Considerations of the Principles of Resistance Training in Exercise Studies for the Management of Knee Osteoarthritis; a Systematic Review

Publication date: Available online 31 March 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Claire Minshull, Nigel Gleeson
ObjectiveTo evaluate the methodological quality of resistance training interventions for the management of knee osteoarthritis.Data SourcesA search of the literature for studies published up to 10^th August 2015 was performed on Medline (OVID platform), PubMed, EMBase and PEDRo databases. Search terms associated with 'osteoarthritis'; 'knee' and 'muscle resistance exercise' were used..Study SelectionStudies 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) RCT design; 3) treatment arms included at least a muscle conditioning intervention and a non-exercise control group; 4) participants had osteoarthritis of the knee; . Studies employing pre-operative (joint replacement) interventions with only post-operative outcomes were excluded. The search yielded 1574 results. The inclusion criteria were met by 34 studies.Data ExtractionTwo reviewers independently screened the papers for eligibility. Critical appraisal of the methodology was assessed according to the principles of resistance training (PoRT) and, separately for the reporting of adherence using a specially designed scoring system. A rating for each was assigned.Data Synthesis34studies described a strength training focus of the intervention, however, the PoRT were inconsistently applied and inadequately reported across all. Methods for adherence monitoring were incorporated in to the design of 28 of the studies but only 13 reported sufficient detail to estimate average dose of exercise.ConclusionsThese findings impact the interpretation of the efficacy of muscle resistance exercise in the management of knee osteoarthritis. Clinicians and health-care professionals cannot be confident whether non-significant findings are due to 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 OA should be properly designed and adherence diligently reported.



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