Jan MH et al.  Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis:  a randomized controlled trial. Physical Therapy. 2008; Volume 88:  pp. 427-436.

We know from prior research that patients with arthritis tend to have more problems when they start to avoid activity completely.  This reflects the fact that joints were made to be used.  When activity is decreased, joints get stiff and more symptomatic.  Walking programs have been shown to significantly decrease symptoms from established arthritis in the knee.  Low-impact exercises such as biking and use of an elliptical glider are also well-tolerated and help keep symptoms at bay.  This study looked at the relative benefit of a strength training program in patients over fifty with symptomatic knee arthritis in both joints, comparing both high and low-resistance programs.  The degree of patient arthritis ranged from mild to moderately-severe in intensity.  Average age was 63 years.  84% of study subjects were female.

The resistance training programs were eight weeks in duration, with a frequency of three times per week.  Each subject was randomly assigned to a group that either lifted three sets of 8 repetitions at 60% of their one-repetition maximum (1 rep max – this is the most a subject can lift without repeating the lift) or 10 sets of 15 repetitions at 10% of the one-repetition maximum.  Training level was increased each week as the one-repetition maximum also increased.  Knee pain and function scores were followed over time.

This study showed that patients in both resistance training groups made similar gains in comparison to control subjects who did not participate in any strength training, with improvements in overall symptom scores of 44% and 38% in the high and low-resistance training groups respectively.  The differences in outcome between the high and low-resistance groups was not significant statistically (meaning that both exercise programs were equally effective in comparison to not exercising).

This study is an important reminder that although medication, injections, bracing, etc. may be important tools to help manage the chronic symptoms associated with knee arthritis, they are not the only effective tools.  It is equally important to keep arthritis patients active so that, to the extent that it is possible, the joint is allowed to function as normally as it can.  Thus, low-impact cardiovascular exercising such as walking and biking should be encouraged.  Strength training is not commonly considered by physicians as an acceptable component of arthritis management programs, but medical evidence suggests that it should be.  Programs can easily be structured in a way to minimize the risk of associated injury and maximize the benefits to the knee.  It is important to keep in mind that arthroscopic surgery for arthritis has not been shown to be effective in most cases.  Although joint replacement is a wonderful option for people who are at a point where nothing else is working, most people understandably choose to delay this option as long as possible.

If you would like to discuss nonoperative management options for arthritis pain, give us a call at (515)221-1102.  We can get you feeling better!