Effects of resistance training in older women with knee osteoarthritis and total knee arthroplasty

Abstract

OBJECTIVES:This study sought to analyze the effects of resistance training on functional performance, lower-limb loading distribution and balance in older women with total knee arthroplasty (TKA) and osteoarthritis (OA) in the contralateral knee. In addition, this older knee OA and TKA group (OKG) was compared to older (OG) and young women (YG) without musculoskeletal diseases who underwent the same resistance training program.METHODS:Twenty-three women divided into OKG (N = 7), OG (N = 8) and YG (N = 8) had their functional performance, lower-limb loading distribution and balance compared before and after 13 weeks of a twice-weekly progressive resistance training program.RESULTS:At baseline, the OKG showed lower functional performance and unilateral balance, and impaired lower-limb loading distribution compared to the OG and the YG (p<0.05). After resistance training, the OKG showed improvements in functional performance (∼13% in sit-to-stand and rising from the floor, ∼16% in stair-climbing and ∼23% in 6-minute walking (6 MW)), unilateral balance (∼72% and ∼78% in TKA and OA leg, respectively) and lower-limb loading distribution, which were greater than those observed in the OG and the YG. The OKG showed post-training 6 MW performance similar to that of the OG at baseline. Sit-to-stand performance and unilateral stand balance were further restored to post-training levels of the OG and to baseline levels of the YG.CONCLUSIONS:Resistance training partially restored functional, balance and lower-limb loading deficits in older women with TKA and OA in the contralateral knee. These results suggest that resistance training may be an important tool to counteract mobility impairments commonly found in this population.

Educational program promoting regular physical exercise improves functional capacity and daily living physical activity in subjects with knee osteoarthritis

“…Although little is known about the effect of educational programs on functional capacity, it is known that physical exercise programs, specifically resistance training, promote improvement on functional capacity in individuals with knee OA [ 3 , 7 , 26 ]. For example, 13 weeks of a twice-weekly whole body resistance training program resulted in improvements on FTSST and stair climbing performance in individuals with total knee arthroplasty and OA in the contralateral knee [ 7 ], which were similar to those observed in the present study.…”

“…Although there is no curative treatment, the optimal management of knee OA requires pharmacological and non-pharmacological modalities, which are focused on alleviating disease symptoms, maintaining or improving patients’ functional independence and quality of life, and reducing disease progression to attempt to delay or avoid total knee arthroplasty [ 5 ]. The regular practice of physical exercise is an important non-pharmacological tool recommended for managing disease symptoms and improving functional capacity in patients with knee OA [ 3 , 6 , 7 ].…”

“…For example, a study by our group showed that educational programs improved pain, function and quality of life (both physical and mental) after 6 [ 9 ] and 12 month of follow-up [ 10 ]. Therefore, to change the habits may have important clinical implication for this population, and the regular practice of physical exercise appears to be a crucial habit that should be incorporated in the daily living [ 3 , 7 , 9 , 10 ].…”

Effects of Motor Learning on Clinical Isokinetic Test Performance in Knee Osteoarthritis Patients

“…Muscle strength plays an important protective role in the progression of knee OA 5-7, and it is inversely associated with physical function in this population 2, 3, 8. Therefore, evaluation of the muscular performance may have important implications to counteract the effects of its reduction on knee OA pathophysiology 2, 3, 7.…”

Endoprothetischer Gelenkersatz und Sport

“…Einfluss von Krafttraining auf die Kniegelenksmuskulatur bei liegender ProtheseRegelmäßiges Krafttraining (2-mal pro Woche über 13 Wochen) bei älteren Damen mit Kniegelenksarthrose und mit Kniegelenksprothesen kann geeignet sein, um ein Niveau der Muskelkraft, der Balance und der funktionellen Stabilität wieder herzustellen, welches dem eines Kontrollkollektivs ohne Kniegelenkspathologie vergleichbar ist[31,32].Petterson et al haben beschrieben, dass nach Knie TEP durch ein progressives Krafttraining innerhalb der ersten 4 Wochen zunächst die Normalisierung der willkürlichen Aktivierung des M. quadriceps wesentlich zur Maximalkraft beiträgt, bevor dann im Verlauf die physiologische Bedeutung des Muskelquerschnitts für die maximale Kraftentfaltung wieder zum Tragen kommt (12 und 52 Wochen post-OP) [33]. Einfluss von alpinem Skisport auf Knieendoprothesen Müller et al haben nach Knieprothesenimplantation den Effekt eines 12-wöchigen Alpin-Ski-Trainings auf multiple Aspekte untersucht und in Form einer Serie von Supplements publiziert: Es wurden positive Effekte auf das allgemeine Wohlbefinden der Patienten, die Kniefunktion und das Schmerzempfinden, auf die Patellarsehne, auf das Gangbild einschließlich seitengleicher Gewichtsverteilung, auf den Muskelquerschnitt des M. quadriceps (M. rectus femoris), auf die Adaptation der Typ I Muskelfasern, auf den Glukosestoffwechsel sowie auf die Kontraktionskraft von Kniestreckern und -beugern berichtet[34][35][36][37][38][39][40].…”