Aerobics, weight training relieve knee osteoarthritis
Aerobics, weight training relieve knee osteoarthritis
Effects beneficial for older or obese patients
Exercise — either aerobic or weight training — helps reduce pain and disability in older patients with osteoarthritis, especially osteoarthritis of the knee. A study from Bowman Gray School of Medicine in Winston-Salem, NC, indicates that exercise had beneficial effects in patients older than age 70, African-Americans, and obese patients.1 As the amount of exercise increased, scores improved on measurements of disability, pain, and performance.
"In the past, opinion was divided as to whether exercise or rest was the better treatment for osteoarthritis," says Stanley Slater, MD, deputy associate director of the National Institute on Aging’s Geriatrics Program in Bethesda, MD, which funded the study.
"These data suggest that exercise is beneficial for a large segment of the older population with knee osteoarthritis," says Walter H. Ettinger Jr., MD, professor of internal medicine at Bowman Gray. "Physicians and other health professionals should prescribe a program of moderate-intensity exercise as part of a treatment program for older people with symptomatic knee osteoarthritis."
The study was called FAST, for Fitness Arthritis and Seniors Trial. In the 18-month study, 439 adults aged 60 or older with radiographically evident knee osteoarthritis, pain, and self-reported physical disability were evaluated. Participants were provided with programs on aerobic exercise, resistance exercise, and health education. The primary outcome of the study was self-reported disability scores that ranged from one to five. The secondary outcomes were knee pain score (range from one to six), performance measures of physical function, X-ray score, aerobic capacity, and knee muscle strength.
Of the 365 patients who completed the trial, overall compliance with exercise was 68% in the aerobic training group and 70% in the resistance training group. Patients in the aerobic exercise and resistance exercise groups had better scores on assessments such as physical disability questionnaires and physical testing compared with patients who received health education only. There were no differences in X-ray scores between either exercise group and the health education group.
The aerobic exercise program consisted of three months of three-times-a-week walking on an indoor track; then, they were instructed on walking in their neighborhood or other areas through home visits from a trained exercise leader. Resistance training included nine exercises such as leg extension, leg curl, and step up. The health education program consisted of group sessions led by a nurse that included videotapes.
Previously, experts have advocated using resistance exercise only to help pain and disability associated with knee osteoarthritis, says William B. Applegate, MD, professor of preventive medicine at the University of Tennessee in Memphis. "FAST indicates that both types of regimens are effective," he notes.
Reference
1. Ettinger WH, Burns R, Messier SP, et al. A randomized trial comparing aerobic exercise with resistance exercise with a health education program in older adults with knee osteoarthritis. JAMA 1997; 277:25-31.
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