Background Quality of life studies in patients with knee osteoarthritis attest to the significant impact of the disease on day to day activities and social interactions. The complex assessment of patients is essential for monitoring the efficacy of various treatments.
Objectives The aim of this study was to assess the efficacy of a 6 months ambulatory exercise program on functional status and quality of life in patients with knee osteoarthritis.
Methods The randomized, controlled, observational study included 181 patients with knee osteoarthritis, 64.3% women, mean age 63.7±7.3 years, randomly assigned to a control group (90 patients) and an exercise group (91 patients). All patients were diagnosed with knee osteoarthritis based on clinical and imagistic assessment and had a stable cardiovascular status. They followed exercise programs based on increasing knee flexion, muscular strength and endurance (especially for quadriceps), improving balance, coordination, respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study and after 6 months based on knee mobility, muscular strength, pain assessment on a Visual Analogue Scale (VAS) and quality of life evaluation using SF-36 Questionnaire.
Results The benefits of the kinetic programs were shown by a significant improvement on knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. For muscular strength, the values we obtained followed an ascendant curve for all the tested muscular groups and the results had high statistic significance. Pain, evaluated on a Visual Analogue Scale, had a mean decrease of 3.558 points and the results were also high statistic significant (p=0.000054). For SF-36 Questionnaire, the best results were obtained for vitality (37.2% amelioration), mental health (20.8% amelioration) and body pain (53.5% amelioration) domains and were also statistic significant (p<0.05). The results for the control group remained basically unchanged. The compliance of the study participants was very good: only six patients did not completed the 6 months training program.
Conclusions The physical exercise program improves both functional status and quality of life in patients with knee osteoarthritis by increasing range of motion and muscular strength and by reducing pain. Kinetic programs that combine aerobic exercise with exercises for increasing muscular strength and endurance, balance and coordination should be introduced in the rehabilitation programs of patients with knee osteoarthritis without medical contraindications for moderate level exercise.
Walter R. Frontera, Julie K. Silver. Essential of Physical Medicine and Rehabilitation, Philadelphia, Hanley& Belfus, 2002.
Edward J. Shahady: Primary care of Musculoskeletal Problems in the Outpatient Setting, New York, Springer Science+Buisness Media, 2006.
Disclosure of Interest None Declared