Report #031 Featured Image

#031 – High or Low-Intensity Exercise and Internet-based Programs for Knee OA

ByAl-Jallad

Estimated reading time: 2 minutes, 50 seconds.

High-intensity training is not superior to low-intensity strength training for knee osteoarthritis

The START Randomized Clinical Trial. (Restricted Access)

Aim

  • To determine whether high-intensity strength training reduces knee pain and knee joint compressive forces more than low-intensity strength training and more than attention control in patients with knee osteoarthritis at 18 months follow-up.

Interventions

  • High-intensity strength training (127 Participants)
    • 3 Sessions/week with exercises at 75% increasing to 90% repetition maximum tests.
  • Low-intensity strength training (126 Participants)
    • 3 sessions/week with exercises at 30%-40% repetition maximum tests.
  • Attention control (124 Participant)
    • 60-min workshops biweekly for 6 months and monthly thereafter including health and nutrition education

Results

  • WOMAC pain scores at the 18-month follow-up were not statistically significantly different between the high-intensity group and the control group or between the high-intensity and low-intensity groups.
  • Knee joint compressive forces (defined as the maximal tibiofemoral contact force exerted along the long axis of the tibia during walking) were not statistically significantly different between the high-intensity group and the control group or between the high-intensity and low-intensity groups.
  • There were 87 non-serious adverse events and 13 serious adverse events unrelated to the study.

Conclusions

  • Among patients with knee osteoarthritis, high-intensity strength training compared with low-intensity strength training or an attention control did not significantly reduce knee pain or knee joint compressive forces at 18 months.
  • The findings do not support the use of high-intensity strength training over low-intensity strength training or an attention control in adults with knee osteoarthritis.

Internet-based rehabilitation programs could improve pain but not physical function for patients with knee OA

A Systematic Review and Meta-analysis of Randomized Controlled Trials. (Open Access)

Aim

  • Assess the effect of internet-based rehabilitation programs on pain and physical function in patients with knee OA.

Results

  • 300 participants in internet-based rehabilitation groups, 349 participant conventional rehabilitation or waitlist groups.

See details of interventions here

Pain:

  • One study that used the Numeric Pain Rating Scale (NPRS), found that internet-based rehabilitation programs improved pain at 3 months but not at 12 months.
  • In another study using the Arthritis Impact Measurement Scale 2 (AIMS2) pain subscale, pain after 8-10 weeks of internet-based rehabilitation was found to be significantly improved in women but not in men compared with that of the control group.
  • Internet-based rehabilitation could significantly reduce knee OA pain compared with conventional rehabilitation as assessed by the WOMAC pain subscale (4 studies, 411 participants).

Physical function:

  • Internet-based rehabilitation could not significantly improve the physical function of patients with knee OA compared with the control group according to the WOMAC function subscale (4 studies, 411 participants).
  • The studies that did not apply the WOMAC function subscale measures showed that internet-based rehabilitation could not significantly improve physical function compared with the control group, even compared with the waitlist group as a control. (Studies: 1, 2)
  • Only one study suggested that the physical function could be significantly improved after 3 months of internet-based rehabilitation compared with the waitlist group. However, the beneficial effect did not last after 12 months.

Conclusion

  • Internet-based rehabilitation could improve pain but not physical function in patients with knee OA.
  • More high-quality studies with large samples are needed, with a focus on the long-term outcomes of internet-based rehabilitation for patients with knee OA.

Similar article with similar results. (Restricted Access)

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