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Jorge Caldas R.1, Cardoso de Souza M.1, Chiari A.1, Jones A.1, da Rocha Correa Fernandes A.2, Lombardi Júnior I.3, Natour J.1
1Universidade Federal de São Paulo, Rheumatology, São Paulo, Brazil, 2Universidade Federal de São Paulo, Diagnostic Imaging, São Paulo, Brazil, 3Universidade Federal de São Paulo, Human Movement Sciences, Santos, Brazil
Background: Knee osteoarthritis (OA) is a common musculoskeletal disorder. Recent guidelines for the management of knee OA emphasize the role of strengthening exercises. While most studies focus on the benefits of quadriceps strengthening, little is known about hip strengthening exercises in knee OA and also, about prescription in terms of intensity, duration, frequency and load.
Purpose: To determine the effect of a progressive resistance exercise (PRE) program on women with osteoarthritis (OA) of the knee.
Methods: Eligible subjects included women aged 40 to 70 years with pain between 3 and 8 on a 10-cm pain scale. Among the 144 subjects screened, 60 met the eligibility criteria and were randomized to the experimental group (EG) or control group (CG). Subjects in the EG participated in a 12-week PRE program twice a week and CG remained on a waiting list for physical therapy. The PRE program consisted of strengthening exercises for knee extensors, knee flexors, hip abductors and hip adductors, all performed with 50% and 70% of the one-repetition maximum (1RM) using machines with free weights.
Resistance was reevaluated every two weeks. Assessments of pain, muscle strength, walking distance,function and quality of life were performed at baseline, six weeks and 12 weeks by a blinded assessor.
Results: Twenty-nine female subjects were randomly assigned to the EG and 31 were randomly assigned to the CG. Repeated-measures ANOVA revealed significantly better results in the EG pain (from 7.0±1.3 to 4.3±3.1 in the EG and from 7.0±1.2 to 6.6±1.5 in the CG - p 0.001), function (p 0.001), some domains of quality of life (physical function: p=0.002; physical role limitation: p=0.002; and pain: p=0.044) and muscle strength (extensors: p 0.001; flexors: p=0.002; and abductors: p 0.001).
Conclusion(s): The PRE program was effective in reducing pain and improving function, some quality of life domains and strength in women with OA of the knee.
Implications: A progressive resistance exercise program including hip muscles was effective in reducing pain and improving function and strength in women with osteoarthritis of
the knee.
- The progressive resistance exercise program did not improve walking distance,
and this is an important problem of women with osteoarthritis of the knee.
- This progressive resistance exercise program could be part of rehabilitation process of women with osteoarthritis of the knee, however other supporting treatments are necessary to address all problems related to osteoarthritis of the knee in women.
Funding acknowledgements: The present study was supported by grants from Brazilian fostering agencies - FAPESP and CAPES.
Topic: Disability & rehabilitation
Ethics approval: Comitê de Ética em Pesquisa (Ethics Committee)
Hospital São Paulo (Saint Paul Hospital)
Number of ethics approval: CEP 0414/08
All authors, affiliations and abstracts have been published as submitted.
