Knee OA – The importance on strength training

Knee osteoarthritis can cause major disability. This piece of current literature supports that resistance training plays a major role in pain relief.

osteoarthritis

Bartholdy 2017

Knee osteoarthritis is a condition that gets treated overly careful due to its painful nature and limiting factors functionally.

Osteoarthritis is the gradual wearing down of the joint surfaces (cartilage) over time. Deterioration over time based on may factors, from the type of work and sport, injury history, genetics (collagen type) etc.

Knee Extensors OA

An exacerbation of osteoarthritis, especially in the knee can be debilitating. Reducing strength, restricting movement and limiting mobility. This recent study analysed almost 5000 participants from 45 trials. It found that the best results for reducing pain and disability was through increasing quads strength by over 30%.

This puts resistance training top of the agenda when trying to alleviate pain in an arthritic knee. Grading the exercises appropriately with the guidance of an expert. This study shows good results of strengthening the quads, we should approach it balanced by also working the other connecting muscles.

Original Abstract

OBJECTIVES: To analyse if exercise interventions for patients with knee osteoarthritis (OA) following the American College of Sports Medicine (ACSM) definition of muscle strength training differs from other types of exercise, and to analyse associations between changes in muscle strength, pain, and disability.

METHODS: A systematic search in 5 electronic databases was performed to identify randomised controlled trials comparing exercise interventions with no intervention in knee OA, and reporting changes in muscle strength and in pain or disability assessed as standardised mean differences (SMD) with 95% confidence intervals (95% CI). Interventions were categorised as ACSM interventions or not-ACSM interventions and compared using stratified random effects meta-analysis models. Associations between knee extensor strength gain and changes in pain/disability were assessed using meta-regression analyses.

RESULTS: The 45 eligible trials with 4699 participants and 56 comparisons (22 ACSM interventions) were included in this analysis. A statistically significant difference favoring the ACSM interventions with respect to knee extensor strength was found [SMD difference: 0.448 (95% CI: 0.091-0.805)]. No differences were observed regarding effects on pain and disability. The meta-regressions indicated that increases in knee extensor strength of 30-40% would be necessary for a likely concomitant beneficial effect on pain and disability, respectively.

CONCLUSION: Exercise interventions following the ACSM criteria for strength training provide superior outcomes in knee extensor strength but not in pain or disability. An increase of less than 30% in knee extensor strength is not likely to be clinically beneficial in terms of changes in pain and disability

https://www.ncbi.nlm.nih.gov/m/pubmed/28438380/

Author: Graeme Lawson

With more than 13 years working both in the UK and New Zealand, Graeme offers a vast amount of experience and knowledge when treating musculoskeletal conditions. Being part of various clubs on the grass roots level to international with the England Volleyball team he has developed a broad skill set. His patient’s see exceptional results from a progressive blend of hands on manual therapy, education and exercise prescription. Catering from the home and work related injuries to athletes from novice to elite levels. Graeme’s outlook is the same with all who visit, that prevention is better than the cure. While providing a variety of hands-on treatments, he knows how important it is to offer education, preventative advice and tailored exercises to continue long after you have been discharged, helping avoid injuries in the future. For pastimes he has played basketball over the last couple of decades at different national levels. Graeme has also been doing CrossFit for 6 years. Having both the knowledge and ability of these technical movements provides athletes confidence with the advice they receive.

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