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A comparison of strength training, self‐management, and the combination for early osteoarthritis of the knee
Author(s) -
McKnight Patrick E.,
Kasle Shelley,
Going Scott,
Villanueva Isidro,
Cornett Michelle,
Farr Josh,
Wright Jill,
Streeter Clara,
Zautra Alex
Publication year - 2009
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20013
Subject(s) - osteoarthritis , physical therapy , stair climbing , medicine , range of motion , balance (ability) , randomized controlled trial , strength training , physical medicine and rehabilitation , knee pain , rehabilitation , self management , surgery , alternative medicine , pathology , machine learning , computer science
Objective To assess the relative effectiveness of combining self‐management and strength training for improving functional outcomes in patients with early knee osteoarthritis. Methods We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community‐dwelling middle‐aged adults (n = 273) ages 35–64 years with knee osteoarthritis, pain, and self‐reported physical disability completed a strength training program, a self‐management program, or a combined program. Outcomes included 5 physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and 2 self‐reported measures of pain and disability. Results A total of 201 participants (73.6%) completed the 2‐year trial. Overall, compliance was modest for the strength training (55.8%), self‐management (69.1%), and combined (59.6%) programs. The 3 groups showed a significant and large increase from pre‐ to posttreatment in all of the physical functioning measures, including leg press (d = 0.85), range of motion (d = 1.00), work capacity (d = 0.60), balance (d = 0.59), and stair climbing (d = 0.59). Additionally, all 3 groups showed decreased self‐reported pain (d = −0.51) and disability (d = −0.55). There were no significant differences among the groups. Conclusion Middle‐aged, sedentary persons with mild early knee osteoarthritis benefited from strength training, self‐management, and the combination program. These results suggest that both strength training and self‐management are suitable treatments for the early onset of knee osteoarthritis in middle‐aged adults. Self‐management alone may offer the least burdensome treatment for early osteoarthritis.