The effect of vitamin D status on pain, lower limb strength and knee function during balance recovery in people with knee osteoarthritis: an exploratory study

Summary: The association between vitamin D and muscle function associated with balance recovery and falls in people with knee osteoarthritis is unclear. Those with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function. Purpose: Low vitamin D status in people with knee osteoarthritis (OA) is often reported to be associated with increased pain and locomotor dysfunction. However, despite the growing evidence of the effect of vitamin D on the pathogenesis of knee OA, its role remains conflicting. Importantly, muscle function is important for knee joint health; however, the association between vitamin D levels and muscle function associated with balance recovery and falls is unclear. This study investigated the effect of circulating 25-hydroxyvitamin D (25 (OH) D) on pain, quadriceps strength, lower limb muscle mass and knee power function during balance recovery in people with knee OA. Methods: Twenty-four participants with clinical symptoms of knee OA (68.6 ± 6.2 years) participated in the study. Serum levels of 25 (OH) D were assessed and participants were classified as follows: vitamin D insufficiency ≤ 50 nmol/L and vitamin D sufficiency > 50 nmol/L. The groups were compared on knee function during balance recovery tasks, lower limb strength and muscle mass as well as perceived pain and function. Results: Seven patients (29.1%) were classified as vitamin D-insufficient. Vitamin D insufficiency was associated with reduced knee muscle function during the balance recovery task, increased pain (Western Ontario and McMasters University Osteoarthritis Index (WOMAC) subscore), dysfunction (WOMAC subscore) and total WOMAC score (p < 0.05). Conclusion: People with knee OA with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.