The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials

Bartholdy, Cecilie; Juhl, Carsten Bogh; Christensen, Robin; Lund, Hans; Zhang, Weiya; Henriksen, Marius

doi:10.1016/j.semarthrit.2017.03.007

Cited by 184 publications

(159 citation statements)

References 54 publications

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“…Exercises commonly used in clinical practice and supported by the findings of previous studies [10,21,22] were performed to enhance muscle strength (mainly the gluteus maximus, gluteus medius and quadriceps). All procedures for the definition and use of loads, repetitions and implementation of loads over time were based on a study by Paula Gomes et al [19] Aiming at the adequacy and consequent standardization of the load used to perform the exercises, 70% of a maximum painless repetition was instituted for each participant [23].…”

Section: Exercisementioning

confidence: 82%

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

Gomes

Politti

Pereira

et al. 2020

BMC Musculoskelet Disord

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Background: It is not yet clear which of the various electrophysical modalities used in clinical practice is the one that contributes most positively when added to an exercise program in patients with knee osteoarthritis (OA). The aim of the present study was to analyze the clinical effects of the inclusion of interferential current therapy (ICT), shortwave diathermy therapy (SDT) and photobiomodulation (PHOTO) into an exercise program in patients with knee OA. Methods: This prospective, five-arm, randomised, placebo-controlled trial was carried out with blinded participants and examiners. We recruited 100 volunteers aged 40 to 80 years with knee OA. Participants were allocated into five groups: exercise, exercise + placebo, exercise + ICT, exercise + SDT, and exercise + PHOTO. The outcome measures included Western Ontario and McMaster Universities (WOMAC), numerical rating pain scale (NRPS), pressure pain threshold (PPT), self-perceived fatigue and sit-to-stand test (STST), which were evaluated before and after 24 treatment sessions at a frequency of three sessions per week. Results: In all groups, there was a significant improvement (p < 0.05) in all variables over time, except pressure pain threshold. We observed significant differences (p < 0.05) between the groups for WOMAC function (exercise vs. exercise + placebo, mean difference [MD] = 5.55, 95% confidence interval [CI] = 3.63 to 7.46; exercise vs. exercise + ICT, MD = 3.40, 95% CI = 1.46 to 5.33; exercise vs. exercise + SDT, MD = 4.75, 95% CI = 1.85 to 7.64; exercise vs. exercise + PHOTO, MD = 5.45, 95% CI = 3.12 to 7.77) and WOMAC pain, with better scores achieved by the exercise group. However, these differences were not clinically relevant when considering the minimum clinically important difference.

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Section: Exercisementioning

confidence: 82%

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

Gomes

Politti

Pereira

et al. 2020

BMC Musculoskelet Disord

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“…In particular, there is abundant high-quality evidence supporting exercise-based treatments for people with hip and knee osteoarthritis (Bennell & Hinman, 2011;Fransen et al, 2015). Research shows that exercise can positively influence pain, muscle function, body weight, cardiovascular fitness, mood and disease progression (Bartholdy et al, 2017;Bennell et al, 2014;Fransen et al, 2015;Kujala, 2009;Zhang et al, 2008), regardless of the structural changes and symptom severity. The addition of joint mobilisation and manipulation to exercise programmes may also be beneficial (Fitzgerald et al, 2016;Pinto et al, 2013).…”

Section: Myth 5: Conservative Treatments Are Ineffectual and Only Desmentioning

confidence: 99%

Time to bust common osteoarthritis myths

O’Brien¹,

Chapple²,

Baldwin³

et al. 2019

NZJP

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Several common beliefs about osteoarthritis held by people living with the condition and some clinicians are discordant with current evidence and can hinder effective management. Therefore, providing information about the disease and its mechanisms could lead to better management of people with osteoarthritis. This paper addresses the seven most common myths surrounding osteoarthritis relating to its causative factors, pathology, assessment and management. We present the evidence to refute these misconceptions and argue that physiotherapists are in an ideal position to provide education to people with osteoarthritis. Ultimately, physiotherapists can play a central role in the provision of care for people with osteoarthritis.

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“…Intensity of exercise may also play a contributory role in OA progression as a recent study found that low and high levels of physical activity were associated with greater cartilage degeneration than engaging in moderate-intensity exercise [79]. Although the type of physical activity may differentially impact OA-related outcomes [80], regular exercise is generally considered an effective tool in reducing pain and disability in patients.…”

Section: Mechanisms Underlying Osteoarthritis Painmentioning

confidence: 99%

Predictors of Osteoarthritis Pain: the Importance of Resilience

2017

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Whereas previous research has mostly focused on risk factors for worsening of OA pain, recently emerging evidence places greater emphasis on the identification of protective mechanisms that enhance pain adaptation and palliate the negative effects of joint pain. In view of this new and important research, more emphasis should be placed on endogenous pain modulation and, in particular, pain attenuation. The result of such work could serve as a basis for optimizing treatment in the OA population.

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The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials

Cited by 184 publications

References 54 publications

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

Time to bust common osteoarthritis myths

Predictors of Osteoarthritis Pain: the Importance of Resilience

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