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

Da-Hon Lin, Chien-Ho Janice Lin, Yeong-Fwu Lin, Mei-Hwa Jan

DOI: 10.2519/jospt.2009.2923

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 McMaster 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 (PrT 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. LEVEL OF EVIDENCE: Therapy, level 1b.

J Orthop Sports Phys Ther 2009;39(6):450-457, Epub 24 February 2009. doi:10.2519/jospt.2009.2923

KEY WORDS: arthritis, randomized clinical trials, tibiofemoral joint, WOMAC

The authors 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).

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