Healthy knee (left) – Osteoarthritis of the Knee (right)
A Cochrane Systematic Review of the scientific evidence published in the Journal of Sports Medicine in 2015, concluded that:
Among people with knee osteoarthritis, land-based therapeutic exercise provides short-term benefit that is sustained for at least 2–6 months after cessation of formal treatment.
So, while many people with “arthritic knee pain” avoid land-based exercise and opt for the swimming pool (or, much worse, the sofa!), land-based exercise provides quick benefits that continue for at least 2-6 months after stopping exercise.
As we are NOT meant to ever stop doing some exercise, it would seem that land-based therapeutic exercise would benefit all of us.
Therapeutic exercise refers to a range of targeted physical activities that directly aim to improve muscle strength, neuromotor control, joint range of motion and aerobic fitness. One of the main aims of exercise is to improve muscle strength, given that weakness is common in knee OA.
What kind of exercise?
The studies varied a lot in terms of exercise prescription provided for knee pain management.
TYPE of SESSION: Individual or class-based format
DURATION: From 20 to 60 min
FREQUENCY: In most studies, exercise frequency was two to three times per week but varied between one to five times per week.
INTENSITY: Intensity achieved during strength training using free or limb weights or Theraband was commonly a 10-repetition maximum with varying numbers of sets or was at least moderate. Aerobic exercise training, achieved via walking or cycling programmes, ranged from low to moderate intensity.
IMPROVEMENTS: meta-analysis demonstrated that land-based therapeutic exercise programmes resulted in an immediate mean treatment benefit for:
- knee pain
- physical function
- quality of life (QOL)
TYPE of EXERCISE: each type of exercise (quadriceps strengthening only, lower limb strengthening, combination strengthening and aerobic exercise, walking programmes and ‘others’) reduced pain and improved physical function
SUPERVISION: the review highlighted that most people with knee OA need some form of ongoing monitoring or supervision to optimise clinical benefits of exercise treatment.
So, while it is probably a good idea to increase exercise, make sure you are doing it correctly so that what you are doing brings benefit!
CONCLUSIONS
- High-quality evidence suggests that land-based therapeutic exercise provides benefit in terms of reduced knee pain and improved quality of life and moderate-quality evidence of improved physical function among people with knee OA
- Healthcare professionals and people with OA can be reassured that any type of exercise programme that is performed regularly and is closely monitored by healthcare professionals can improve pain, physical function and quality of life related to knee OA in the short term.
ACTION POINTS:
- Continue to attend my Pilates sessions, which include lower body strengthening
- Consider attending Friday vitality circuit, which covers cardio as well as (upper and) lower body strength training
- Or sign up for some Personal Training sessions with me to make sure you can perform the exercises correctly for best benefits of reduced pain, better physical function and better quality of life!
Emanuela – www.pilatesfitness.co.uk
Reference:
http://www.medscape.com/viewarticle/855543