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    Living with knee osteoarthritis: the positive impact of reducing the knee torque induced when sleeping supine. A randomised clinical trial

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    Publication date
    2022-03-09
    Author
    Buckley, John G.
    Scally, Andy J.
    Bhattacharjee, C.
    Keyword
    Knee osteoarthritis
    Knee extension
    Knee pain
    Supine
    Sleeping position
    Rights
    (c) 2022 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)
    Peer-Reviewed
    Yes
    Open Access status
    openAccess
    
    Metadata
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    Abstract
    When lying supine, due to the reaction force from the mattress acting mostly through the heel, an external knee-extension joint-torque is induced that keeps the knee fully extended. This torque becomes zero if the feet are hung over the end of the support. This study investigated, in patients with knee-osteoarthritis (knee-OA) who routinely sleep supine, whether a change to such a sleeping position would ameliorate the knee pain and associated physical problems they suffer. Patients were recruited (General-Practitioners Centre, UK) over a 9-month period; those eligible (51/70) were randomly allocated to an intervention (65% female; age 71.5 [11.3] yrs; BMI, 29.20 [5.54] kg/m2; knee-OA severity, 20 mild–mod/3 severe) or control group (63% female; age, 68.3 [9.7] yrs; BMI, 28.69 [5.51] kg/m2; knee-OA severity, 17 mild–mod/2 severe). The primary outcome was improvements (0 [worst] to 100 [best]) in knee pain at 3 months and was rated in the Knee-Injury-and-Osteoarthritis-Outcome-Score questionnaire (KOOS). Secondary outcomes were improvements (0–100) in the other four KOOS-subscales. There were no differences between groups in KOOS outcomes at baseline, and there were no changes in KOOS outcomes in the control group at 3 months. Relative to the baseline KOOS values in Knee-Pain (50.1), Symptoms (52.5), Activities-of-Daily-Living (53.8) and Quality-of-Life (31.5), were all seen to improve at 3 months in the intervention group (by between 11.9 and 12.9); however, when comparing to controls, only the improvements in the subscale Activities-of-Daily-Living (which improved by 12.2) were statistically significant. Findings indicate that for those with knee-OA who routinely sleep supine, sleeping with the feet over the end of the mattress (to prevent the knee being pushed into/held in full extension) can help ameliorate the physical problems they suffer.
    URI
    http://hdl.handle.net/10454/18829
    Version
    Published version
    Citation
    Buckley JG, Scally AJ and Bhattacharjee C (2022) Living with knee osteoarthritis: the positive impact of reducing the knee torque induced when sleeping supine. A randomised clinical trial. Biomechanics. 2(1): 95-106.
    Link to publisher’s version
    https://doi.org/10.3390/biomechanics2010010
    Type
    Article
    Collections
    Health Studies Publications

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