Managing Knee Osteoarthritis

Peeler, Jason; Christian, Mathew; Cooper, Juliette; Leiter, Jeffrey; MacDonald, Peter B.

doi:10.1097/jsm.0000000000000173

Cited by 42 publications

(16 citation statements)

References 33 publications

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“…Rasch et al [37] believes that the muscle weakness caused by osteoarthritis is related to decreased joint function and increased pain, and that quadriceps training can increase muscle strength and relieve joint pain. Canadian researchers Peeler et al [38] found that the strength of the quadriceps and hamstring muscles of KOA patients living in the community increased significantly after 12 weeks of training. This is consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

Chen

Zheng

Huang

et al. 2019

BMC Musculoskelet Disord

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Background Knee osteoarthritis (KOA) is common in elderly people, causes pain, loss of physical functioning, and disability. This was a two-arm, superiority, quasi-experimental trial. The aim of this study was to evaluate the effectiveness of a home-based exercise intervention (HBEI) to reduce KOA symptoms and improve the physical functioning of elderly patients. Methods A total of 171 elderly patients (60 years of age or older) with KOA were recruited from four community centers. Patients from two community centers were randomly assigned to the intervention group (IG) and the other two centers were randomly assigned to the control group (CG). Participants in the IG received a 12-week HBEI (including four 2-h sessions supervised by a physiotherapist and fortnightly telephone support) combined with health education, while patients in the CG only received health education. The participants and physiotherapists were aware of the group assignment and alternative treatment components, but the study’s hypotheses were not disclosed to the participants. Pain intensity, joint stiffness, lower-limb muscle strength, balance, mobility, and quality of life were measured before and after the intervention by the same blinded assessor. Results A total of 171 patients (IG: n = 84, CG: n = 87) were enrolled. Data were obtained from 141 patients with an average age of 68 (range, 60–86 years) who completed the 12-week study (IG: n = 71, CG: n = 70). No significant group differences were found in any outcome measures at baseline. At week 12, the pretest/posttest changes 3significant between-group differences in decreases in pain intensity (− 1.60 (CI, − 2.75 to − 0.58)) and stiffness (− 0.79 (CI, − 1.37 to − 0.21)), with the IG exhibiting significantly larger improvements on both measures than the CG. The IG also showed significantly greater improvements on all the secondary outcomes than the CG did. Conclusions HBEI may be effective for relieving KOA symptoms, increasing the physical functioning, and improving quality of life in community-dwelling KOA elderly patients. A large randomized controlled trial with long-term follow-up is needed to confirm these findings. Trial registration Chinese Clinical Trails Registry number ChiCTR1800017026 (retrospectively registered). Registered 9 July 2018. Electronic supplementary material The online version of this article (10.1186/s12891-019-2521-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

Chen

Zheng

Huang

et al. 2019

BMC Musculoskelet Disord

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“…Our results are consistent with the study of Peeler, in which the VAS, Knee Injury and Osteoarthritis Score (KOOS) questionnaire, and isokinetic strength were evaluated. Peeler's study found that AlterG can effectively reduce knee pain, improve knee function, and increase related muscle strength in OA patients, [5] but Peeler did not assess AlterG's changes in gait patterns and parameters in KOA patients objectively. Also, follow-up evaluation after 4 months showed that the patient's VAS score, 10 MWT, and TUG test were similar to the post-treatment evaluation results, suggesting that the treatment effect could be maintained for more than 4 months.…”

Section: Discussionmentioning

confidence: 99%

“…[2–4] Due to the above changes, daily life activities are affected accordingly. [5,6] The management of KOA based on the Evidence-Based Guidelines involves exercises and strength training and weight control. [7] Therefore, appropriate exercise therapy, such as aerobic exercise, has been known as an effective countermeasure.…”

