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MEDLINE Abstracts

Results 1 - 15 of 15

The effect of eight weeks of exercise on knee adduction moment in early knee osteoarthritis--a pilot study.

Osteoarthritis Cartilage.  2007; 15(10):1163-70 (ISSN: 1063-4584)

Thorstensson CA; Henriksson M; von Porat A; Sj??dahl C; Roos EM
Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden; Department of Orthopedics, Clinical Sciences Lund, Lund University, Sweden.

OBJECTIVE: Reduced muscle function, causing greater knee joint load, is a potentially modifiable risk factor of knee osteoarthritis (OA). Exercise is an important treatment of knee OA, but the effect on joint load has not been determined. The aim of this study was to investigate the effect of exercise on knee adduction moment during one-leg rise and gait. DESIGN: Patients below age 65 with early signs of radiographic knee OA, from a population-based cohort on OA development, were invited to participate in the study. They defined their most symptomatic knee as the index knee. Knee adduction moment during one-leg rise from a stool (48cm), and during gait was assessed using a three-dimensional motion analysis system, before and after eight weeks of supervised exercise. RESULTS: Thirteen patients, seven women, mean age 54.5, 12/13 with Kellgren and Lawrence grade I or II, took part in the study. Peak knee adduction moment during one-leg rise was reduced by 0.08 (95% CI 0.01;0.16) Nm/kg, or 14%, for the index knee, and 0.05 (95% CI -0.04;0.14), or 8% for the opposite knee after eight weeks. The reductions in peak adduction moment during gait were smaller and not significant. CONCLUSIONS: This study indicates that peak knee adduction moment could be reduced by supervised, individualized exercise in middle-aged patients presenting early signs of knee osteoarthritis, suggesting further investigation of this area. Peak adduction moment during one-leg rise seems to be more sensitive to deviations and change than peak adduction moment during gait in this population.

Major Subject Heading(s)Minor Subject Heading(s)
    • PreMedline Identifier: 17466541

    Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus.

    Rheumatology (Oxford).  2005; 44(1):67-73 (ISSN: 1462-0324)

    Roddy E; Zhang W; Doherty M; Arden NK; Barlow J; Birrell F; Carr A; Chakravarty K; Dickson J; Hay E; Hosie G; Hurley M; Jordan KM; McCarthy C; McMurdo M; Mockett S; O'Reilly S; Peat G; Pendleton A; Richards S
    Academic Rheumatology, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.

    OBJECTIVES: Exercise is an effective and commonly prescribed intervention for lower limb osteoarthritis (OA). Many unanswered questions remain, however, concerning the practical delivery of exercise therapy. We have produced evidence-based recommendations to guide health-care practitioners. METHODS: A multidisciplinary guideline development group was formed from representatives of professional bodies to which OA is of relevance and other interested parties. Each participant contributed up to 10 propositions describing key clinical points regarding exercise therapy for OA of the hip or knee. Ten final recommendations were agreed by the Delphi technique. The research evidence for each was determined. A literature search was undertaken in the Medline, PubMed, EMBASE, PEDro, CINAHL and Cochrane databases. The methodological quality of each retrieved publication was assessed. Outcome data were abstracted and effect sizes calculated. The evidence for each recommendation was assessed and expert consensus highlighted by the allocation of two categories: (1) strength of evidence and (2) strength of recommendation. RESULTS: The first round of the Delphi process produced 123 propositions. This was reduced to 10 after four rounds. These related to aerobic and strengthening exercise, group versus home exercise, adherence, contraindications and predictors of response. The literature search identified 910 articles; 57 intervention trials relating to knee OA, 9 to hip OA and 73 to adherence. The evidence to support each proposition is presented. CONCLUSION: These are the first recommendations for exercise in hip and knee OA to clearly differentiate research evidence and expert opinion. Gaps in the literature are identified and issues requiring further study highlighted.

    Major Subject Heading(s)Minor Subject Heading(s)
      • PreMedline Identifier: 15353613

      Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis.

