How Physical Activity Affects Knee Cartilage and a Standard Intervention Procedure for an Exercise Program: A Systematic Review

Abstract

(1) Background: Cartilage degeneration with the natural aging process and the role of physical activity on cartilage wellness is still not clear. The objective of the present review was to understand how different physical activity interventions affect the cartilage and to propose a Standard Operating Procedure for an exercise program to maintain knee joint health; (2) Methods: Articles were collected on three different electronic databases and screened against the eligibility criteria. Results were collected in tables and the main outcomes were discussed narratively; (3) Results: A total of 24 studies have been included after the screening process and aerobic, strength, flexibility, postural balance, and mobility interventions were detected. Different protocols and types of interventions were adopted by the authors; (4) Conclusions: Physical activity interventions have mainly positive outcomes on cartilage structure, but the protocols adopted are different and various. A Standard Operating Procedure has been proposed for a physical intervention focalized on cartilage wellness that could be adopted as an intervention in the clinical setting. Furthermore, the creation of a standardized protocol wants to help scientific research to move in the same direction.

Molecular Assessment of Healthy Pathological Articular Cartilages in Physically Active People: A Scoping Review

“…Data from several recent reports [ 36 , 85 , 86 ] portrayed COMP, MMPs, CTX-I, CTX-II, and IL-1b as valid biomarkers for OA. There is heterogeneity in the published studies on this topic, most likely due to the variable selection of biomarker panels [ 29 ]. This critical aspect highlights the importance of establishing: (1) the reliability of the chosen biomarkers, as well as (2) defining the most suitable panel of biomarkers for OA and cartilage health in general.…”

“…Many studies have been conducted over the years on OA biomarkers, identifying many options for evaluating its progression and severity; however, the literature has been widely heterogeneous when physical activity is an included variable. Considering the importance of regular physical activity for articular cartilage health, the broad heterogeneity of findings in published studies [ 29 ], and the importance of personalized protocols and treatments (especially for people with OA) [ 30 ], and also taking into account that it is fundamental to better understand the role of the intervention on cartilage health through an appropriate and comparable evaluation, it is consequently important to standardize the evaluation methods by adopting the same biomarkers, and for this reason, standard operating procedures are required [ 24 ]. Consequently, this review aims to narrow the evaluation of relevant articular cartilage biomarkers, with emphasis on those markers that can draw some benefits from physical activity, and eventually propose a standard operating procedure.…”

Adherence to Exercise Training and Physical Function in Older Adults Diagnosed with Knee Osteoarthritis

“…Corroborating our findings, distinct studies have shown that older adults with KOA have impaired functional parameters. ( 6 , 13 , 14 , 15 , 34 , 35 )…”

“…On the other hand, strengthening training in combination with other types of exercises (e.g., functional exercise) significantly improved pain relief, physical function, and quality of life in KOA patients. ( 15 ) Pain has also eased after performing aerobic training, resistance training, or combined training in KOA patients. ( 16 )…”

Simulating Knee-Stress Distribution Using a Computed Tomography-Based Finite Element Model: A Case Study

“…Osteoarthritis (OA) is the most common knee-joint disease in middle-aged and elderly people [ 8 , 9 ]. OA is a classic example of joint destruction and osteoproliferative changes influenced by significant risk factors for joint degeneration, such as obesity, malalignment, trauma, or changes in joint loading associated with joint instability [ 10 , 11 , 12 ]. It is an age-related disease, and weight gain in particular causes significant progression of cartilage and meniscal lesions.…”