores from both legs were used; cut-off points were based on previous data
Exclusion criteria were (1) other forms of arthritis than OA (e.g., crystal arthropathy, septic arthritis, spondyloarthropathy) identified by radiography and/or blood- and urine samples, (2) presence ofcomorbidity resulting in severe activitylimitations, (3) total knee arthroplasty (TKA) or TKA in near future, (4) severe knee pain (i.e., numeric rating scale (NRS) >8), (5) insufficient comprehension of Dutch language, (6) inability to be scheduled for therapy, and (7) unwillingness to give informed consent.
Participants were recruited from February 2009 to March 2011 Participants were recruited from February 2009 to March 2011 regular referral from rheumatologists or rehabilitation physicians from our rehabilitation center. Participants’ eligibility was first assessed by screening questionnaire and telephone screening by the researcher, and subsequently by physical examination by a rheumatologist, rehabilitation physician and assessor. All participants provided written informed consent.
Inclusion criteria were (1) diagnosis of knee OA according to clinical American College of Rheumatology (ACR) criteria ,(2)age between 40 and 75 years, and (3) presence of self-reported and/or biomechanically assessed knee instability. Self-reported knee instability was defined as at least one episode of buckling, shifting or giving way of the knee in the past 3 months, reported by the patient Biomechanically assessed knee instability was defined as the presence of muscle weakness (i.e., bodyweight-adjusted isokinetic hamstrings strength 0.80 Nm/kg for men or 0.55 Nm/kg for women) in combination with presence of (1) impaired proprioceptive accuracy (i.e., score 4.3 ) and/or (2) high passive varuse-valgus laxity (i.e., score 4.6 for men or 7.7For women).Mean scores from both legs were used; cut-off points were based on previous data
Exclusion criteria were (1) other forms of arthritis than OA (e.g., crystal arthropathy, septic arthritis, spondyloarthropathy) identified by radiography and/or blood- and urine samples, (2) presence ofcomorbidity resulting in severe activitylimitations, (3) total knee arthroplasty (TKA) or TKA in near future, (4) severe knee pain (i.e., numeric rating scale (NRS) >8), (5) insufficient comprehension of Dutch language, (6) inability to be scheduled for therapy, and (7) unwillingness to give informed consent.
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