Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis

Abstract

Knee osteoarthritis is a chronic degenerative disease. Cartilage and subchondral bone degeneration, as well as synovitis, are the main pathological changes associated with knee osteoarthritis. Mechanical overload, inflammation, metabolic factors, hormonal changes, and aging play a vital role in aggravating the progression of knee osteoarthritis. The main treatments for knee osteoarthritis include pharmacotherapy, physiotherapy, and surgery. However, pharmacotherapy has many side effects, and surgery is only suitable for patients with end-stage knee osteoarthritis. Exercise training, as a complementary and adjunctive physiotherapy, can prevent cartilage degeneration, inhibit inflammation, and prevent loss of the subchondral bone and metaphyseal bone trabeculae. Increasing evidence indicates that exercise training can improve pain, stiffness, joint dysfunction, and muscle weakness in patients with knee osteoarthritis. There are several exercise trainings options for the treatment of knee osteoarthritis, including aerobic exercise, strength training, neuromuscular exercise, balance training, proprioception training, aquatic exercise, and traditional exercise. For Knee osteoarthritis (KOA) experimental animals, those exercise trainings can reduce inflammation, delay cartilage and bone degeneration, change tendon, and muscle structure. In this review, we summarize the main symptoms of knee osteoarthritis, the mechanisms of exercise training, and the therapeutic effects of different exercise training methods on patients with knee osteoarthritis. We hope this review will allow patients in different situations to receive appropriate exercise therapy for knee osteoarthritis, and provide a reference for further research and clinical application of exercise training for knee osteoarthritis.

Comparison of Warming Needle Moxibustion and Drug Therapy for Treating Knee Osteoarthritis: A Systematic Review and Meta-analysis

“…Knee osteoarthritis (KOA) refers to a degenerative disease characterized by knee pain, movement disorder, and muscle dysfunction [ 1 , 2 ] with high morbidity and incidence of joint deformity. It not only compromises patients' qualify of life but causes social-psychological problems such as anxiety, depression, sense of helplessness, and social dysfunction [ 3 , 4 ] and brings heavy burden on their family and public health system [ 5 ]. Pathological features of KOA mainly include cartilage damage, osteophyte formation, and degenerations of subchondral bone and meniscus [ 6 ].…”

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

“…We also found that the PASTR was positively correlated with functional improvement. The main core muscle group in this position is the quadriceps tendon, which may be the reason why exercising the lower limb core muscle group to increase knee stability can improve pain and function of knee patients [19,20] , improving the muscle strength of the lower extremities through exercise and increasing the richness of the soft tissue around the knee joint was more bene cial to ESWT treatment of KOA.To some extent, the soft tissue around the knee joint may be an effective new target for KOA diagnosis, evaluation, treatment and rehabilitation, and we expect our research to contribute to the formulation of primary prevention strategies for the prevention of KOA in older adults.…”

Time to Total Knee Arthroplasty after Intra-Articular Hyaluronic Acid or Platelet-Rich Plasma Injections: A Systematic Literature Review and Meta-Analysis

“…It may use non-pharmacological (physiotherapy, exercise training, knee braces, etc.) [ 6 , 7 ] and pharmacological options (analgesic, non-steroidal anti-inflammatory, intra-articular [IA] injections of corticosteroids) [ 8 , 9 ]. Among pharmacological options, IA hyaluronic acid (HA) injections have been used for several years for symptom reduction, although controversial [ 10 ].…”