The evaluation of various exercise types with clinical and radiological parameters in knee osteoarthritis

Osteoarthritis is a very common disease of the articular joints. Pain and physical disability are the major symptoms. Due to lack of a curative treatment, current treatment options mainly directed at relieving symptoms and preventing the loss of articular cartilage. The degenerative process in osteoarthritis causes loss and thinning of articular cartilage. Magnetic resonance imaging (MRI) is a very important progress in osteoartritis research. It enables direct visualization and measurement of articular cartilage. Cartilage volume measurement from MRI scans is a very sensitive and reliable method for evaluating articular cartilage. Exercise decreases pain and improves physical function in osteoarthritis. The aim of this study is evaluate the effect of various exercise protocols on pain, physical function and articular cartilage in osteoarthritis.Forty five women between 45 and 65, with grade 2 or 3 primary knee osteoarthritis were included in the study. Three groups, one receiving isokinetic, the other one receiving walking and the last one receiving isometric exercise were formed. Patients performed exercise for 5 days a week for 4 weeks. All the patients? quadriceps and hamstring muscles were evaluated with a Cybex isokinetic device before and after treatment. Pain was assessed with visual analog scale, pain and functional capacity were assessed with WOMAC and Lequesne index. In eleven patients from isokinetic group and 8 patients from each of walking and isometric groups, MR imaging was performed with a 1,5 T MRI unit before and after exercise treatment. Femoral and patellar cartilage volumes were assessed by a radiologist blinded to the treatment protocols.There were no differences between the groups for age, weight, height and body mass index. There were statistically significant improvement for pain (VAS), WOMAC pain, stifness and physical function, and lequesne index scores in all groups. In isokinetic exercise group both extensor and flexor muscle peak torque values increased significantly whereas in the other groups only extensor muscle peak torque values increased. No difference was found for femoral cartilage volume for all groups but there was a significant increase in patellar cartilage thickness in isometric exercise group.In conclusion exercise decreases pain, improves physical function and muscle power. No significant decrease in cartilage volumes due to exercise was found.