Comparison of the effects of concentric and eccentric isokinetic exercises on proprioception and muscle architecture in patients with knee osteoarthritis

This study was conducted to examine and compare the effects of concentric and eccentric isokinetic exercises on proprioception and muscle architecture in patients with knee OA. The study was completed with 42 patients between the ages of 45-65, diagnosed with K&L stage 2-3 primary knee osteoarthritis. The patients were divided into control group (Contr.G), concentric isokinetic exercise group (CG) and eccentric isokinetic exercise group (EG) by simple randomization method and were included in a treatment program of 18 sessions, 3 days a week for 6 weeks. Traditional physiotherapy and exercise programs were applied to all patients in all three groups included in the study. No additional application was applied to the Contr.G other than the traditional physiotherapy program. In the CG and EG, group-specific concentric and eccentric isokinetic exercises were applied in addition to the traditional physiotherapy program. All patients were evaluated before starting treatment and after treatment. After recording the demographic information of the cases included in the study, pain during activity and rest was evaluated by Visual Analogue Scale (VAS); knee joint range of motion (ROM) and muscle shortness evaluations with a universal goniometer; muscle strength with manual muscle testing and the Biodex System 3Pro (Biodex Corp, Shirley, NY) isokinetic device; functional performance with timed up and go test (TUG), repeated sit-to-stand test (RSS), 10 meter walk test (10 m walking); disability status by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); balance test with standing on one leg with eyes open and closed; joint position sense with the Biodex System 3Pro (Biodex Corp, Shirley, NY) isokinetic device; quality of life with the Short Form-12 Quality of Life Scale (SF-12); muscle architecture was evaluated by ultrasonographic measurement. All assessments results of the groups were similar at baseline. According to the findings, all three groups had positive results after the treatment in terms of activity and rest pain, hamstring shortness, TUG, eyes open and closed balance, joint position sense at 70° knee flexion, WOMAC scores, quality of life SF-12 physical component score parameters compared to before the treatment (p<0.05). In addition to these results it was found that, the KG group was also effective on knee extension and flexion concentric isokinetic muscle strength, RSS, vastus medialis muscle thickness parameters; the EG was also effective in active knee flexion ROM, manual muscle strength of knee flexors and hip extensors, and knee extension and flexion concentric isokinetic muscle strength, RSS and 10 m walking parameters (p<0.05). When the percentage changes after treatment were compared between the groups, it was seen that the EG provided more improvement in active knee flexion ROM, knee flexion isokinetic muscle strength, and 10 m walking test than Contr.G; in the 10 m walking test evaluation than the KG (p<0.05). As a result of our study, the traditional physiotherapy program is effective in the treatment of patients with knee OA, concentric and eccentric isokinetic exercises applied in addition to traditional physiotherapy increase these effects, but eccentric isokinetic exercises were found to be more effective in some parameters than other methods, it was concluded that it may be beneficial to include isokinetic exercises in treatment programs.