Exercise is effective in reducing pain in knee osteoarthritis (moderate effect size)1. The working mechanisms of the positive effects of exercise therapy in knee OA are not fully elucidated. Improvement in physiological factors such as upper leg muscle strength, joint range of motion and proprioception have been found to be related to improvement in pain and activity limitations2, but also psychosocial and general health related mechanism might be involved. Additionally, reduction in local as well as systemic inflammation seems to be a working mechanism of exercise therapy, although evidence is still limited.
Severe knee pain hampers the ability to participate in exercise therapy. Patients with knee OA who experience severe knee pain form a substantial group of patients with knee OA. These patients may benefit insufficiently from exercise therapy. Recently, an intervention protocol which combines standardized analgesic prescription and exercise therapy has been developed3. The purpose of this intervention protocol was to reduce pain by optimization of analgesics, thereby allowing the patient to participate in exercise therapy. The feasibility and outcome of this combined intervention will be presented.
Fransen et al, Br J Sports Med 2015
Runhaar et al, Osteoarthritis Cartilage 2015
van Tunen et al, Arthritis Care Res 2016.
Disclosure of Interest None declared