Abstract
BackgroundStudies on exercise in knee osteoarthritis (OA) have focused on elderly subjects. Subjects in this study were middle-aged with symptomatic and definite radiographic knee osteoarthritis. The aim was to test the effects of a short-term, high-intensity exercise program on self-reported pain, function and quality of life.MethodsPatients aged 36–65, with OA grade III (Kellgren & Lawrence) were recruited. They had been referred for radiographic examination due to knee pain and had no history of major knee injury. They were randomized to a twice weekly supervised one hour exercise intervention for six weeks, or to a non-intervention control group. Exercise was performed at ≥ 60% of maximum heart rate (HR max). The primary outcome measure was the Knee injury and Osteoarthritis Outcome Score (KOOS). Follow-up occurred at 6 weeks and 6 months.ResultsSixty-one subjects (mean age 56 (SD 6), 51 % women, mean BMI 29.5 (SD 4.8)) were randomly assigned to intervention (n = 30) or control group (n = 31). No significant differences in the KOOS subscales assessing pain, other symptoms, or function in daily life or in sport and recreation were seen at any time point between exercisers and controls. In the exercise group, an improvement was seen at 6 weeks in the KOOS subscale quality of life compared to the control group (mean change 4.0 vs. -0.7, p = 0.05). The difference between groups was still persistent at 6 months (p = 0.02).ConclusionA six-week high-intensive exercise program had no effect on pain or function in middle-aged patients with moderate to severe radiographic knee OA. Some effect was seen on quality of life in the exercise group compared to the control group.
Highlights
Studies on exercise in knee osteoarthritis (OA) have focused on elderly subjects
Quality of life improved significantly in the exercise group compared to the control group at 6 weeks (4.0 vs. -0.7, p = 0.05) and the results persisted at 6 months (5.1 vs. -2.3, p = 0.02, Table 2)
Secondary outcomes A significant improvement was found in the exercise group compared to the control group at six weeks with regard to the Short Form-36 item (SF-36) Mental Component Summary scale (MCS) (2.1 vs -1.6, p = 0.04)
Summary
Studies on exercise in knee osteoarthritis (OA) have focused on elderly subjects. Subjects in this study were middle-aged with symptomatic and definite radiographic knee osteoarthritis. The dose-response relationship of exercise on symptoms and function is not clear and exercise recommendations in osteoarthritis guidelines are based mostly on studies on elderly people, i.e. mean age ≥ 65 [3,13,14,15]. It is not clear whether exercise has a similar effect on pain and function in middleaged patients compared with elderly patients. The aim of this study was to examine the effects of a short-term, highintensity exercise program in middle-aged subjects (age 36–65) with definite radiographic knee osteoarthritis on self-reported pain, function, and quality of life
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