While exercise is the cornerstone of treatment for mild to moderate osteoarthritis, few researchers have explored its potential in patients in severe disease, said Dr Allan A. Villadsen from the University of Southern Denmark.
"We were able to establish that it's possible to exercise with osteoarthritis patients this has a positive impact on their performance," he said.
For the trial, Dr Villadsen and his colleagues randomised 84 patients who were scheduled for total hip replacement into two groups: eight weeks of neuromuscular exercise. or care as usual (verbal and written preoperative instructions). Therapists supervised the exercise twice a week, with each session lasting one hour.
The research team tested the effectiveness of the program by having the patients walk for 20 meters at maximum speed, stand up from a chair five times in a row, and perform multi-joint leg extensions with a leg-extension press and perform single-joint knee extensions on a seated knee extension machine.
At the end of the eight weeks, they found significant between-group differences favouring the exercise group in the 20-meter walk (2.2 seconds, p=0.009), chair stands (1.7 seconds, p=0.022) and leg extension for the non operated leg (0.17 Watts/kg, p=0.049).
More patients should exercise
Dr Sharon L. Kolasinski, a University of Pennsylvania rheumatologist who wasn't involved in the research, said the results show that more patients should try exercise. "It's often thought that nothing can be done for these patients," she said.
But Dr Villadsen said doctors must be careful about prescribing exercise in this population because many patients are in great pain. "The disc joint is pretty worn, so you have to be careful that the patients don't have more pain," he said. "If they do, you have to regress the level of exercise."
On the other hand, if patients can do the prescribed exercises too easily, the therapist can increase the level of difficulty, he said. The researchers also collected data on self-reported physical functioning and on pain but have not yet analysed the numbers, Dr Villadsen said.
The study was funded by the Health Region of Southern Denmark and by several non-profit foundations.
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