      Arthritis Rheum.  2005; 52(11):3507-14 (ISSN: 0004-3591)

      Roos EM; Dahlberg L
      Lund University, Lund, Sweden.

      OBJECTIVE: To evaluate the effects of moderate exercise on glycosaminoglycan (GAG) content in knee cartilage in subjects at high risk of knee osteoarthritis (OA). METHODS: Forty-five subjects (16 women, mean age 46 years, mean body mass index 26.6 kg/m(2)) who underwent partial medial meniscus resection 3-5 years previously were randomized to undergo a regimen of supervised exercise 3 times weekly for 4 months or to a nonintervention control group. Cartilage GAG content, an important aspect of the biomechanical properties of cartilage, was estimated by delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), with results expressed as the change in the T1 relaxation time in the presence of Gd-DTPA (T1[Gd]). RESULTS: Thirty of 45 patients were examined by dGEMRIC at baseline and followup. The exercise group (n = 16) showed an improvement in the T1(Gd) compared with the control group (n = 14) (15 msec versus -15 msec; P = 0.036). To study the dose response, change in the T1(Gd) was assessed for correlation with self-reported change in physical activity level, and a strong correlation was found in the exercise group (n = 16, r(S) = 0.70, 95% confidence interval [95% CI] 0.31-0.89) and in the pooled group of all subjects (n = 30, r(S) = 0.74, 95% CI 0.52-0.87). CONCLUSION: This in vivo cartilage monitoring study in patients at risk of knee OA who begin exercising indicates that adult human articular cartilage has a potential to adapt to loading change. Moderate exercise may be a good treatment not only to improve joint symptoms and function, but also to improve the knee cartilage GAG content in patients at high risk of developing OA.

      Major Subject Heading(s)Minor Subject Heading(s)CAS Registry / EC Numbers
        • PreMedline Identifier: 16258919

        The efficacy of a muscle exercise program to improve functional performance of the knee in patients with osteoarthritis.

        J Med Assoc Thai.  2002; 85(1):33-40 (ISSN: 0125-2208)

        Kuptniratsaikul V; Tosayanonda O; Nilganuwong S; Thamalikitkul V
        Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

        Osteoarthritis (OA) is a common chronic and progressive degenerative joint condition. A major consequence of knee OA is physical disability; especially difficulty with activities requiring ambulation and transfer, which are necessary to maintain independence and a good quality of life. The purposes of this study were to determine the efficacy of a muscle exercise program along with education about knee care, and investigate the clinical factors which influence its therapeutic efficacy. A prospective study was carried out among elderly Thai people aged 60 years and over, living in an urban community of the Bangkok metropolitan area around Siriraj Hospital, between October 1997 and September 1999. The number of elderly people with osteoarthritis of the knee was 392 (male:female=86:306) with a mean age of 67.7+/-6 years. They were interviewed for demographic data and information about their symptoms. The range of the knee movement, quadriceps strength and the six-minute walking distance and a knee X-ray were evaluated. Group exercise was arranged twice a week for 8 weeks for the intervention group only. The results of the study revealed that the quadriceps strength in the intervention group had a tendency to increase and the walking distance was significantly improved especially in the first two months but there was a tendency to decline by the sixth and twelfth month after enrollment. On the other hand, there was no statistically significant difference of both important outcomes for the control group when assessed in the second month. The findings at the sixth and twelfth month after enrollment were that the quadriceps strength was slightly increased but the walking distance was decreased when compared with the initial assessment. An exercise frequency of 12 sessions in two months was sufficient to improve muscle strength and walking distance. Group exercise produces a significant improvement in strength and walking ability, especially in the first two months. Deterioration over time could be due to multiple factors, such as lack of regular exercise, lack of motivation, lack of family support or poor economic status, so we should encourage the elderly to exercise regularly.

        • PreMedline Identifier: 12075718

        Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial.

