Now, treatment for osteoarthritis

According to researchers in the Multidimensional Intervention for Early Osteoarthritis of the Knee (Knee Study), Osteoarthritis (OA) is the most common form of arthritis. A number of studies have compared strength training protocols with self-management programmes in older patient populations, but few have examined the potential benefit of using both approaches in conjunction.

“We hypothesized that combining the two treatments might enhance the outcome,” said Patrick McKnight, lead author of the Knee Study. The Knee Study, conducted at the University of Arizona Arthritis Center in Tucson, AZ, was a 24-month unblinded, randomised intervention trial to compare the effects of strength training programmes, self-management programmes, and a combination of both.

The 273 study participants were between the ages of 35 and 65 years, reported pain and disability due to knee pain on most days in one or both knees for a period of no more than 5 years, and had Kellgren/ Lawrence classification grade 2 radiographic evidence of knee OA in one or both knees. Study participants were randomly assigned to one of three treatment groups – the strength training group engaged in a 9-month initial phase designed to improve the core areas of stretching and balance, range of motion and flexibility, and isotonic muscle strength.

The second, 15-month phase of this group concentrated on developing independent, long-term exercise habits. The second study group participated in a second-phase self-management programme designed to educate participants and provide one-on-one treatment advice. The combined group participated in both the complete strength training and self-management programmes.

A total of 201 out of 273 participants completed the two-year trial, with the self-management group achieving the highest compliance rates. The researchers wanted to demonstrate that a combination of OA treatment programs would prove most effective, however, the study failed to uncover significant differences in results among the three study participant groups.

All three groups demonstrated improvements in physical function tests and decreased self-reported pain and disability. “The logic behind the combined treatment was that the different factors addressed in physical and psychological treatments might produce an additive effect if administered together. These results suggest otherwise. Instead, the comparison of the three treatment arms showed no difference, suggesting similar benefits for all three over a two-year period,” said McKnight. The researchers suggested that self-management may be a less intrusive and equally effective early treatment for knee OA.