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Progressive resistance training and dynamic alignment in osteoarthritis: A single-blind randomised controlled trial
Nasim Foroughi1, Richard M Smith, Angela K Lange
1Discipline of Exercise, Health, and Performance, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia. nasim.foroughi@syndney.edu.au
Clinical Biomechanics (Bristol, Avon)
|September 28, 2010
Summary
High-intensity resistance training improved muscle strength in women with knee osteoarthritis, but did not alter knee alignment or reduce pain. However, improved alignment correlated with reduced disability.
Area of Science:
- Orthopedics
- Biomechanics
- Exercise Science
Background:
- Knee osteoarthritis (OA) is a prevalent condition often associated with altered lower limb biomechanics.
- Dynamic knee alignment, particularly the knee adduction moment, is a key factor in OA progression.
- Progressive resistance training (PRT) is a potential intervention to modify biomechanics and improve function in knee OA.
Purpose of the Study:
- To investigate the effects of high-intensity PRT on lower limb dynamic alignment and function in women with knee OA.
- To assess improvements in knee adduction moment, muscle strength, gait speed, and OA symptoms.
Main Methods:
- A 6-month randomized controlled trial comparing PRT with a sham-exercise program in 54 women with knee OA.
- Quantitative gait analysis was used to measure dynamic shank and knee adduction angles and knee adduction moment.
- Secondary outcomes included muscle strength, gait velocity, and self-reported OA symptoms.
Main Results:
- PRT did not significantly alter dynamic alignment or knee adduction moment compared to the sham group.
- Muscle strength improved significantly more in the PRT group (P=0.002).
- Both groups showed improvements in gait velocity and pain (P ≤ 0.009), with improvements in shank adduction angle correlating with reduced disability (r=0.381, P=0.015).
Conclusions:
- While PRT enhanced muscle strength, it did not lead to the hypothesized improvements in knee alignment or reduced knee adduction moment.
- Improvements in disability were directly related to changes in shank adduction angle.
- Future trials should consider baseline alignment for patient stratification and explore alternative training modalities for enhanced knee alignment benefits.