        BMJ.  2002; 325(7367):752 (ISSN: 1468-5833)

        Thomas KS; Muir KR; Doherty M; Jones AC; O'Reilly SC; Bassey EJ
        Academic Rheumatology, City Hospital, Nottingham NG5 1PB.

        OBJECTIVES: To determine whether a home based exercise programme can improve outcomes in patients with knee pain. DESIGN: Pragmatic, factorial randomised controlled trial of two years' duration. SETTING: Two general practices in Nottingham. PARTICIPANTS: 786 men and women aged >/=45 years with self reported knee pain. Interventions: Participants were randomised to four groups to receive exercise therapy, monthly telephone contact, exercise therapy plus telephone contact, or no intervention. Patients in the no intervention and combined exercise and telephone groups were randomised to receive or not receive a placebo health food tablet. MAIN OUTCOME MEASURES: Primary outcome was self reported score for knee pain on the Western Ontario and McMaster universities (WOMAC) osteoarthritis index at two years. Secondary outcomes included knee specific physical function and stiffness (scored on WOMAC index), general physical function (scored on SF-36 questionnaire), psychological outlook (scored on hospital anxiety and depression scale), and isometric muscle strength. RESULTS: 600 (76.3%) participants completed the study. At 24 months, highly significant reductions in knee pain were apparent for the pooled exercise groups compared with the non-exercise groups (mean difference -0.82, 95% confidence interval -1.3 to -0.3). Similar improvements were observed at 6, 12, and 18 months. Regular telephone contact alone did not reduce pain. The reduction in pain was greater the closer patients adhered to the exercise plan. CONCLUSIONS: A simple home based exercise programme can significantly reduce knee pain. The lack of improvement in patients who received only telephone contact suggests that improvements are not just due to psychosocial effects because of contact with the therapist.

        Major Subject Heading(s)Minor Subject Heading(s)
        • PreMedline Identifier: 12364304

        Osteoarthritis of the knee: isokinetic quadriceps exercise versus an educational intervention.

        Arch Phys Med Rehabil.  1999; 80(10):1293-9 (ISSN: 0003-9993)

        Maurer BT; Stern AG; Kinossian B; Cook KD; Schumacher HR
        Medical Research Service, Department of Veterans Affairs Medical Center, Philadelphia, PA 19104, USA.

        OBJECTIVE: To evaluate the effects of isokinetic exercise versus a program of patient education on pain and function in older persons with knee osteoarthritis. DESIGN: A randomized, comparative clinical trial, with interventions lasting 8 weeks and evaluations of 12 weeks. SETTING: An outpatient Veterans Affairs Medical Center clinic and an affiliated university hospital. PATIENTS: One hundred thirteen men and women between 50 and 80 years old with diagnosed osteoarthritis of the knee; 98 completed the entire assigned treatment. INTERVENTION: Patients received either a regimen of isokinetic exercise of the quadriceps muscle three times weekly over 8 weeks or a series of 4 discussions and lectures led by health care professionals. MAIN OUTCOME MEASURES: Variables studied for change were isokinetic and isometric quadriceps strength, pain and function determined by categorical and visual analog scales, and overall status using physician and patient global evaluations by the Arthritis Impact Scale, version 2, Western Ontario McMaster's Arthritis Index, and Medical Outcome Study Short Form 36. RESULTS: Both treatment groups showed significant strength gains (p < .05), which occurred over a wider velocity spectrum for the exercise group. Exercised patients also had improved pain scores for more of the variables measured than those receiving education. Both groups had positive functional outcomes and slightly improved measures of overall status. CONCLUSIONS: Isokinetic exercise is an effective and well-tolerated treatment for knee osteoarthritis, but a much less costly education program also showed some benefits.

        • PreMedline Identifier: 10527090

        Biochemical change in joint fluid after isometric quadriceps exercise for patients with osteoarthritis of the knee.

        Osteoarthritis Cartilage.  2003; 11(4):252-9 (ISSN: 1063-4584)

        Miyaguchi M; Kobayashi A; Kadoya Y; Ohashi H; Yamano Y; Takaoka K
        Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.

