Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial

J Knoop; J Dekker; M van der Leeden; M van der Esch; C A Thorstensson; M Gerritsen; R E Voorneman; W F Peter; M de Rooij; S Romviel; W F Lems; L D Roorda; M P M Steultjens

doi:10.1016/j.joca.2013.05.012

Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial

J Knoop, J Dekker, M van der Leeden, M van der Esch, C A Thorstensson, M Gerritsen, R E Voorneman, W F Peter, M de Rooij, S Romviel, W F Lems, L D Roorda, M P M Steultjens

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint.

DESIGN: A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability.

RESULTS: Both treatment groups demonstrated large (∼20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04).

CONCLUSIONS: Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475.

Original language	English
Pages (from-to)	1025-1034
Number of pages	10
Journal	Osteoarthritis and Cartilage
Volume	21
Issue number	8
Early online date	28 May 2013
DOIs	https://doi.org/10.1016/j.joca.2013.05.012
Publication status	Published - Aug 2013

Keywords

Activities of Daily Living
Adult
Aged
Exercise Therapy/methods
Female
Humans
Joint Instability/etiology
Knee Joint/physiopathology
Male
Middle Aged
Muscle Strength/physiology
Muscle, Skeletal/physiopathology
Osteoarthritis, Knee/complications
Pain Measurement/methods
Severity of Illness Index
Single-Blind Method
Treatment Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.joca.2013.05.012

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Knoop, J., Dekker, J., van der Leeden, M., van der Esch, M., Thorstensson, C. A., Gerritsen, M., Voorneman, R. E., Peter, W. F., de Rooij, M., Romviel, S., Lems, W. F., Roorda, L. D., & Steultjens, M. P. M. (2013). Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial. Osteoarthritis and Cartilage, 21(8), 1025-1034. https://doi.org/10.1016/j.joca.2013.05.012

@article{1ef5843cebec482893a385b11c222685,

title = "Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial",

abstract = "OBJECTIVE: To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint.DESIGN: A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability.RESULTS: Both treatment groups demonstrated large (∼20-40\%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95\% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04).CONCLUSIONS: Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475.",

keywords = "Activities of Daily Living, Adult, Aged, Exercise Therapy/methods, Female, Humans, Joint Instability/etiology, Knee Joint/physiopathology, Male, Middle Aged, Muscle Strength/physiology, Muscle, Skeletal/physiopathology, Osteoarthritis, Knee/complications, Pain Measurement/methods, Severity of Illness Index, Single-Blind Method, Treatment Outcome",

author = "J Knoop and J Dekker and \{van der Leeden\}, M and \{van der Esch\}, M and Thorstensson, \{C A\} and M Gerritsen and Voorneman, \{R E\} and Peter, \{W F\} and \{de Rooij\}, M and S Romviel and Lems, \{W F\} and Roorda, \{L D\} and Steultjens, \{M P M\}",

year = "2013",

month = aug,

doi = "10.1016/j.joca.2013.05.012",

language = "English",

volume = "21",

pages = "1025--1034",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "W.B. Saunders Ltd",

number = "8",

}

Knoop, J, Dekker, J, van der Leeden, M, van der Esch, M, Thorstensson, CA, Gerritsen, M, Voorneman, RE, Peter, WF, de Rooij, M, Romviel, S, Lems, WF, Roorda, LD & Steultjens, MPM 2013, 'Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial', Osteoarthritis and Cartilage, vol. 21, no. 8, pp. 1025-1034. https://doi.org/10.1016/j.joca.2013.05.012

TY - JOUR

T1 - Knee joint stabilization therapy in patients with osteoarthritis of the knee

T2 - a randomized, controlled trial

AU - Knoop, J

AU - Dekker, J

AU - van der Leeden, M

AU - van der Esch, M

AU - Thorstensson, C A

AU - Gerritsen, M

AU - Voorneman, R E

AU - Peter, W F

AU - de Rooij, M

AU - Romviel, S

AU - Lems, W F

AU - Roorda, L D

AU - Steultjens, M P M

PY - 2013/8

Y1 - 2013/8

N2 - OBJECTIVE: To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint.DESIGN: A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability.RESULTS: Both treatment groups demonstrated large (∼20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04).CONCLUSIONS: Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475.

AB - OBJECTIVE: To investigate whether an exercise program, initially focusing on knee stabilization and subsequently on muscle strength and performance of daily activities is more effective than an exercise program focusing on muscle strength and performance of daily activities only, in reducing activity limitations in patients with knee osteoarthritis (OA) and instability of the knee joint.DESIGN: A single-blind, randomized, controlled trial involving 159 knee OA patients with self-reported and/or biomechanically assessed knee instability, randomly assigned to two treatment groups. Both groups received a supervised exercise program for 12 weeks, consisting of muscle strengthening exercises and training of daily activities, but only in the experimental group specific knee joint stabilization training was provided. Outcome measures included activity limitations (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC physical function, primary outcome), pain, global perceived effect and knee stability.RESULTS: Both treatment groups demonstrated large (∼20-40%) and clinically relevant reductions in activity limitations, pain and knee instability, which were sustained 6 months post-treatment. No differences in effectiveness between experimental and control treatment were found on WOMAC physical function (B (95% confidence interval - CI) = -0.01 (-2.58 to 2.57)) or secondary outcome measures, except for a higher global perceived effect in the experimental group (P = 0.04).CONCLUSIONS: Both exercise programs were highly effective in reducing activity limitations and pain and restoring knee stability in knee OA patients with instability of the knee. In knee OA patients suffering from knee instability, specific knee joint stabilization training, in addition to muscle strengthening and functional exercises, does not seem to have any additional value. Dutch Trial Register (NTR) registration number: NTR1475.

KW - Activities of Daily Living

KW - Adult

KW - Aged

KW - Exercise Therapy/methods

KW - Female

KW - Humans

KW - Joint Instability/etiology

KW - Knee Joint/physiopathology

KW - Male

KW - Middle Aged

KW - Muscle Strength/physiology

KW - Muscle, Skeletal/physiopathology

KW - Osteoarthritis, Knee/complications

KW - Pain Measurement/methods

KW - Severity of Illness Index

KW - Single-Blind Method

KW - Treatment Outcome

UR - https://www.scopus.com/pages/publications/84879887066

UR - https://www.scopus.com/inward/citedby.url?scp=84879887066&partnerID=8YFLogxK

U2 - 10.1016/j.joca.2013.05.012

DO - 10.1016/j.joca.2013.05.012

M3 - Article

C2 - 23721797

SN - 1063-4584

VL - 21

SP - 1025

EP - 1034

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 8

ER -

Knee joint stabilization therapy in patients with osteoarthritis of the knee: a randomized, controlled trial

Abstract

Keywords

UN SDGs

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