Hip abductor strength–based exercise therapy in treating women with moderate-to-severe knee osteoarthritis: a randomized controlled trial

Abstract

Objective: To investigate whether hip abductor strength–based exercise therapy could result in further function improvement and more pain relief in women with knee osteoarthritis. Design: Randomized controlled trial. Settings: Rehabilitation department of Affiliated Hospital of Southwest Medical University from years 2016 to 2018. Subjects: In total, 82 women aged 50–70 years, with knee osteoarthritis grade II–IV on the Kellgren–Lawrence scale. Intervention: The experimental group engaged in hip abductor strength–based exercises under the supervision of physical therapists (once a day for six weeks), while the control group engaged in quadriceps femoris strength–based exercises. Main measures: Osteoarthritis severity measured by the Western Ontario and McMaster Universities Osteoarthritis Index, pain on a visual analogue scale and three objective functional tests were assessed at the sixth and 12th week. Repeated measures analysis of variance and multivariable analysis were applied. Results: Finally, 72 participants completed the study: 35 in the experimental group and 37 in the control group. The self-reported functional difficulties score in the experimental group was significantly lower than that in the control group both at the sixth week and at the 12th week ( P < 0.001). There were significant differences between groups in the stair ascent/descent task and Figure of 8 Walk test, but not in the Five Times Sit-to-Stand Test. The pain in the experimental group decreased compared with that in the control group at the sixth week ( P < 0.05), but not at the 12th week ( P > 0.05). Conclusion: Hip abductor strength–based exercises could result in better performance and higher self-reported function in women with symptomatic knee osteoarthritis.

Effect of Hip Abductors Versus Knee Extensor Strengthening on Pain,function and Quadriceps Isometric Strength in Knee Osteoarthritis : Protocol for a Randomized Clinical Trial

“…Since strengthening of hip abductors with patients, suffering Knee OA had been reported in previous studies when conducted in combination with knee muscles strengthening [6].It is likely that strengthening of hip abductors hold similar effects when applied without combination with knee extensors strengthening. Thus, reaching same target with less possible risk of knee OA progression from knee extensors strengthening.…”

“…Sample size of 70 patients in the 2 experimental groups is based on power analysis done calculating effect size from the outcomes of a previous study [6]. Power analysis was done using G*power software.…”

“…Based on the importance of thigh muscle strengthening in patients with knee OA, several authors [5]included strengthening of thigh muscles as an integral component of the treatment program of these patients. Further, hip muscles strengthening had been suggested to aid clinical improvement in patients with Knee OA in combination with knee extensors strengthening [6].…”

“…It seemed that hip abductor strength had a greater impact on functional activities in women [6]. Therefore, [6] hypothesized that women would be more responsive to the hip abductor strength-based exercise, males may also benefit from these exercises, although additional research is needed to prove it across the knee…”

Intervenções não medicamentosas na promoção da saúde

“…Tai Chi e Baduanjin, por exemplo, foram comparados ao ciclismo estacionário, demonstrando ser igualmente eficazes na redução da dor (LIU et al, 2019). O pilates demonstrou ser superior aos exercícios de contração isométrica de glúteo, quadríceps e adutores (MAZLOUM et al, 2017 Terapia manual combinada ao exercício de resistência parece adicionar benefícios quando comparado ao exercício realizado de forma isolada (ABBOTT et al, 2015) e acrescentar o fortalecimento da musculatura abdutora do quadril ao fortalecimento do quadríceps e orientação também adiciona benefícios sobre a dor em pacientes com OAJ (WANG et al, 2020). Em relação à educação, o exercício de resistência realizado de forma isolado (ROOIJ et al, 2017), assim como, de forma combinada com ciclismo subaquático (REWALD et al, 2020) ou combinada a palmilha e educação (SKOU et al, 2015) foi superior à educação feita de forma isolada.…”