Effects of computer-aided rowing exercise systems on improving muscle strength and function in older adults with mild knee osteoarthritis: a randomized controlled clinical trial

Abstract

Background Osteoarthritis (OA) is common in aged adults and can result in muscle weakness and function limitations in lower limbs. Knee OA affects the quality of life in the elderly. Technology-supported feedback to achieve lower impact on knee joints and individualized exercise could benefit elderly patients with knee OA. Herein, a computer-aided feedback rowing exercise system is proposed, and its effects on improving muscle strength, health conditions, and knee functions of older adults with mild knee OA were investigated. Methods Thirty-eight older adults with mild knee OA and satisfying the American College of Rheumatology (ACR) clinical criteria participated in this randomized controlled clinical trial. Each subject was randomly assigned to a computer-aided rowing exercise (CRE) group (n = 20) or a control group (CON) (n = 18) that received regular resistance exercise programs two times per week for 12 weeks. Outcome measurements, including the Western Ontario and MacMaster Universities (WOMAC), muscle strength and functional fitness of the lower limbs, were evaluated before and after the intervention. Results Participants’ functional fitness in the CRE group exhibited significantly higher adjusted mean post-tests scores, including the WOMAC (p = 0.006), hip abductors strength (kg) (MD = 2.36 [1.28, 3.44], p = 5.67 × 10–5), hip adductors strength (MD = 3.04 [1.38, 4.69], p = 0.001), hip flexors strength (MD = 4.01 [2.24, 5.78], p = 6.46 × 10−5), hip extensors strength (MD = 2.88 [1.64, 4.12], p = 4.43 × 10−5), knee flexors strength (MD = 2.03 [0.66, 3.41], p = 0.005), knee extensors strength (MD = 1.80 [0.65, 2.94], p = 0.003), and functional-reach (cm) (MD = 3.74 [0.68, 6.80], p = 0.018), with large effect sizes (η2 = 0.17–0.42), than those in the CON group after the intervention. Conclusions Older adults with knee OA in the CRE group exhibited superior muscle strength, health conditions, and functional fitness improvements after the 12-week computer-aided rowing exercise program than those receiving the conventional exercise approach. Trial registration The Institutional Review Board of the Taipei Medical University approved the study protocol (no. N201908020, 27/05/2020) and retrospectively registered at ClinicalTrials.gov (trial registry no. NCT04919486, 09/06/2021).

Efficacy of virtual reality exercise in knee osteoarthritis rehabilitation: a systematic review and meta-analysis

“…A total of 23 articles were screened through this meticulous collation process. As complete data were still not available after contacting the corresponding authors, we further refined the articles, and after including one article from Google Scholar, we ultimately retained nine articles that met specific criteria ( Lin et al, 2007 ; Abdelazeem et al, 2016 ; Kim et al, 2017 ; Lin et al, 2020 ; Nambi et al, 2020 ; Lin et al, 2022 ; Mete and Sari, 2022 ; Ozlu et al, 2023 ; Oliveira et al, 2024 ). The detailed literature screening process is shown in Figure 1 .…”

“…The age distribution ranged from 20 to 70 years, with 229 participants receiving VR–based rehabilitation therapy and 227 participants receiving traditional rehabilitation therapy. Regarding the severity of KOA, four studies ( Abdelazeem et al, 2016 ; Nambi et al, 2020 ; Mete and Sari, 2022 ; Ozlu et al, 2023 ) included patients with Kellgren-Lawrence (K-L) grade 2 to 3, one ( Oliveira et al, 2024 ) study included patients with K-L grade 2 to 4, one study ( Lin et al, 2022 ) included patients with K-L grade 2, one study ( Kim et al, 2017 ) did not specify the severity of KOA in the recruited patients, and two studies included patients with K-L grade ≥2 ( Lin et al, 2020 ) and ≤3 ( Lin et al, 2007 ), respectively. These studies were conducted across various countries and regions, including two in Turkey ( Mete and Sari, 2022 ; Ozlu et al, 2023 ), two in Saudi Arabia ( Abdelazeem et al, 2016 ; Nambi et al, 2020 ), one in Brazil ( Oliveira et al, 2024 ), one in South Korea ( Kim et al, 2017 ), and three in China ( Lin et al, 2007 ; Lin et al, 2020 ; Lin et al, 2022 ).…”

“…Regarding the severity of KOA, four studies ( Abdelazeem et al, 2016 ; Nambi et al, 2020 ; Mete and Sari, 2022 ; Ozlu et al, 2023 ) included patients with Kellgren-Lawrence (K-L) grade 2 to 3, one ( Oliveira et al, 2024 ) study included patients with K-L grade 2 to 4, one study ( Lin et al, 2022 ) included patients with K-L grade 2, one study ( Kim et al, 2017 ) did not specify the severity of KOA in the recruited patients, and two studies included patients with K-L grade ≥2 ( Lin et al, 2020 ) and ≤3 ( Lin et al, 2007 ), respectively. These studies were conducted across various countries and regions, including two in Turkey ( Mete and Sari, 2022 ; Ozlu et al, 2023 ), two in Saudi Arabia ( Abdelazeem et al, 2016 ; Nambi et al, 2020 ), one in Brazil ( Oliveira et al, 2024 ), one in South Korea ( Kim et al, 2017 ), and three in China ( Lin et al, 2007 ; Lin et al, 2020 ; Lin et al, 2022 ). The immersion level of VR therapy included non-immersive and immersive modalities, with five studies ( Lin et al, 2007 ; Kim et al, 2017 ; Lin et al, 2020 ; Lin et al, 2022 ; Oliveira et al, 2024 ) utilizing non-immersive VR and four studies ( Abdelazeem et al, 2016 ; Nambi et al, 2020 ; Mete and Sari, 2022 ; Ozlu et al, 2023 ) utilizing immersive VR.…”

Intervenções fisioterapêuticas atuais aplicadas em idosos com doenças reumáticas: revisão integrativa da literatura

“…Não houve diferenças significativas para os dois grupos, pois ambos apresentaram aprimoramento da função neuromuscular o que explica o aumento da propriocepção, da força muscular de membros inferiores que pode ser quantificado através do teste de sentar/levantar da cadeira, maior desempenho funcional na velocidade da marcha, acréscimo de força dos membros superiores e por consequência isto pode se refletir no menor índice de quedas. Lin et. al.…”

“…(2018), os testes de sentar e levantar da cadeira de 30 segundos e o teste de caminhar de 10 metros não revelaram qualquer relevância entre os dois grupos. Contudo,Lin et al (2022) apresenta que diferente dos exercícios convencionais utilizados como ferramenta para tratamento de OA leve em idosos, o exercício de remo pode ser um meio útil aplicado pelos fisioterapeutas para redução de impacto articular e consequentemente suscitar a redução da dor.Ledingham et al (2019) em seu estudo com 25 idosos diagnosticados com OA de joelho (n = 14 GI, n = 11 GC), com idade média de 67 anos, teve como objetivo entender as experiências, sentimentos e perspectivas relacionadas à adesão ao exercício físico supervisionado pelo fisioterapeuta ao longo de dois anos seguidos. Após a análise, observou-se que os idosos participantes do GI sentiram-se mais confiantes, motivados e seguros ao desempenharem com mais habilidade as atividades do dia a dia, devido ao aprimoramento da capacidade funcional, e para exercitarem-se por conta própria em ambiente fora do consultório.…”