The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objective To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Design Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Results Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m 2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index −0.07 [−0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. Conclusions We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153.

Original languageEnglish
JournalOsteoarthritis and Cartilage
Volume25
Issue number4
Pages (from-to)470-480
ISSN1063-4584
DOIs
Publication statusPublished - Apr 2017

Fingerprint

Knee Osteoarthritis
Knee Joint
Knee
Exercise
Composite materials
Knee Injuries
Pharmaceutical Preparations
Body Mass Index
Randomized Controlled Trials
Compliance

Keywords

  • Exercise
  • Gait
  • Knee
  • Knee joint
  • Osteoarthritis
  • Pain management
  • Single-Blind Method
  • Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
  • Humans
  • Middle Aged
  • Analgesics, Non-Narcotic/therapeutic use
  • Male
  • Osteoarthritis, Knee/physiopathology
  • Weight-Bearing/physiology
  • Physical Therapy Modalities
  • Acetaminophen/therapeutic use
  • Adult
  • Female
  • Aged
  • Exercise Therapy/methods

Cite this

@article{546aee6fb15b4f8ca941446f19eb8dfc,
title = "The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis: a randomized, single-blind, controlled trial",
abstract = "Objective To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Design Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Results Ninety three participants (57{\%} women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m 2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94{\%}) and 41 (89{\%}) participants respectively, were available at follow-up. 49{\%} of the participants in NEMEX and only 7{\%} in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index −0.07 [−0.17; 0.04] Nm/{\%}BW HT. Secondary outcomes largely supported this finding. Conclusions We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153.",
keywords = "Exercise, Gait, Knee, Knee joint, Osteoarthritis, Pain management, Single-Blind Method, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Humans, Middle Aged, Analgesics, Non-Narcotic/therapeutic use, Male, Osteoarthritis, Knee/physiopathology, Weight-Bearing/physiology, Physical Therapy Modalities, Acetaminophen/therapeutic use, Adult, Female, Aged, Exercise Therapy/methods",
author = "A Holsgaard-Larsen and B Clausen and J S{\o}ndergaard and R Christensen and Andriacchi, {T P} and Roos, {E M}",
note = "Copyright {\circledC} 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.",
year = "2017",
month = "4",
doi = "10.1016/j.joca.2016.10.022",
language = "English",
volume = "25",
pages = "470--480",
journal = "Osteoarthritis and Cartilage",
issn = "1063-4584",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - The effect of instruction in analgesic use compared with neuromuscular exercise on knee-joint load in patients with knee osteoarthritis

T2 - a randomized, single-blind, controlled trial

AU - Holsgaard-Larsen, A

AU - Clausen, B

AU - Søndergaard, J

AU - Christensen, R

AU - Andriacchi, T P

AU - Roos, E M

N1 - Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

PY - 2017/4

Y1 - 2017/4

N2 - Objective To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Design Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Results Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m 2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index −0.07 [−0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. Conclusions We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153.

AB - Objective To investigate the effect of a neuro-muscular exercise (NEMEX) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild to moderate knee osteoarthritis (OA). We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA. Design Single-blind, randomized controlled trial (RCT) comparing NEMEX therapy twice a week with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee OA were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome was change in knee load during walking (Knee Index, a composite score from all three planes based on 3D movement analysis) after 8 weeks of intervention. Secondary outcomes were frontal plane peak knee adduction moment (KAM), Knee Injury and Osteoarthritis Outcome Scores (KOOS) and functional performance tests. Results Ninety three participants (57% women, 58 ± 8 years with a body mass index [BMI] of 27 ± 4 kg/m 2 (mean ± standard deviation [SD])) were randomized to NEMEX group (n = 47) or PHARMA (n = 46); data from 44 (94%) and 41 (89%) participants respectively, were available at follow-up. 49% of the participants in NEMEX and only 7% in PHARMA demonstrated good compliance. We found no difference in the primary outcome as evaluated by the Knee Index −0.07 [−0.17; 0.04] Nm/%BW HT. Secondary outcomes largely supported this finding. Conclusions We found no difference in the primary outcome; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs. ClinicalTrials.gov Identifier: NCT01638962 (July 3, 2012). Ethical Committee: S-20110153.

KW - Exercise

KW - Gait

KW - Knee

KW - Knee joint

KW - Osteoarthritis

KW - Pain management

KW - Single-Blind Method

KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use

KW - Humans

KW - Middle Aged

KW - Analgesics, Non-Narcotic/therapeutic use

KW - Male

KW - Osteoarthritis, Knee/physiopathology

KW - Weight-Bearing/physiology

KW - Physical Therapy Modalities

KW - Acetaminophen/therapeutic use

KW - Adult

KW - Female

KW - Aged

KW - Exercise Therapy/methods

U2 - 10.1016/j.joca.2016.10.022

DO - 10.1016/j.joca.2016.10.022

M3 - Journal article

C2 - 27836677

VL - 25

SP - 470

EP - 480

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

SN - 1063-4584

IS - 4

ER -