medwireNews: A home-based exercise intervention aiming to strengthen multiple muscles improves pain and physical function among patients with preradiographic knee osteoarthritis (OA), Japanese study results suggest.
As reported in Clinical Rheumatology, 52 patients aged an average of approximately 60 years with medial knee pain and a Kellgren/Lawrence grade of 0 or 1 were randomly assigned to participate in a home exercise program to train and stretch the hip and knee muscles (multiple exercise group), or to train the quadriceps muscles only (control group). Both interventions lasted for 4 weeks and were taught by a physical therapist.
Participants in both groups experienced improvements in knee pain over the study period, with average visual analog scale (VAS) scores improving from 36.70 points at baseline to 21.32 points at the 4-week follow-up in the multiple exercise group, and from 36.49 to 26.85 points in the control group.
The mean difference in VAS pain scores between the two groups, at 2.77 points, did not reach statistical significance, but patients taking part in the multiple exercise intervention experienced significantly greater improvements in activities of daily living and general health conditions as indicated by the Japanese Knee Osteoarthritis Measure score, with average reductions of 2.1 versus 0.37 points, and 0.82 versus 0.33 points, respectively.
Tomoki Aoyama (Kyoto University, Japan) and co-investigators say that patient adherence to both exercise programs was high, with 97% of participants in the multiple exercise group and 100% of those in the control group reporting that they carried out the exercises five times per week and completed three sets of 10 repetitions for each exercise as instructed.
Taken together, these findings suggest that “[w]hen targeting pre-radiographic knee OA […], it is important to implement home exercise programs that aim to improve muscle strength and joint flexibility rather than knee extension muscle power only,” write the researchers.
They note, however, that the trial had a number of limitations, including the lack of a control group not receiving treatment and the number of enrolled patients not meeting the prespecified sample size.
Furthermore, because all study participants had preradiographic knee OA, the findings cannot be generalized to patients with more advanced disease, caution Aoyama and team.
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