Strength Training, Self-Management Programs or a Combination are Equally Effective for Osteoarthritis


A 24 month unblinded, random intervention study to compare the effects of strength training programs, self-management programs, and a combination of both carried out at the University of Arizona Arthritis Center found that physically inactive, middle aged people with symptomatic osteoarthritis benefited equally from strength training regimes, self-management programs, or a combination of the two. In this study, known as the Knee Study the researchers hypothesized that combining the two treatments might enhance the outcome.
Two hundred seventy three study participants between the ages of 35 and 65 who had reported pain and disability due to knee pain on most days in one or both knees for a period of not more than five years, and had a Kellgren/Lawrence classification grade 2 radiographic evidence of knee osteoarthritis in one or both knees were included.
Study participants were randomly assigned to 1 of 3 treatment groups-strength training, self management program, and the combination group. The strength training group spent the first 9 months improving the core areas of stretching and balance, range of motion and flexibility, and isotonic muscle strength. This was followed by 15 months of developing independent, long-term exercise habits. The second group participated in a 2-phase self-management program to educate participants and provide one on one treatment advice. The combined group participated in both the complete training and self-management program. Two hundred one of the original 273 participants completed the two year program with the self management group having the highest compliance rate.

Despite the lack of differences in finding in the three groups, all groups demonstrated improvements in physical function tests and decreased self-reported pain and disability. The researchers stated that because the self management group demonstrated higher compliance and there was no differences found in the outcome of the three groups, self-management might be a less intrusive and equally effective early treatment for knee osteoarthritis. More information is available in the January 2010 issue of Arthritis Care & Research.

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