Effects Of Customized, Comprehensive Exercise Therapy On Clinical Symptoms Among Older Adults With Knee Osteoarthritis

Knee osteoarthritis (KOA) results in pain, limited joint range of motion (ROM), muscle weakness, and impaired proprioception. It affects 12% of older adults. Single-type exercise therapy may not be adequately effective in improving multifunction disorders of KOA. PURPOSE: To investigate the effects of customized, comprehensive exercise therapy on clinical symptoms for older adults with KOA. METHODS: Sixty-six older adults with KOA were randomly assigned to either the exercise group (EG, age: 67.0 ± 2.7 yrs, BMI: 25.7 ± 2.3 kg/m2), the physiotherapy group (PG, age: 67.5 ± 4.4 yrs, BMI: 25.7 ± 3.0 kg/m2), or the control group (CG, age: 65.7 ± 1.9 yrs, BMI: 27.4 ± 2.1 kg/m2) to receive an 8-week exercise (proprioceptive neuromuscular facilitation + muscle strength training +gait training), physical therapy, or health education for 1 hour 3 times per week, respectively. Pain, proprioception threshold (PT), joint ROM, and strength data were measured before (W0) and after (W9) the intervention using a Visual Analogue Scale (VAS), proprioception device, goniometer, and IsoMed 2000 system, respectively. Two-way repeated measures ANOVA was used to analyze the data. RESULTS: In Table 1, significant interactions were detected in VAS, knee flexion ROM and PT, and knee extensor strength. Compared to W0, the EG had decreased VAS scores and PT, increased joint ROM and strength at W9; the PG had decreased VAS scores at W9. Compared to the PG, the EG showed lower VAS score and greater strength at W9; compared to the CG, the EG group showed lower VAS scores, PT, and greater ROM and strength at W9. CONCLUSION: Comprehensive exercise therapy customized to clinical symptoms facilitates KOA rehabilitation, reduces pain, and improved joint proprioception, ROM, and strength among older adults with KOA. Table 1. - Indicators of the injured leg, presented as mean ± S.D. Group Interaction Post-hoc Exercise Physiotherapy Control Week (n = 18) (n = 20) (n = 18) P η2 p P d Pain (mm) 0 6.27 ± 1.01 5.74 ± 1.39 7.80 ± 1.38 <.001 0.436 a < .001;b < .001;c = .043;d < .001; e = .005. a = 3.13;b = 1.04;c = 0.84;d = 2.10;e = 1.01. 9 2.92 ± 1.15a,c,d 4.13 ± 1.66b,e 8.50 ± 1.37 Knee flexion ROM (°) 0 111.9 ± 8.3 110.0 ± 7.5 111.1 ± 7.5 .033 0.121 a = .011; a = 0.54; 9 116.5 ± 8.6a,d 111.7 ± 7.7 109.1 ± 10.5 c = .049. c = 0.77; Knee flexion Proprioception (°) 0 4.05 ± 2.83 4.22 ± 2.69 3.91 ± 2.43 .034 0.120 a = .002;d = .048. a = 0.64;d = 0.78. 9 2.49 ± 1.50a,d 3.48 ± 2.00 4.18 ± 2.66 Knee extensor strength (Nm/kg) 0 0.90 ± 0.27 0.73 ± 0.25 0.78 ± 0.24 .042 0.113 a = .029; a = 0.47; 9 1.02 ± 0.24a 0.69 ± 0.28 0.72 ± 0.25 a / b Denotes significant difference in the EG / PG between W0 and W9; c / d / e Denotes significant difference compared with the PG / CG / CG at W9. This project was funded by the China Scholarship Council (Number 202106520019), and the International Society of Biomechanics Council (Student Matching Dissertation Grant).