Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial

Abstract

To compare the efficacy and adherence rates of two parallel home exercise therapy programs-multiple exercise (training and stretching the knee and hip muscles) and control (training the quadriceps muscles)-on knee pain, physical function, and knee extension strength in community-dwelling elderly individuals with pre-radiographic knee osteoarthritis (OA). One hundred patients with medial knee pain were randomly allocated to one of two 4-week home exercise programs. Individuals with a Kellgren/Lawrence (K/L) grade 0 or 1 OA (pre-radiographic knee OA) in the medial compartment were enrolled. Primary outcomes were knee pain (visual analog scale), self-reported physical function (Japanese Knee Osteoarthritis Measure [JKOM]), and isometric maximum muscle strength of the knee extensor measured using a hand-held dynamometer. A total of 52 patients (28 [53.8%] in the multiple exercise group, 24 [46.2%] in the control group) completed the trial. The JKOM activities of daily living and general health conditions outcomes improved significantly in the multiple exercise group compared to the control group (JKOM activities of daily living, beta = - 0.76; 95% confidence interval [CI], - 1.39 to - 0.13; p = 0.01; JKOM general health conditions, beta = - 0.25; 95% CI, - 0.48 to - 0.01; p = 0.03). The home exercise compliance rates of the multiple exercise and control groups were 96.6 and 100%, respectively. When targeting pre-radiographic knee OA in community-dwelling elderly, it is important to implement home exercise programs that aim to improve muscle strength and joint flexibility rather than knee extension muscle power only.

Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORT‐prospective, randomised controlled clinical trial

“…50 The evolution of osteoarthritis of the knees leads to a limitation of ADL, compromising the QOL of the elderly. 51 In 2019, Suzuki et al 52 up to 1 year. 60 Aas et al 61 A recent systematic review 62 demonstrated evidence of a strong association between physical exercise and the QOL of the elderly.…”

Effect of hip abductor strengthening exercises in knee osteoarthritis: a randomized controlled trial

“…Strengthening exercises are a general accepted treatment for OA knees. Quadriceps exercises were studied, and reported the effectiveness for reduced pain and improved function in OA knees [20,21]. Hip abductor exercises were of interest as an adjuvant exercise for OA knee patients [7].…”

Stationary cycling exercise for knee osteoarthritis: A systematic review and meta-analysis

“…39,40 From a cost point of view, it may be economical for individuals with knee osteoarthritis to add in body-weight knee-loading exercises such as Tai Chi and Walking. 41 –43…”

“…39,40 From a cost point of view, it may be economical for individuals with knee osteoarthritis to add in body-weight knee-loading exercises such as Tai Chi and Walking. [41][42][43] There are three main limitations to the current review. First, we may have missed some studies since the databases searched were limited to those listed, and there may have been some potentially relevant trials that were not included due to the search terms used.…”