To compare the effectiveness of eccentric strengthening exercise for managing individuals with knee OA.
The study design was a double-center, parallel, assessor and participant-blinded randomized controlled trial and allocation in 1:1 split of knee OA participants into: an experimental group (eccentric strengthening exercise along with conventional care) or a control group (conventional care only). Treatment provided for five weeks (3 sessions/week) and sample size were 100. Participants with 40 – 75 aged, both men and women, the presence of unilateral knee OA for at least six months following American College of Rheumatology criteria, and anterior-posterior bilateral standing radiograph presents Kellgren and Lawrence Grade II/III knee OA included for this study. The primary outcomes were pain, muscle strength and functional disability measured by Numeric pain rating scale, Pressure pain threshold, Sphygmomanometer, and Western Ontario and McMaster Universities Osteoarthritis Index. Also, secondary outcomes were range of motion, aerobic capacity and depression measured by Goniometer, 6 Minute Walk Test, and Patient Health Questionnaire.
A total of 94 participants (mean age 52.45 ± 9.16 years; 51.1% men) were enrolled in the study, with 48 completing the intervention in the experimental group and 46 in the control group. After five weeks of intervention, the experimental group demonstrated a statistically significant improvement compared to the control group (p0.001 and p0.05, respectively). In within-group comparison, both the experimental and control groups showed significant improvements across all outcome measures (p0.001). When comparing between groups, the experimental group showed significant enhancements in pain, muscle strength, functional disability, aerobic capacity, and depression relative to the control group (p- ranging from 0.003 to 0.001). However, no significant difference was observed in knee joint range of motion between the groups (F ratio =0.209, p=0.998).
The results of this study suggested that combination of different therapeutic approach including eccentric strengthening exercise can reduce pain, disability and improve muscle strength, and aerobic capacity in knee OA patients. The focus should be on the participants' conditions and tolerance levels to avoid any adverse effects. Baseline compatibility, larger sample size, and home exercise should be considered for future study to maximize the suitability and benefits of exercise for knee OA patients.
This was the first study that combined stretching, isometric exercise, mobilization with movement, patellar mobilization, therapeutic ultrasound as well as eccentric strengthening exercise together. This added a new dimension as one of the best combined therapeutic treatment approaches for management of knee OA. This outcome will benefit researchers, patients, treatment provider as well as physiotherapy sector. This study also contributes to informed decision-making and policy development for the management of knee osteoarthritis. Future research should be evaluated based on these findings. However, further studies are necessary to examine the long-term effect.
Eccentric strengthening exercise
Randomised Controlled trial
