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Neuromuscular Versus Quadriceps Strengthening Exercise in Patients With Medial Knee Osteoarthritis and Varus Malalignment

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Author

  • Kim L. Bennell
  • Mary Kyriakides
  • Ben Metcalf
  • Thorlene Egerton
  • Tim V. Wrigley
  • Paul W. Hodges
  • Michael A. Hunt
  • Ewa M. Roos
  • Andrew Forbes
  • Eva Ageberg
  • Rana S. Hinman
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Summary, in English

Objective. To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of medio-lateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment. Methods. One hundred patients with medial knee pain, mostly moderate-to-severe radiographic medial knee OA, and varus malalignment were randomly allocated to one of two 12-week exercise programs. Each program involved 14 individually supervised exercise sessions with a physiotherapist plus a home exercise component. Primary outcomes were peak external knee adduction moment (3-dimensional gait analysis), pain (visual analog scale), and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). Results. Eighty-two patients (38 [76%] of 50 in the NEXA group and 44 [88%] of 50 in the QS group) completed the trial. There was no significant between-group difference in the change in the peak knee adduction moment (mean difference 0.13 Nm/[body weight x height]% [95% confidence interval (95% CI) -0.08, 0.33]), pain (mean difference 2.4 mm [95% CI -6.0, 10.8]), or physical function (mean difference -0.8 units [95% CI -4.0, 2.4]). Neither group showed a change in knee moments following exercise, whereas both groups showed similar significant reductions in pain and improvement in physical function. Conclusion. Although comparable improvements in clinical outcomes were observed with both neuromuscular and quadriceps strengthening exercise in patients with moderate varus malalignment and mostly moderate-to-severe medial knee OA, these forms of exercise did not affect the knee adduction moment, a key predictor of structural disease progression.

Publishing year

2014

Language

English

Pages

950-959

Publication/Series

Arthritis & Rheumatology

Volume

66

Issue

4

Document type

Journal article

Publisher

John Wiley & Sons Inc.

Topic

  • Rheumatology and Autoimmunity

Status

Published

Research group

  • Sport Sciences

ISBN/ISSN/Other

  • ISSN: 2326-5191