        OBJECTIVE: The purpose of this study was to analyze the biochemical changes in the joint fluid, and pain relief resulting from isometric quadriceps exercise in patients with osteoarthritis of the knee. DESIGN: Nineteen osteoarthritic knees in 17 patients with joint effusion were included. The patients performed isometric quadriceps exercise for 3 months. Isometric muscle torque at 30 and 60 degrees flexion, pain as measured using the visual analog scale and biochemical markers in joint fluid were evaluated before and after the exercise. RESULTS: Pain score decreased from 3.9 to 2.3 after 12 weeks of exercise (P<0.001). Extension torque at 30 and 60 degrees knee flexion significantly increased from 4.7 to 6.9 kgm (47% increase, P<0.001) and from 10.8 to 12.6 kgm (17% increase, P<0.005) after 12 weeks of exercise. The molecular weight of hyaluronan increased from 2.11 to 2.40x10(6)(P<0.05) and the viscosity of joint fluid increased from 45.8 to 59.8 mPas after 12 weeks of exercise (P<0.05). Chondroitin 4-, 6-sulfate concentration in joint fluid decreased from 81.9 to 75.5 nmol/ml (P<0.05).CONCLUSIONS: Isometric quadriceps exercise resulted in significant changes in joint fluid biochemical parameters, and these changes, at least in part, may explain the ameliorative effect of muscle exercise for osteoarthritis of the knee.

        Major Subject Heading(s)Minor Subject Heading(s)CAS Registry / EC Numbers
          • PreMedline Identifier: 12681951

          Is exercise effective treatment for osteoarthritis of the knee?

          Br J Sports Med.  2000; 34(5):326-31 (ISSN: 0306-3674)

          Petrella RJ
          Department of Family Medicine, Faculty of Medicine, School of Kinesiology, University of Western Ontario, London, Canada.

          OBJECTIVE: To review and determine the effectiveness of exercise treatment in osteoarthritis of the knee. METHODS: A computerised literature search of Medline was carried out searching between June 1966 and January 2000. RESULTS: Twenty three randomised controlled trials were identified from the literature. Only three trials were sufficiently powered. Small to moderate beneficial effects of exercise treatment were found for pain, small beneficial effects on disability outcome measures, and moderate to great beneficial effects were observed according to patient global assessment of effect. It was not possible to obtain evidence on the content of exercise interventions, as studies were hampered by lack of attention to proper concealment, reporting of adverse effects, and long term effects of exercise treatment. The lack of standard outcomes measures is also noted. CONCLUSIONS: The available evidence indicates beneficial short term effects of exercise treatment in patients with osteoarthritis of the knee. However, the number of available studies is limited, and more research is needed to expand this recommendation. Specifically, additional trials should provide information on adherence, home based interventions, interaction with pharmacological treatments, functional outcomes measures relevant to exercise treatment in these patients, and long term effects. At present, doctors should recommend exercise to all patients with mild/moderate disease. Further study should be encouraged and exercise should be continued to be recommended as a mainstay of non-pharmacological treatment of osteoarthritis of the knee.

          Major Subject Heading(s)Minor Subject Heading(s)
          • PreMedline Identifier: 11049140

          Improvements in quadriceps sensorimotor function and disability of patients with knee osteoarthritis following a clinically practicable exercise regime.

          Br J Rheumatol.  1998; 37(11):1181-7 (ISSN: 0263-7103)

          Hurley MV; Scott DL
          Physiotherapy Division, School of Biomedical Sciences, King's College, London.

