Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomised controlled trial

Bennell, Kim L., Kyriakides, Mary, Metcalf, Ben, Egerton, Thorlene, Wrigley, Tim V., Hodges, Paul W., Hunt, Michael A., Roos, Ewa M., Forbes, Andrew, Ageberg, Eva and Hinman, Rana S. (2014) Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Arthritis and Rheumatism, 66 4: 950-959. doi:10.1002/art.38317


Author Bennell, Kim L.
Kyriakides, Mary
Metcalf, Ben
Egerton, Thorlene
Wrigley, Tim V.
Hodges, Paul W.
Hunt, Michael A.
Roos, Ewa M.
Forbes, Andrew
Ageberg, Eva
Hinman, Rana S.
Title Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment: a randomised controlled trial
Journal name Arthritis and Rheumatism   Check publisher's open access policy
ISSN 0004-3591
1529-0131
2326-5191
2326-5205
Publication date 2014-04-01
Year available 2014
Sub-type Article (original research)
DOI 10.1002/art.38317
Open Access Status Not yet assessed
Volume 66
Issue 4
Start page 950
End page 959
Total pages 10
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Abstract 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.
Formatted abstract
Objective To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral 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 × 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.
Keyword Rheumatology
Rheumatology
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 628644
FT0991413
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Thu, 20 Mar 2014, 21:35:26 EST by Professor Paul Hodges on behalf of School of Health & Rehabilitation Sciences