Knee Joint Stabilization Therapy in Patients with Osteoarthritis of the Knee: A Randomized, Controlled Trial

Jesper Knoop¹, Joost Dekker², Marike van der Leeden³, Martin van der Esch¹, Carina A. Thorstensson⁴, Martijn Gerritsen⁵, Ramon E. Voorneman⁵, Wilfred FH Peter¹, Mariette de Rooij¹, Suzanne Romviel¹, Willem F. Lems⁶, Leo D. Roorda⁷ and Martijn P.M. Steultjens⁸, ¹Amsterdam Rehabilitation Research Center, Reade, centre for rehabilitation and rheumatology, Amsterdam, Netherlands, ²VU University Medical Centre, Department of Rehabilitation Medicine, EMGO Institute and Department of Psychiatry, Amsterdam, Netherlands, ³Amsterdam Rehabilitation Research Center, Reade, Amsterdam, Netherlands, ⁴Department of Clinical Neurosciences and Rehabilitation, University of Gothenburg, Institute of Neuroscience and Physiology, Gothenburg, Sweden, ⁵Jan van Breemen Research Institute, Reade, centre for rehabilitation and rheumatology, Amsterdam, Netherlands, ⁶Rheumatology, VU University Medical Center, Amsterdam, Netherlands, ⁷Amsterdam Rehabilitation Research Center | Reade, Amsterdam, the Netherlands, Amsterdam, Netherlands, ⁸Institute for Applied Health Research and School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: exercise, Knee, osteoarthritis and randomized trials

Session Information

Title: Osteoarthritis - Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose: Patients with knee osteoarthritis (OA) and instability of the knee joint may not benefit optimally from regular strengthening training. Therefore, we evaluated the effectiveness of a newly developed exercise program which initially focused on knee joint stabilization, before starting with muscle strengthening exercises and training of daily activities in knee OA patients and instability of the knee joint, compared to muscle strengthening exercises and training of daily activities only.

Methods: A single-blind, randomized, controlled trial involving 159 patients with knee OA and knee joint instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group exercises initially focused on knee joint stabilization. Outcome measures included activity limitations (WOMAC physical function, primary outcome), pain and knee stability.

Results: Both treatment groups demonstrated large (~20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained six months post treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% CI) = -0.36 (-2.85-2.12)) or any secondary outcome measure.

Conclusion: Both exercise programs were effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. Against this background, no additional effect of initial knee joint stabilization training, before starting muscle strengthening exercises and training of daily activities could be demonstrated, emphasizing a dominant role of muscle function in stabilizing the knee joint.

Disclosure:

J. Knoop,
None;

J. Dekker,
None;

M. van der Leeden,
None;

M. van der Esch,
None;

C. A. Thorstensson,
None;

M. Gerritsen,
None;

R. E. Voorneman,
None;

W. F. Peter,
None;

M. de Rooij,
None;

S. Romviel,
None;

W. F. Lems,
None;

L. D. Roorda,
None;

M. P. M. Steultjens,
None.

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