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INTRODUCTIONSymptomatic radiographic knee osteoarthritis (OA) has a functional impact on 12% of adults aged 60 or older—4.3 million people—in the United States(1). The knee is one of the joints most commonly affected by OA(2). Given projected increases in the aging and obese populations, the incidence of OA of the knee is predicted to rise(3). Moreover, despite earlier research indicating joint cartilage degeneration as a possible primary cause of knee OA—initiating internal joint inflammation, edema, and pain(2)—recent research has investigated the causative role of the quadriceps muscle, which is located on the anterior thigh. In this muscle, weakness, impairments in function, influence on knee joint loading, and proprioceptive deficits seem to contribute to the development or progression of knee OA(4). Sufficient quadriceps function is essential to basic activities of daily living such as rising from a chair, standing, walking, and ascending and descending stairs(5). Researchers have found correlations among quadriceps weakness, increased pain, and altered walking patterns(6). Symptom management is typically the priority in OA treatment(7), and conventional health care management of knee OA involves nonpharmacological measures—such as patient education, exercise, physiotherapy, and braces—followed by pharmaceutical management and surgery(8).
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