Effects of strength training on the incidence and progression of knee osteoarthritis

Abstract

Objective. Quadriceps weakness is a risk factor for incident knee osteoarthritis (OA). We describe a randomized controlled trial of effects of lower-extremity strength training on incidence and progression of knee OA. Methods. A total of 221 older adults (mean age 69 years) were stratified by sex, presence of radiographic knee OA, and severity of knee pain, and were randomized to strength training (ST) or range-of-motion (ROM) exercises. Subjects exercised 3 times per week (twice at a fitness facility, once at home) for 12 weeks, followed by transition to home-based exercise after 12 months. Assessments of isokinetic lower-extremity strength and highly standardized knee radiographs were obtained at baseline and 30 months. Results. Subjects in both groups lost lower-extremity strength over 30 months; however, the rate of loss was slower with ST than with ROM. Compared with ROM, ST decreased the mean rate of joint space narrowing (JSN) in osteoarthritic knees by 26% (P ‫؍‬ not significant). However, the difference between ST and ROM groups with respect to frequency of knee OA progression in JSN consensus ratings was marginally significant (18% versus 28%; P ‫؍‬ 0.094). In knees that were radiographically normal at baseline, JSN >0.50 mm was more common in ST than in ROM (34% versus 19%; P ‫؍‬ 0.038). Incident JSN was unrelated to exercise adherence or changes in quadriceps strength or knee pain. Conclusion. The ST group retained more strength and exhibited less frequent progressive JSN over 30 months than the ROM group. The increase in incident JSN >0.50 mm in ST is unexplained and requires confirmation.

Adaptive patterns of movement during stair climbing in patients with knee osteoarthritis

“…6 Research therapies have emerged directed at improving quadriceps strength in hopes to reduce OA disease progression and pain in patients with knee OA. [8][9][10] Although the loss of quadriceps function may have several causes, it is likely that patients will adopt patterns of movement during stair climbing to compensate for the loss of quadriceps function. Thus, the mechanics of movement during stair climbing in patients with knee OA could provide useful functional information on the severity of the disease state.…”

“…Nevertheless, physical therapy and exercise programs including quadriceps strengthening are frequently prescribed to patients with knee OA and have resulted in lower rate of progression of the disease. 10 Pain may act as a protective mechanism to keep OA patients from overloading their degenerating joint. 25 However, it is possible that quadriceps inhibition is a more sensitive and consistent marker than perceived pain.…”

Home Stretching Exercise is Effective for Improving Knee Range of Motion and Gait in Patients with Knee Osteoarthritis

“…The effectiveness of regular exercise in the management of pain and improvement of physical function has been established in patients with knee OA 3,4,[16][17][18] . In the present study, the stretching group showed significantly greater improvement in S-ROM than the control group and the mean percentage change was about 9%.…”

Efeitos de oito semanas de treinamento com estimulação elétrica neuromuscular nas razões de ativação muscular / torque de idosas com osteoartrite

“…Its main objective is to increase the musculature force that is inhibited due to joint pain, through the artificial generation of muscle contractions. [9][10][11][12][13][14] However, there is little evidence describing the use of NMES and its relation to an improvement in neuromuscular and mechanical properties in elderly patients with OA. Similarly, the effects of NMES training on the root mean square (RMS)/torque ratio have not yet been fully explained.…”