Effects of resistance training on gait velocity and knee adduction moment in knee osteoarthritis patients: a systematic review and meta-analysis

Abstract

The systematic review aimed to analyze the effects of resistance training in knee osteoarthritis (OA) rehabilitation from a biomechanical perspective. A meta-analysis was performed to determine the potential benefits of resistance training on patients with knee OA. Relevant studies based on the inclusion and exclusion criteria were selected from CENTRAL, PubMed, Scopus, and Web of Science databases inception to August 2020. Outcome measures included gait velocity and knee adduction moment (KAM). The mean differences of the data with a 95% confidence interval were analyzed using STATA 15.1 software The search identified eight studies that satisfied all the inclusion criteria, in which 164 patients were involved in gait velocity studies and another 122 patients were part of KAM studies. Analysis of the pooled data showed that resistance training significantly improved the gait velocity in patients with knee OA (p < 0.01, z = 2.73), ES (95% CI) = 0.03 (0.01, 0.06) m/s. However, resistance training had no significant effect on improving KAM in patients with knee OA (p = 0.98, z = 0.03), ES (95% CI) = 0.00 (− 0.16, 0.16) percentage of body weight × height (%BW × Ht). Therefore, resistance training may enhance gait velocity but not KAM in knee OA patients. The protocol was registered at PROSPERO (registration number: CRD42020204897).

Protection against Osteoarthritis Symptoms by Aerobic Exercise with a High-Protein Diet by Reducing Inflammation in a Testosterone-Deficient Animal Model

“…The present study also showed that walking exercises improved pain-related behaviors, OA symptoms, inflammation status, and weight loss to decrease body fat more and muscle mass less. On the other hand, a systematic review showed that resistance training enhances the gait velocity in patients with knee OA but not knee adduction moment [38]. Furthermore, the present study showed that walking exercise reduced proinflammatory cytokine expression in the articular cartilage and the morphology of the knee joint in MIA-induced knee OA.…”

Identifying the modification factors of exercise therapy on biomechanical load in patients with knee osteoarthritis: A systematic review and meta-analysis

“…Interestingly, the first peak KAM did not increase with walking speed after exercise therapy; conversely, a previous systematic review suggested that walking speed affected the amplitude of joint moment in patients with knee OA, as well as in different populations 51 . Considering results from our regression analysis and a previous systematic review that suggested resistance training would enhance walking speed, but not KAM, in patients with knee OA 9 , it may be suggested that patients with knee OA demonstrate an increase in the first peak KAM through different pathways than the increase in the first peak KAM owing to an increase in walking speed. Other potential mediators, such as pain improvement, also increased the first peak KAM.…”

“…The specific search strategies are shown in the Supplementary Method. Google Scholar functioned as a complementary search engine, and a manual search of the reference lists of previous systematic reviews 8,9 was also performed. After excluding duplicate studies, two reviewers (MY and HI) independently evaluated all titles and abstracts to determine whether they would be eligible for subsequent full-text review.…”

“…The effect of exercise therapy on biomechanical loads currently remains unclear; some studies have reported a significant reduction in biomechanical loading 7 while others have reported no significant effect 8,9 or increment 10 . Additionally, although two previous systematic reviews investigated the effect of exercise therapy on peak KAM, only a limited number of studies were included, as the purpose was to clarify the relationship between altered peak KAM, pain, and walking speed after exercise therapy 8,9 . Therefore, comprehensive knowledge is required regarding the effect of exercise therapy on biomechanical loads, which may provide scope for exercise therapy.…”

Comparison of the open kinetic chain and closed kinetic chain strengthening exercises on pain perception and lower limb biomechanics of patients with mild knee osteoarthritis: a randomized controlled trial protocol

“…A decrease of 2 points in the pain score and a decrease of 9.1 scores in the function subscale of the WOMAC questionnaire are examples of clinically relevant improvement [ 47 , 49 , 50 ]. A mere 5% change in KAM was shown to improve OA symptoms [ 51 , 52 ] which will be considered as a clinically relevant improvement of the KAM in this trial. The results from this trial will provide vital evidence on clinical and biomechanical outcomes following OKC and CKC exercise programs in people with mild knee OA.…”