          OBJECTIVE: Quadriceps sensorimotor dysfunction may be important in the pathogenesis of knee osteoarthritis (OA) and a determinant of disability. Exercise regimes can increase quadriceps strength, but whether this improves proprioception and reduces disability is uncertain. Moreover, research regimes involve protracted treatment which is clinically impracticable. METHODS: We compared quadriceps sensorimotor function and disability in 60 patients with knee OA, before and after an exercise regime, with a control group (n = 37) who did not exercise. RESULTS: Exercise improved quadriceps strength (mean change, 95% CI; 73 N, 26-19 N), voluntary activation (14%, 5-20%), knee joint position sense (0.6 degrees, 0.1-1.8 degrees), and reduced the Lequesne Index (3.5, 0.5-4) and aggregate time of four activities of daily living (8.4 s, 0.2-16.7 s). At 6 month follow-up, these improvements were maintained. The parameters of the control group were unchanged. CONCLUSIONS: These results substantiate the association between quadriceps sensorimotor dysfunction and disability, emphasizing the importance of quadriceps exercise in the management of knee OA. The regimen is relatively brief and clinically practicable, but could be adapted to make it more cost effective.

          • PreMedline Identifier: 9851266

          Synovial fluid chondroitin sulphate epitopes 3B3 and 7D4, and glycosaminoglycan in human knee osteoarthritis after exercise.

          Ann Rheum Dis.  2000; 59(11):887-91 (ISSN: 0003-4967)

          Bautch JC; Clayton MK; Chu Q; Johnson KA
          Winona State University, Winona, Minnesota, USA.

          OBJECTIVE: Walking exercise alleviates some symptoms, such as pain, in patients with mild to moderate knee osteoarthritis (OA). However, a major concern is that weightbearing exercise on osteoarthritic joints may exacerbate articular cartilage degradation. Loading of proteoglycan depleted articular cartilage in vitro increased expression of the chondroitin sulphate epitope 3B3, suggesting that loading may influence metabolism of osteoarthritic cartilage. This study aimed at evaluating the effects of walking exercise on articular cartilage metabolism in patients with knee OA, as reflected by changes in concentrations of synovial fluid markers. METHODS: Thirty elderly patients with knee OA (Kellgren-Lawrence grades II to IV) were randomly allocated to control (n = 15) and 12 week exercise (n = 15) groups. Synovial fluid obtained from 21 of the patients at time zero and after 12 weeks was examined by enzyme linked immunosorbent assay (ELISA) for the chondroitin sulphate epitopes 3B3 and 7D4, and by a dye binding assay with 1, 9-dimethylmethylene blue for total sulphated glycosaminoglycan (GAG) concentrations. The 3B3/GAG and 7D4/GAG ratios were calculated. RESULTS: No significant changes in concentrations of 3B3, 7D4, GAG, 3B3/GAG, or 7D4/GAG between time zero and 12 weeks were found in either group. However, there were significant declines in 3B3 (p=0. 001), GAG (p=0.007), and the 3B3/GAG ratio (p=0.049) with aging. CONCLUSION: Twelve weeks of walking exercise had no demonstrable adverse effects on articular cartilage metabolism, as reflected by the concentrations of synovial fluid GAG or the chondroitin sulphate epitopes 3B3 and 7D4.

          Major Subject Heading(s)Minor Subject Heading(s)CAS Registry / EC Numbers
          • PreMedline Identifier: 11053067

          Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months' follow up.

          Ann Rheum Dis.  2001; 60(12):1123-30 (ISSN: 0003-4967)

          van Baar ME; Dekker J; Oostendorp RA; Bijl D; Voorn TB; Bijlsma JW
          Netherlands Institute of Primary Health Care, Utrecht, The Netherlands.

          OBJECTIVE: To determine whether the effects of an exercise programme in patients with osteoarthritis of hip or knee are sustained at six and nine months' follow up. METHODS: A randomised, single blind, clinical trial was conducted in a primary care setting. Patients with osteoarthritis of hip or knee (ACR criteria) were selected. Two intervention groups were compared. Both groups received treatment from their general practitioner, including patient education and drug treatment if necessary. The experimental group also received exercise treatment from a physiotherapist in primary care. The treatment period was 12 weeks, with an ensuing 24 week follow up. The main outcome measures were pain, drug use (non-steroidal anti-inflammatory drugs), and observed disability. RESULTS: 201 patients were randomly allocated to the exercise or control group, and 183 patients completed the trial. At 24 weeks exercise treatment was associated with a small to moderate effect on pain during the past week (difference in change between the two groups -11.5 (95% CI -19.7 to -3.3). At 36 weeks no differences were found between the groups. CONCLUSIONS: Beneficial effects of exercise decline over time and finally disappear.

