Abstract
Objective
To evaluate the methodologic quality of resistance training interventions for the
management of knee osteoarthritis.
Data Sources
A search of the literature for studies published up to August 10, 2015, was performed
on MEDLINE (OVID platform), PubMed, Embase, and Physiotherapy Evidence Database databases.
Search terms associated with osteoarthritis, knee, and muscle resistance exercise were used.
Study Selection
Studies were included in the review if they were published in the English language
and met the following criteria: (1) muscle resistance training was the primary intervention;
(2) randomized controlled trial design; (3) treatment arms included at least a muscle
conditioning intervention and a nonexercise group; and (4) participants had osteoarthritis
of the knee. Studies using preoperative (joint replacement) interventions with only
postoperative outcomes were excluded. The search yielded 1574 results. The inclusion
criteria were met by 34 studies.
Data Extraction
Two reviewers independently screened the articles for eligibility. Critical appraisal
of the methodology was assessed according to the principles of resistance training
and separately for the reporting of adherence using a specially designed scoring system.
A rating for each article was assigned.
Data Synthesis
There were 34 studies that described a strength training focus of the intervention;
however, the principles of resistance training were inconsistently applied and inadequately
reported across all. Methods for adherence monitoring were incorporated into the design
of 28 of the studies, but only 13 reported sufficient detail to estimate average dose
of exercise.
Conclusions
These findings affect the interpretation of the efficacy of muscle resistance exercise
in the management of knee osteoarthritis. Clinicians and health care professionals
cannot be confident whether nonsignificant findings are because of the lack of efficacy
of muscle resistance interventions, or occur through limitations in treatment prescription
and patient adherence. Future research that seeks to evaluate the effects of muscle
strength training interventions on symptoms of osteoarthritis should be properly designed
and adherence diligently reported.
Keywords
List of abbreviations:
OA (osteoarthritis), RCT (randomized controlled trial), RM (repetition maximum)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 30, 2017
Footnotes
Current affiliation for Gleeson, Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
