The influence of arthrogenous muscle inhibition on quadriceps rehabilitation of patients with early, unilateral osteoarthritic knees

Reflex arthrogenous muscle inhibition (AMI) may cause muscle atrophy or impede effective rehabilitation of affected muscle groups. To investigate this, bilateral quadriceps AMI, isometric and isokinetic muscle strength were measured in 10 patients with unilateral osteoarthritic knees, before and after a course of routine physiotherapy. Before rehabilitation, quadriceps of all the diseased legs were inhibited (P < 0.05) and 40% weaker (P < 0.02) than the non-diseased legs. Following rehabilitation, AMI decreased (P < 0.01) in the diseased leg and strength increased at all test velocities (P < 0.05-0.005); however, strength deficits compared with the non-diseased leg remained. Subjective improvements in functional ability and confidence in the diseased leg were reported. Though AMI may be partially responsible for unilateral muscle weakness, it does not preclude strength gain in affected muscles. Possible physiological mechanisms which evoke AMI may also adversely affect muscle proprioception, implicating AMI as a possible cause of initiation or progression of degenerative joint disease.