Abstract
To determine the added benefits of short-term glucosamine and chondroitin sulfate supplementation in combination with manual therapy and resistance exercise training in the management of knee osteoarthritis. A parallel-design, double-blind randomised controlled trial was conducted from January to September 2020 at the Foundation University Institute of Rehabilitation Sciences and Fauji Foundation Hospital, Rawalpindi, Pakistan, and comprised of knee osteoarthritis patients of either gender having radiological evidence of grade III or less on Kellgren classification. The subjects were randomly allocated to active comparator group A and experimental group B. Both the groups received manual therapy and resistance exercise training, while group B additionally received glucosamine and chondroitin sulfate supplementation for 4 weeks. Study outcomes included pain, function, quality of life, range of motion, strength, fall risk, skeletal muscle mass, visceral fat area, body fat, intracellular water ratio, and segmental lean and fat mass. Data was analysed using SPSS 21. Of the 24 subjects, there were 12(50%) in each of the two groups. Each groups had 9(75%) males and 3(25%) females. In terms knee osteoarthritis grade, there was no significant difference between the groups (p=1.00). No significant differences were observed in any of the outcome measures neither at 2 weeks, nor at 4 weeks post-intervention between the groups (p>0.05) except for percentage change in segmental lean mass of the right leg at 2nd week and of the left leg at 4th week (p<0.05). Manual therapy and resistance exercise training are effective in the management of knee osteoarthritis, however, glucosamine and chondroitin sulfate supplementation for 4 weeks showed no additional benefits. NCT04654871. https://www.clinicaltrials.gov/ct2/show/NCT04654871.
Highlights
Half of the world’s population over the age of 65 years suffers from osteoarthritis [1, 2], making it the most common cause of joint pain and disability [3,4,5,6]
The current study looked into the effects of resistance exercise training and manual therapy with and without short-term glucosamine and chondroitin sulfate
The current study determined the additive benefits of glucosamine and chondroitin sulfate supplementation in knee osteoarthritis (KOA) management in addition to resistance exercise and manual therapy, both of which are found to be effective in KOA
Summary
Half of the world’s population over the age of 65 years suffers from osteoarthritis [1, 2], making it the most common cause of joint pain and disability [3,4,5,6]. The prevalence of knee osteoarthritis (KOA) has been shown to continually increase in the elderly population [3, 4], and a 2.1 fold increase has been observed in its prevalence since the mid20th century [4]. This is perhaps in accordance with the general trend of increase in non-communicable diseases related to advancements in medical field and increase in life expectancy, as well as sedentary lifestyle. Literature has shown muscular atrophy [20], especially weakness of quadriceps femoris being a significant contributor in terms of knee pain and related disability in persons with KOA [18, 21], advocating the importance of resistance exercise training in KOA management
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