Efficacy of 2 Non-Weight-Bearing Interventions, Proprioception Training Versus Strength Training, for Patients with Knee Osteoarthritis: A Randomized Clinical Trial

Abstract

STUDY DESIGN: Randomized clinical trial OBJECTIVE: To investigate the clinical and functional efficacy of 2 different non-weight-bearing exercise regimens, proprioceptive training (PrT) versus strength training (ST), for patients with knee osteoarthritis (OA). BACKGROUND: Both strength and proprioceptive training are important interventions for individuals with knee OA. The benefits of weight-bearing exercises are generally recognized in the clinical setting. However, exercising in a standing or weight-bearing position may aggravate symptoms in patients with knee OA. METHODS AND MEASURES: One hundred eight patients were randomly assigned to the PrT, ST, or no exercise (control) group for an 8- week intervention. Both the PrT and ST interventions consisted of non- weight-bearing exercises. Western Ontario and MacMaster Universities Osteoarthritis Index-pain (WOMAC-pain) and -function scores, walking time on 3 different terrains, knee strength, and absolute knee reposition error were assessed before and after intervention. Data were analyzed using mixed-model ANOVAs. RESULTS: Both PrT and ST significantly improved WOMAC- pain and -function score after intervention (P<008). The improvement secondary to ST in the WOMAC-function scores (17.2 points) and for knee extension strength (10.3-14.9 Nm) was greater than the minimally clinically important difference for these measurements. The PrT group demonstrated greater improvement in walking time on a spongy surface and knee reposition error than the other 2 groups. No improvements were apparent in the control group. CONCLUSION: Both types of non-weight- bearing exercises (PIT and ST) significantly improved outcomes in this study. PrT led to greater improvements in proprioceptive function, while ST resulted in a greater increase in knee extensor muscle strength.