          Major Subject Heading(s)Minor Subject Heading(s)CAS Registry / EC Numbers
            • 0  (Anti-Inflammatory Agents, Non-Steroidal)
            • PreMedline Identifier: 11709454

            Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee.

            J Epidemiol Community Health.  2001; 55(2):132-8 (ISSN: 0143-005X)

            Campbell R; Evans M; Tucker M; Quilty B; Dieppe P; Donovan JL
            Department of Social Medicine, University of Bristol, Whiteladies Road, Bristol BS8 4SH, UK.

            STUDY OBJECTIVES: To understand reasons for compliance and non-compliance with a home based exercise regimen by patients with osteoarthritis of the knee. DESIGN: A qualitative study, nested within a randomised controlled trial, examining the effectiveness of physiotherapy in reducing pain and increasing mobility in knee osteoarthritis. In the intervention arm, participants undertook a series of simple exercises and repositioning of the kneecap using tape. In depth interviews were conducted with a subset of participants in the intervention arm using open ended questions, guided by a topic schedule, to encourage patients to describe their experiences and reflect on why they did or did not comply with the physiotherapy. Interviews were audiotaped, fully transcribed and analysed thematically according to the method of constant comparison. A model explaining factors influencing compliance was developed. SETTING: Patients were interviewed at home. The study was nested within a pragmatic randomised controlled trial. PARTICIPANTS: Twenty participants in the intervention arm of the randomised trial were interviewed three months after they had completed the physiotherapy programme. Eight were interviewed again one year later. MAIN RESULTS: Initial compliance was high because of loyalty to the physiotherapist. Reasoning underpinning continued compliance was more complex, involving willingness and ability to accommodate exercises within everyday life, the perceived severity of symptoms, attitudes towards arthritis and comorbidity and previous experiences of osteoarthritis. A necessary precondition for continued compliance was the perception that the physiotherapy was effective in ameliorating unpleasant symptoms. CONCLUSIONS: Non-compliance with physiotherapy, as with drug therapies, is common. From the patient's perspective, decisions about whether or not to comply are rational but often cannot be predicted by therapists or researchers. Ultimately, this study suggests that health professionals need to understand reasons for non-compliance if they are to provide supportive care and trialists should include qualitative research within trials whenever levels of compliance may have an impact on the effectiveness of the intervention.

            Major Subject Heading(s)Minor Subject Heading(s)
              • PreMedline Identifier: 11154253

              [Comparison of effects among Tai-Chi exercise, aquatic exercise, and a self-help program for patients with knee osteoarthritis]

              Taehan Kanho Hakhoe Chi.  2006; 36(3):571-80 (ISSN: 1598-2874)

              Lee HY
              College of Nursing Science, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemun-Gu, Seoul, Korea.

              PURPOSE: This study was to compare the effects among Tai-Chi exercise, aquatic Exercise, and a self-help program for knee osteoarthritis patients on symptoms of arthritis, muscle strength, balance, and difficulty of performing activities. METHOD: There were 50 final subjects50. A non-equivalent pretest-posttest design was used. The collected data was analyzed using SPSS for Window. One-way ANOVA and Scheffe's multiple comparison test were used 8 weeks after each program. RESULT: There were significant differences in joint pain (p=.000), stiffness (p=.001), knee extensor peak torque (p=.006), knee flexor (p=.002), and difficult of performing activity (p=.000), but there was no significant difference in balance (p=.648). The Tai-Chi group was significantly different from the self-help group for knee extensor peak torque, knee flexor and stiffness on Scheffe's multiple comparison tests. In addition, the Tai-Chi group or aquatic group were significantly different from the self-help group for difficulty of performing activities (p<0.05). CONCLUSION: There are significant differences in the effects of the nursing intervention among the three groups. The Tai-Chi group and aquatic group were significantly different from the self-help group. However, it seems that Tai-Chi exercise may be more suitable than aquatic exercise in osteoarthritis exercise programs. Further studies with a longitudinal study are necessary to confirm the longer exercise period.