Section: Introductionmentioning

confidence: 99%

The effect of anti-gravity treadmill training for knee osteoarthritis rehabilitation on joint pain, gait, and EMG

et al. 2019

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Introduction: To date, the anti-gravity treadmill (AlterG), as a representative method of Lower body positive pressure (LBPP) treadmills, has been rarely reported for knee osteoarthritis (KOA) rehabilitation. The purpose of this case study was to setup the clinical protocol example for AlterG intervention on KOA and evaluate treatment effectiveness by 3D gait analysis combined with free EMG to explore the kinematic gait parameter changes. Patient concerns: A 65-year-old female patient (BMI = 26, mild obesity) undergoing “more than 7 years of KOA.” The activity of the right knee joint was obviously limited and she suffered from severe pain over the past month. Diagnosis: Due to the patient's symptoms and radiographic findings, she was diagnosed with acute attack of KOA. Interventions: The patient has performed clinical function evaluation and gait analysis combined at pretreatment, post-treatment, and 4 months follow-up assessment. AlterG training was performed 6 days/week for 2 weeks, with up to 30 min of training per session. The training protocol included two major parts, walking and squatting in AlterG. Outcomes: After 2 weeks of AlterG intervention, the 10-m walking test (10 MWT) and Timed-up-and-go (TUG) test improved significantly post-treatment, whereas the Visual Analog Scale (VAS) score decreased post-treatment. The Modified Barthel Index improved post-treatment and the patient restored basic community walk after treatment. The temporal parameter results showed that stride length (%height), mean velocity (%height), and cadence gradually increased before treatment, after treatment, and at 4-month follow-up. The right range of motion (ROM) of knee flexion-extension were gradually increased. Meanwhile, the synchronized EMG data showed that the RMS (root means square) values of the rectus femoris, semitendinosus, and biceps femoris at post-treatment were improved to different degrees than at pretreatment. Conclusion: We found that for this patient with KOA, AlterG relieved pain, and was also effective at improving spatio-temporal parameters, knee flexion/extension gait pattern, and corresponding muscle strength, thereby restoring certain community activities.

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“…This poses a significant challenge to research that is designed to examine the effect of exercise on inflammation associated with OA disease progression. The introduction of a novel technology called Lower Body Positive Pressure (LBPP) now facilitates safe and individualized exercise prescription for patients at significant risk (such as those with knee OA) of exacerbation of knee joint symptoms during regular exercise (Peeler et al, 2015;Peeler & Ripat, 2018;Takacs et al, 2011Takacs et al, , 2013. Previous research indicates that LBPP technology can be successfully used during walking exercise to control knee pain and symptoms, and helps promote long-term walking exercise adherence by knee OA patients at significant risk of exacerbation of joint symptoms (Peeler et al, 2015Peeler & Ripat, 2018).…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Lower Body Positive Pressure Supported Treadmill Exercise Regime on Systemic Biomarkers of Inflammation and Cartilage Degradation in Individuals with Knee Osteoarthritis: A Pilot Study

Cornish

Peeler

2021

IJKSS

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Background: Knee osteoarthritis (OA) has been linked to a chronic low-grade inflammatory response and altered metabolic activity of articular cartilage. Objective: The purpose of this investigation was to evaluate the effectiveness of a 12-week (3 times/week) lower body positive pressure (LBPP) treadmill walking regime on knee pain and systemic biomarkers of inflammation and cartilage degradation. Methods: Sixteen overweight (BMI > 25 kg/m2) knee OA patients were randomized to a LBPP treadmill walking exercise group (N = 7) or non-exercise control group (N = 9). Baseline and 12-week follow-up assessments evaluated the following dependent variables: acute knee pain during full weight bearing treadmill walking; inflammatory biomarkers (C-reactive protein, interleukin-1β, interleukin-6, s100A8/A9, and tumor necrosis factor-α), and catabolic metabolism of articular cartilage (sCOMP). Results: Knee pain at baseline and follow-up remained unchanged for the non-exercise control group (P > 0.05). However, knee pain for the LBPP exercise group was significantly decreased at follow-up (P ≤ 0.05). No differences in the biomarkers of inflammation and cartilage degradation were observed for between and within group comparisons (all P > 0.05). Conclusions: Data suggested that the LBPP supported walking regime could be effectively used to promote regular weight bearing exercise without exacerbation of knee joint pain and did not increase levels of systemic inflammation or catabolic activity of articular cartilage in overweight knee OA patients. This pilot investigation offers important insight regarding the potential role that the LBPP technology could play in facilitating investigations examining the disease modifying effect of exercise on knee OA pathogenesis.

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Managing Knee Osteoarthritis

Cited by 42 publications

References 33 publications

The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

The effect of anti-gravity treadmill training for knee osteoarthritis rehabilitation on joint pain, gait, and EMG

The Effect of a Lower Body Positive Pressure Supported Treadmill Exercise Regime on Systemic Biomarkers of Inflammation and Cartilage Degradation in Individuals with Knee Osteoarthritis: A Pilot Study

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