The Effects of Well-Rounded Exercise Program on Systemic Biomarkers Related to Cartilage Metabolism

Abstract

Nonsurgical treatment such as exercise is the preferred method for management of knee osteoarthritis (OA). A combination of aerobic, muscle strengthening, and flexibility exercises is recommended for older adults. However, effects of the exercise intervention on cartilage metabolism remain unclear. This study used biomarkers to investigate the effects of well-rounded exercise program on cartilage metabolism in 42 women (mean age: 59 years). Participants started a weekly supervised exercise program and continued for 12 weeks. Before and after the program, we measured physical performance on the Timed Up-and-Go Test, 3-Minute Walk Test, and 30-Second Chair Stand Test. We collected serum and urine samples at the start of the program until 24 weeks and measured the concentrations of 4 biomarkers related to type II collagen metabolism: serum cartilage type II procollagen carboxy propeptide (sPIICP), urine C-terminal telopeptide of collagen type II (uCTX-II), urine cleavage of type II collagen by collagenases (uC2C), and serum cartilage oligomeric matrix protein (sCOMP). Participants were divided into pre-OA and OA groups based on X-ray findings. The pre-OA group showed significant increases and decreases in sPIICP and uCTX-II concentrations with improved physical performance, respectively. sCOMP concentrations significantly increased in both groups. The exercise also improved physical performance with no detrimental effect on type II collagen metabolism in the OA group. Thus, well-rounded exercise may not only improve physical capacity but also have beneficial effects on type II collagen metabolism, especially in people without radiological OA.

The effect of 4 months exercise training on systemic biomarkers of cartilage and bone turnover in hip osteoarthritis patients

“…Further reduction was shown when adding 30 minutes of whole‐body vibration exercise . Likewise, Azukizawa et al showed reduced CTX‐II level at 24 weeks after a well‐rounded exercise program with one weekly supervised exercise class the first 12 weeks followed by a 12‐week period of encouraged self‐training. In contrast, Petersen et al and Hunt et al found no significant change in CTX‐II levels after 12 weeks of supervised progressive quadriceps strength training at 3 times weekly (70%‐80% of 1 RM), respectively, 10 weeks of lower extremity strength training (10 RM) performed a minimum of 4 days per week at home and supervised 5 times.…”

“…These results could indicate that exercise‐induced changes in CTX‐II level are not related to training intensity in patients with knee OA. OA‐severity may have played a role since Azukizawa et al showed different training response in patients with pre‐radiological knee OA (KL grade 0‐1) and radiological knee OA (KL grade ≥2). Exercises induced reduction in CTX‐II level was only present in the patients with pre‐radiological OA while CTX‐II level was unchanged in those with radiological OA .…”

“…OA‐severity may have played a role since Azukizawa et al showed different training response in patients with pre‐radiological knee OA (KL grade 0‐1) and radiological knee OA (KL grade ≥2). Exercises induced reduction in CTX‐II level was only present in the patients with pre‐radiological OA while CTX‐II level was unchanged in those with radiological OA . Finally, none of the studies in patients with knee OA based their results on duplicate measurements of CTX‐II level.…”

“…In agreement with our findings, Petersen et al and Andersson et al found no change in COMP level after 12 weeks of moderate to heavy progressive quadriceps strength training 3 times weekly, respectively 24 weeks of high‐intensity weight‐bearing exercise one hour twice weekly in patients with knee OA. In contrast, COMP level was found to be decreased after 24 weeks of quadriceps resistance training or increased in patients with pre‐radiological knee OA and radiological knee OA after the 24‐week well‐rounded exercise program and in a group of overweight and obese patients with knee OA following one hour of aerobic and resistance training three times weekly for 18 months when compared to a control group . Andersson et al confirmed an acute rise in COMP after one hour of exercise, but also that the increased COMP level was normalized after 30 minutes of rest underlining the importance of controlling for physical activity before sampling.…”

Physical Exercise Improves Quality of Life in Patients with Connective Tissue Disease

“…Patients with their connective tissue, affected by degenerative or autoimmune diseases, are subject to periods of acute crisis that make simple movements painful and more elaborate movements impossible. Consequently, it makes the physical activity practice a challenge [1][2][3].…”