Free accessResearch articleFirst published online 2017-8
The effects of strengthening,neuromuscular and lumbopelvic stabilization exercises on strength,physical function and symptoms in men with mild knee osteoarthritis: A pilot study
To investigate the effects of strengthening, neuromuscular and lumbopelvic stabilization exercises on strength, symptoms and physical function in men with mild knee osteoarthritis.
METHODS:
A total of 17 men with mild knee osteoarthritis participated in this study. Subjects underwent clinical and radiographic examinations and isokinetic strength evaluations and completed the Western Ontario & McMaster Universities questionnaire before and after an intervention program comprising strengthening, neuromuscular and lumbopelvic stabilization exercises twice per week for eight weeks.
RESULTS:
After the intervention program, subjects exhibited significant reductions in pain (P= 0.009), improvements in physical function(P= 0.015) and quadriceps and hip abductor strength. There was no change in hamstring and hip adductor strength or stiffness after the intervention program.
CONCLUSIONS:
An eight-week supervised exercise therapy program comprising strengthening, neuromuscular and lumbopelvic stabilization exercises may help reduce muscle weakness, pain and disability in men with early knee osteoarthritis.
FelsonDT, NaimarkA, AndersonJ, KazisL, CastelliW, MeenanRF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987; 30(8): 914-918.
2.
McAlindonTE, BannuruRR, SullivanMC, ArdenNK, BerenbaumF, Bierma-ZeinstraSM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014; 22(3): 363-388.
3.
ZhangW, NukiG, MoskowitzRW, AbramsonS, AltmanRD, ArdenNK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: Part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010; 18(4): 476-499.
4.
BennellKL, KyriakidesM, MetcalfB, EgertonT, WrigleyTV, HodgesPW, et al. Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: A randomized controlled trial. Arthritis & Rheumatology (Hoboken, NJ). 2014; 66(4): 950-959.
5.
BennellKL, HinmanRS. A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport. 2011; 14(1): 4-9.
6.
RoosEM, HerzogW, BlockJA, BennellKL. Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis. Nature reviews Rheumatology. 2011; 7(1): 57-63.
7.
McAlindonTE, CooperC, KirwanJR, DieppePA. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993; 52(4): 258-262.
8.
AlnahdiAH, ZeniJA, Snyder-MacklerL. Muscle impairments in patients with knee osteoarthritis. Sports Health. 2012; 4(4): 284-292.
9.
LiikavainioT, LyytinenT, TyrvainenE, SipilaS, ArokoskiJP. Physical function and properties of quadriceps femoris muscle in men with knee osteoarthritis. Arch Phys Med Rehabil. 2008; 89(11): 2185-2194.
10.
SegalNA, GlassNA, FelsonDT, HurleyM, YangM, NevittM, et al. Effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc. 2010; 42(11): 2081-2088.
11.
ThorpLE, WimmerMA, FoucherKC, SumnerDR, ShakoorN, BlockJA. The biomechanical effects of focused muscle training on medial knee loads in OA of the knee: A pilot, proof of concept study. J Musculoskelet Neuronal Interact. 2010; 10(2): 166-173.
12.
SledEA, KhojaL, DeluzioKJ, OlneySJ, CulhamEG. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: A clinical trial. Phys Ther. 2010; 90(6): 895-904.
13.
Baldon RdeM, LobatoDF, CarvalhoLP, WunPY, SantiagoPR, SerraoFV. Effect of functional stabilization training on lower limb biomechanics in women. Med Sci Sports Exerc. 2012; 44(1): 135-145.
14.
Baldon RdeM, SerraoFV, Scattone SilvaR, PivaSR. Effects of functional stabilization training on pain, function, and lower extremity biomechanics in women with patellofemoral pain: A randomized clinical trial. The Journal of Orthopaedic and Sports Physical Therapy. 2014; 44(4): 240-a8.
15.
HenriksenM, KlokkerL, Graven-NielsenT, BartholdyC, Schjodt JorgensenT, BandakE, et al. Association of exercise therapy and reduction of pain sensitivity in patients with knee osteoarthritis: A randomized controlled trial. Arthritis Care Res. 2014; 66(12): 1836-1843.
16.
SerraoPR, VasilceacFA, Gramani-SayK, LessiGC, OliveiraAB, ReiffRB, et al. Men with early degrees of knee osteoarthritis present functional and morphological impairments of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2015; 94(1): 70-81.
17.
SowersMR, McConnellD, JannauschM, BuyukturAG, HochbergM, JamadarDA. Estradiol and its metabolites and their association with knee osteoarthritis. Arthritis Rheum. 2006; 54(8): 2481-2487.
18.
BellamyN, BuchananWW, GoldsmithCH, CampbellJ, StittLW. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. The Journal of Rheumatology. 1988; 15(12): 1833-1840.
19.
JanMH, LinJJ, LiauJJ, LinYF, LinDH. Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: A randomized controlled trial. Phys Ther. 2008; 88(4): 427-436.
20.
LinDH, LinCH, LinYF, JanMH. Efficacy of 2 non-weight-bearing interventions, proprioception training versus strength training, for patients with knee osteoarthritis: A randomized clinical trial. The Journal of Orthopaedic and Sports Physical Therapy. 2009; 39(6): 450-457.
21.
NakagawaTH, MoriyaET, MacielCD, SerraoFV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. The Journal of Orthopaedic and Sports Physical Therapy. 2012; 42(6): 491-501.
22.
AnwerS, AlghadirA. Effect of isometric quadriceps exercise on muscle strength, pain, and function in patients with knee osteoarthritis: A randomized controlled study. Journal of Physical Therapy Science. 2014; 26(5): 745-748.
23.
ImotoAM, PeccinMS, TeixeiraLE, SilvaKN, AbrahaoM, TrevisaniVF. Is neuromuscular electrical stimulation effective for improving pain, function and activities of daily living of knee osteoarthritis patients? A randomized clinical trial. Sao Paulo Medical Journal = Revista Paulista De Medicina. 2013; 131(2): 80-87.
24.
TubachF, RavaudP, BaronG, FalissardB, LogeartI, BellamyN, et al. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: The minimal clinically important improvement. Ann Rheum Dis. 2005; 64(1): 29-33.
25.
KeanCO, BirminghamTB, GarlandSJ, BryantDM, GiffinJR. Minimal detectable change in quadriceps strength and voluntary muscle activation in patients with knee osteoarthritis. Arch Phys Med Rehabil. 2010; 91(9): 1447-1451.
26.
ToppR, WoolleyS, HornyakJ, KhuderS, KahalehB. The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee. Arch Phys Med Rehabil. 2002; 83(9): 1187-1195.
27.
BennellKL, HuntMA, WrigleyTV, HunterDJ, McManusFJ, HodgesPW, et al. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: A randomised controlled trial. Osteoarthritis Cartilage. 2010; 18(5): 621-628.
28.
CostaRA, OliveiraLM, WatanabeSH, JonesA, NatourJ. Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee. Clinics (Sao Paulo, Brazil). 2010; 65(12): 1253-1259.
29.
HinmanRS, HuntMA, CreabyMW, WrigleyTV, McManusFJ, BennellKL. Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res (Hoboken). 2010; 62(8): 1190-1193.