              • PreMedline Identifier: 16825841

              The effect of iyengar yoga and strengthening exercises for people living with osteoarthritis of the knee: a case series.

              Int Q Community Health Educ.  2006; 26(3):287-305 (ISSN: 0272-684X)

              Bukowski EL; Conway A; Glentz LA; Kurland K; Galantino ML
              Richard Stockton College of New Jersey, Pomona, NJ 08240, USA.

              This case series describes the impact of various forms of exercise on symptoms associated with osteoarthritis of the knee. A group of 15 women and men performed one of the following: traditional stretching and strengthening exercises, Iyengar yoga, or no structured group exercise. Low back and hamstring flexibility and quadriceps strength and function were monitored before and after the program. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess subjective change after the six-week intervention period. A global assessment questionnaire was also completed by each participant and each instructor at the exit sessions to measure perceived changes in improvements since the initiation of the intervention. This study found functional changes and improvement in quality of life in traditional exercise and a yoga based approach that should encourage further comprehensive and carefully designed studies of yoga in osteoarthritis.

              • PreMedline Identifier: 17827096

              Efficacy of a target-matching foot-stepping exercise on proprioception and function in patients with knee osteoarthritis.

              J Orthop Sports Phys Ther.  2008; 38(1):19-25 (ISSN: 0190-6011)

              Jan MH; Tang PF; Lin JJ; Tseng SC; Lin YF; Lin DH
              Department of Physical Medicine and Rehabilitation, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, San-shia Town, Taipei, Taiwan.

              STUDY DESIGN: A randomized clinical trial design. OBJECTIVE: To investigate the efficacy of high, repetitive, target-matching foot-stepping exercise (TMFSE) performed in a sitting position on proprioception, functional score, and walking velocity for patients with knee osteoarthritis (OA). BACKGROUND: Researchers have suggested that exercises to address knee OA should include proprioceptive training. However, most patients cannot tolerate conventional proprioceptive training performed in a standing position. METHODS AND MEASURES: Forty-nine subjects (mean age +/- SD, 63.3 +/- 8.1) with knee OA were randomly assigned to the exercise or no intervention groups. The exercise group practiced TMFSE in sitting, 3 sessions weekly for 6 weeks. All subjects underwent assessments of knee reposition error, functional incapacity score, and walking velocity prior to and after intervention. RESULTS: The TMFSE significantly improved reposition error from a mean +/- SD of 3.0 degrees +/- 1.6 degrees to 1.5 degrees +/- 0.6 degree, walking velocity on ground level from 44.1 +/- 2.9 to 38.6 +/- 2.5 sec for 60 meters, time to complete a stairs task from 34.2 +/- 2.1 to 26.5 +/- 2.3 seconds, time to complete a figure-of-eight from 51.3 +/- 6.7 to 29.1 +/- 3.6 seconds, and score on a functional incapacity scale from 12.0 +/- 3.1 to 4.9 +/- 1.7, in subjects with knee OA after 6-week intervention (P <.0125). In contrast, the control group showed no change in any of the measured tests. CONCLUSION: TMFSE in sitting appears to be an option for exercise in patients with mild to moderate knee OA. This may be an especially attractive option for patients who may have pain with weight-bearing exercises. A longitudinal study with a larger sample size is needed to confirm the potential use of TMFSE for patients with knee OA.

              • PreMedline Identifier: 18357655

              MEDLINE Abstracts

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