Influence of biomechanical characteristics on pain and function outcomes from exercise in medial knee osteoarthritis and varus malalignment: Exploratory analyses from a randomized controlled trial

Bennell, Kim L., Dobson, Fiona., Roos, Ewa M., Skou, Soren T., Hodges, Paul, Wrigley, Tim V., Kyriakides, Mary, Metcalf, Ben, Hunt, Michael A. and Hinman, Rana S. (2015) Influence of biomechanical characteristics on pain and function outcomes from exercise in medial knee osteoarthritis and varus malalignment: Exploratory analyses from a randomized controlled trial. Arthritis Care and Research, 67 9: 1281-1288. doi:10.1002/acr.22558


Author Bennell, Kim L.
Dobson, Fiona.
Roos, Ewa M.
Skou, Soren T.
Hodges, Paul
Wrigley, Tim V.
Kyriakides, Mary
Metcalf, Ben
Hunt, Michael A.
Hinman, Rana S.
Title Influence of biomechanical characteristics on pain and function outcomes from exercise in medial knee osteoarthritis and varus malalignment: Exploratory analyses from a randomized controlled trial
Journal name Arthritis Care and Research   Check publisher's open access policy
ISSN 2151-4658
2151-464X
Publication date 2015-09
Year available 2015
Sub-type Article (original research)
DOI 10.1002/acr.22558
Open Access Status Not Open Access
Volume 67
Issue 9
Start page 1281
End page 1288
Total pages 8
Place of publication Hoboken, New Jersey, United States
Publisher John Wiley and Sons
Collection year 2016
Language eng
Formatted abstract
Objective
To investigate whether selected biomechanical characteristics influence changes in pain and physical function with exercise in people with medial knee osteoarthritis (OA) and varus malalignment.

Methods
We conducted post hoc exploratory analyses from a randomized controlled trial involving 100 people with medial knee OA and varus malalignment who were randomly allocated to one of two 12-week exercise programs (quadriceps strengthening [QS] or neuromuscular exercise [NEXA]). The outcome measures were change in overall average knee pain (visual analog scale) and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). Candidate biomechanical characteristics measured at baseline were visually observed varus thrust during walking, obesity (determined by body mass index), static varus alignment, and isometric quadriceps strength. Data were analyzed with separate two-way analyses of covariance using the interaction term of exercise group by biomechanical characteristic.

Results
Ninety-two participants were analyzed for each characteristic except varus thrust, for which 85 participants were included. For change in pain, there was a significant interaction effect between type of exercise and both varus thrust (P = 0.001) and obesity (P = 0.023). NEXA was more effective for nonobese participants (mean change 29.5 mm [95% confidence interval (95% CI) 20.5, 38.5]) and for those with varus thrust (mean change 28.7 mm [95% CI 19.4, 38.1]), whereas QS was more effective for obese people (mean change 24.7 mm [95% CI 14.9, 34.4]) and for those without varus thrust (mean change 29.4 mm [95% CI 21.2, 37.7]). Biomechanical characteristics did not influence the effect of exercise on physical function (P > 0.05).

Conclusion
These preliminary findings suggest that varus thrust and obesity influence the pain-relieving effects of 2 different types of exercise. Further research is needed to confirm whether or not exercise that is prescribed according to specific biomechanical characteristics optimizes knee OA outcomes.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
 
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