The role and efficacy of exercise on a joint inflicted with arthritis has been the focus of many studies and clinical research trials across the globe. This article will examine recent literature on the impact that exercise has on arthritis, particularly osteoarthritis.
According to a clinical study published in Arch Phys Med Rehabi 2009 Jun;90(6):897-904, investigators recruited patients inflicted with knee arthritis to investigate whether weight-bearing (WB) exercise enhances functional capacity to a greater extent than nonweight-bearing (NWB) exercise. Participants were randomly assigned to WB exercise, NWB exercise, or a control group (no exercise).
WB exercise and NWB exercise groups underwent an 8-week knee extension-flexion exercise program. Walking speed, muscle torque, and knee reposition error were assessed before and after intervention. Investigators discovered that equally significant improvements were apparent for all outcomes after WB exercise and NWB exercise, except for reposition error, for which improvement was greater in the WB exercise group.
In contrast, there were no improvements in the control group. Simple knee flexion and extension exercises (WB and NWB) performed over 8 weeks resulted in significant improvement in knee strength compared with the control group.
In another study published in BMC Musculoskelet Disord. 2007 DEC 7;8: 121, Bennell KL et al showed how Lower limb strengthening exercises are an important component of the treatment for knee osteoarthritis (OA). Strengthening the hip abductor and adductor muscles may influence joint loading and/or OA-related symptoms, but no study has evaluated these hypotheses directly. The aim of this randomised, single-blind controlled trial was to determine whether hip abductor and adductor muscle strengthening can reduce knee load and improve pain and physical function in people with medial compartment knee OA.
88 participants with knee OA were recruited from the community and randomly allocated to a hip strengthening or control group. The hip strengthening group performed 6 exercises to strengthen the hip abductor and adductor muscles at home 5 times per week for 12 weeks. The control group were requested to continue with their usual care. Blinded follow up assessment were conducted at 12 weeks after randomization.
The primary outcome measure was the change in the peak of knee adduction moment measured during walking. Questionnaires were assessed in pain and physical function as well as overall perceived rating of change. An intention-to-treat analysis was performed using linear regression modelling and adjusting for baseline outcome values and other demographic characteristics.
Results from this trial contributed to the evidence regarding the effect of hip strengthening on knee loads and symptoms in people with knee OA. If shown to reduce the knee adduction moment, hip strengthening has the potential to slow disease progression.
Turkish researchers analyzed the effects of exercise on articular cartilage. Ozkan C et al published his findings in Acta Orthop Traumatol. 207;41 Suppl 2:13-8. This article reviews the influence of controlled, passive-active exercise on healing, and on the development of osteoarthritis and the short- and long-term changes in articular cartilage associated with exercise and participation in sports of different duration and intensity.
Joint cartilage, whose water content decreases itself thanks to its unique permeable medium, maintains load distribution and joint function together with the synovial fluid under physiologic conditions and sports activities. The adaptive capacity of joint cartilage is limited under various conditions such as excessive load bearing or prolonged immobilization; however, when these factors are reversed deformed cartilage returns to its former state under normal conditions.
Ozkan et al suggest that exercise contributes to cartilage healing and reduces risk for injury, and that moderate exercise can even decrease the number of cases requiring a hip replacement. Conversely, excessive (harsh) exercise may be associated with increased cartilage damage or degenerative changes. Despite the presence of osteophytic changes in joint cartilage of athletes performing mild sports activities, these may not result in osteoarthritis due to the adaptive feature of joint cartilage.
Similarly, Messier et al (J AM Geriatr Soc. 2000 Feb;48(2):131-8.), examined the effects of 18-month aerobic walking and strength training programs on static postural stability among older adults with knee osteoarthritis.
A cohort of 103 older adults (age = 60 years) with knee osteoarthritis were the participants and randomly assigned to undergo biomechanical testing. The subjects were randomized to one of three treatment arms: (1) aerobic walking; (2) health education control; or (3) weight training. Measures were made under four conditions: eyes open, double- and single-leg stances and eyes closed, double- and single-leg stances.
In the eyes closed, double-leg stance condition, both the aerobic and weight training groups demonstrated significantly better sway measures relative to the health education group. The aerobic group also demonstrated better balance in the eyes open, single-leg stance condition. Results suggested that long-term weight training and aerobic walking programs significantly improved postural sway in older, osteoarthritic adults, thereby decreasing the likelihood of larger postural sway disturbances relative to a control group.
Dr. Jack Haddad, MD, MBA is the founder and owner of King of Home Care, an independently owned non-medical In-home care agency. In addition to his compassion and dedication to the home care industry, Dr. Haddad\’s expertise and knowledge with In-Home Care is evident by the clinical research trials that he has conducted over the years.
Tags: disease, elderly, Elderly Care, Home Care, Hospice, hospice care, illness, in-home care
