{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:11:32Z","timestamp":1778238692861,"version":"3.51.4"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>\n                    Knee osteoarthritis (KOA) is a prevalent musculoskeletal disorder characterized by pain, functional impairment, and structural degeneration. While quadriceps and hip abductor weakness are well-established in KOA, the role of hip extensor strength remains underexplored despite its biomechanical importance in lower limb alignment and joint loading. This cross-sectional study aimed to examine whether hip extensor strength differs between asymptomatic individuals and symptomatic KOA patients, and its relationship with pain, function, and radiographic severity. Adults aged 45\u201370 years (\n                    <jats:italic toggle=\"yes\">N<\/jats:italic>\n                    = 112; 56 asymptomatic, 56 symptomatic for KOA) were included. Pain, function, and hip extensor strength were evaluated using Visual Analogue Scale, Western Ontario and McMaster Universities Osteoarthritis Index and modified sphygmomanometer respectively; radiographic severity was graded by Kellgren\u2013Lawrence system. Between-group differences were analyzed using the Mann\u2013Whitney\n                    <jats:italic toggle=\"yes\">U<\/jats:italic>\n                    test, associations by Spearman's correlation, and multiple linear regression adjusted for age, gender, and BMI. Symptomatic participants demonstrated significantly lower bilateral hip extensor strength than asymptomatic subjects (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.001). Lower strength was associated with greater pain, poorer function, and higher Kellgren\u2013Lawrence grades (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05). Strength reductions were more pronounced in females across radiographic grades. After adjustment, age and gender were significantly associated with strength in the asymptomatic group, whereas only gender remained significant in the symptomatic group. These findings highlight hip extensor strength as a clinically relevant yet underemphasized factor associated with symptom and structural severity in KOA. Targeted strengthening warrants exploration as a rehabilitation component; however, causality cannot be inferred from this cross-sectional design, and longitudinal studies are needed to establish its effect on clinical or structural outcomes.\n                  <\/jats:p>","DOI":"10.1097\/mrr.0000000000000702","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:00:14Z","timestamp":1774260014000},"page":"129-137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Can hip extensor strength influence the knee osteoarthritis severity? A cross-sectional analysis"],"prefix":"10.1097","volume":"49","author":[{"given":"Babina","family":"Rani","sequence":"first","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine (Physiotherapy Section), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehak","family":"Singla","sequence":"additional","affiliation":[{"name":"Pandit Deendayal Upadhyaya National Institute for Persons with Physical Disabilities"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Tyagi","sequence":"additional","affiliation":[{"name":"JPNATC, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivam","family":"Sharma","sequence":"additional","affiliation":[{"name":"Falls, Balance and Injury Research Center, Neuroscience Research Australia"},{"name":"School of Population Health, UNSW, Sydney, Australia"},{"name":"Movement Care Lab (MCL), Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md Salman","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine (Physiotherapy Section), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binod K","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Physical and Rehabilitation Medicine (Physiotherapy Section), Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandeep S.","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Orthopaedic and Sports Medicine, Fortis Hospital, Mohali, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"R1-20260508","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1016\/S0140-6736(16)31678-6","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015.","volume":"388","author":"Vos","year":"2016","journal-title":"Lancet"},{"key":"R2-20260508","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s40520-022-02312-8","article-title":"Associations between obesity, diabetes mellitus, and cardiovascular disease with progression states of knee osteoarthritis (KOA).","volume":"35","author":"Long","year":"2023","journal-title":"Aging Clin Exp 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