The effectiveness of proprioceptive-based exercise for osteoarthritis of the knee: a systematic review and meta-analysis

Smith, Toby; King, Jonathan J.; Hing, Caroline B.

doi:10.1007/s00296-012-2480-7

Cited by 52 publications

(51 citation statements)

References 45 publications

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“…Most studies are small and include people with mild to moderate knee OA [17,33-35], and only two include patients with severe hip or knee OA [36,37]. These latter studies are small RCTs, evaluating the effect of pre-surgical training on post-surgical outcomes [36,37].…”

Section: Discussionmentioning

confidence: 99%

Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis: a controlled before-and-after study

Ageberg

Nilsdotter²,

Kosek

et al. 2013

BMC Musculoskelet Disord

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BackgroundThe benefits of exercise in mild and moderate knee or hip osteoarthritis (OA) are apparent, but the evidence in severe OA is less clear. We recently reported that neuromuscular training was well tolerated and feasible in patients with severe primary hip or knee OA. The aims of this controlled before-and-after study were to compare baseline status to an age-matched population-based reference group and to examine the effects of neuromuscular training on patient-reported outcomes and physical function in patients with severe primary OA of the hip or knee.Methods87 patients (60–77 years) with severe primary OA of the hip (n = 38, 55% women) or knee (n = 49, 59% women) awaiting total joint replacement (TJR) had supervised, neuromuscular training (NEMEX-TJR) in groups with individualized level and progression of training. A reference group (n = 43, 53% women) was included for comparison with patients’ data. Assessments included self-reported outcomes (HOOS/KOOS) and measures of physical function (chair stands, number of knee bends/30 sec, knee extensor strength, 20-meter walk test) at baseline and at follow-up before TJR. Analysis of covariance (ANCOVA) was used for comparing patients and references and elucidating influence of demographic factors on change. The paired t-test was used for comparisons within groups.ResultsAt baseline, patients reported worse scores than the references in all HOOS/KOOS subscales (hip 27–47%, knee 14–52%, of reference scores, respectively) and had functional limitations (hip 72–85%, knee 42–85%, of references scores, respectively). NEMEX-TJR (mean 12 weeks (SD 5.6) of training) improved self-reported outcomes (hip 9–29%, knee 7–20%) and physical function (hip 3–18%, knee 5–19%) (p < 0.005). Between 42% and 62% of hip OA patients, and 39% and 61% of knee OA patients, displayed a clinically meaningful improvement (≥15%) in HOOS/KOOS subscales by training. The improvement in HOOS/KOOS subscale ADL was greater for patients with knee OA than hip OA, while the improvement in subscale Sport/Rec was greater for patients with hip OA than knee OA.ConclusionsBoth self-reported outcomes and physical function were clearly worse compared with the reference group. Neuromuscular training with an individualized approach and gradual progression showed promise for improving patient-reported outcomes and physical function even in older patients with severe primary OA of the hip or knee.

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Section: Discussionmentioning

confidence: 99%

Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis: a controlled before-and-after study

Ageberg

Nilsdotter²,

Kosek

et al. 2013

BMC Musculoskelet Disord

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“…Proprioceptive exercises aim at improving detection of where the body is in space. Smith et al 59 conducted a recent systematic review and meta-analysis to examine effectiveness of proprioceptive exercises for knee OA (Table 1). Seven RCTs with moderate methodological quality, involving a total of 203 males and 357 females (mean age, 63 years), were included in the analysis.…”

Section: Methodsmentioning

confidence: 99%

A Comprehensive Review of the Effectiveness of Different Exercise Programs for Patients with Osteoarthritis

Golightly

Allen

Caine

2012

The Physician and Sportsmedicine

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Exercise is recommended as a first-line conservative intervention approach for osteoarthritis (OA). A wide range of exercise programs are available, and scientific evidence is necessary for advising patients with OA on the optimal treatment strategy. The purpose of this review is to discuss the effectiveness of different types of exercise programs for OA based on trials, systematic reviews, and meta-analyses in the literature. Publications from January 1997 to July 2012 were searched in 4 electronic databases using the terms osteoarthritis, exercise, exercise program, effectiveness, and treatment outcome. Strong evidence supports that aerobic and strengthening exercise programs, both land- and water-based, are beneficial for improving pain and physical function in adults with mild to moderate knee and hip OA. Areas that require further research include examination of the long-term effects of exercise programs for OA, balance training for OA, exercise programs for severe OA, the effect of exercise programs on progression of OA, the effectiveness of exercise for joint sites other than the knee or hip, and the effectiveness of exercise for OA by such factors as age, gender and obesity. Efforts to improve adherence to evidence-based exercise programs for OA and to promote the dissemination and implementation of these programs are crucial.

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“…OA affects over 27 million people in the United States and is anticipated to be the fourth cause of disability by 20202,3,4 ) . People older than 50 have a prevalence of 35%, which increases to 55% in people over 70 years of age2 ) , with the knee being the most affected joint with an incidence of 240/100,000 people per year5 ) .…”

Section: Introductionmentioning

confidence: 99%

“…According to previous studies, patients with knee OA who receive physical therapy focused on improving neuromuscular control obtain favorable results9, 10 ) . Nevertheless, specific reports about the effectiveness of short-, medium-, and long-term progressive neuromuscular training do not exist3, 10 ) .…”

Section: Introductionmentioning

confidence: 99%

The effects of progressive neuromuscular training on postural balance and functionality in elderly patients with knee osteoarthritis: a pilot study

et al. 2017

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[Purpose] To determine the effects of progressive neuromuscular training on postural balance and functionality in elderly patients with knee osteoarthritis (OA). [Subjects and Methods] Eleven participants between 60 and 75 years of age performed the progressive neuromuscular training for 8 weeks and 4 weeks of follow-up. The area and velocity of the center of pressure were measured on a force platform, and the functionality was measured with a Western Ontario and McMaster Universities Osteoarthritis Index. [Results] The area and velocity (anteroposterior and mediolateral directions) of the center of pressure showed significant differences after 4 and 8 weeks of intervention. Additionally, the global score and some questionnaire dimensions (pain and physical function) showed significant differences after 4 and 8 weeks of intervention. These changes were maintained in all variables at week 4 of follow-up. [Conclusion] The intervention generated improvements in balance and functionality in elderly patients with knee OA. These changes were observed after 4 weeks of training and were maintained 4 weeks after the end of the intervention.

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The effectiveness of proprioceptive-based exercise for osteoarthritis of the knee: a systematic review and meta-analysis

Cited by 52 publications

References 45 publications

Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis: a controlled before-and-after study

Effects of neuromuscular training (NEMEX-TJR) on patient-reported outcomes and physical function in severe primary hip or knee osteoarthritis: a controlled before-and-after study

A Comprehensive Review of the Effectiveness of Different Exercise Programs for Patients with Osteoarthritis

The effects of progressive neuromuscular training on postural balance and functionality in elderly patients with knee osteoarthritis: a pilot study

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