| Change in Knee Cartilage Volume in Individuals Completing a Therapeutic Exercise Program for Knee Osteoarthritis. | |
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MedLine Citation:
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PMID: 21891881 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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STUDY DESIGN: Prospective cohort study. OBJECTIVES: To characterize knee cartilage change in individuals with knee osteoarthritis (KOA) who have completed a therapeutic exercise program. BACKGROUND: While therapeutic exercise is frequently used successfully to improve pain and function in individuals with KOA, no studies have reported the volume of cartilage change, or individual factors that may impact volume of cartilage change, in those completing an exercise program for KOA. METHODS: 13 individuals with KOA underwent magnetic resonance imaging (MR) to quantify cartilage volume change for the weight-bearing regions of the medial and lateral femoral condyles and the entire surface of the tibial plateaus from baseline to 1-year follow-up. Measurements of body structure and function and activity levels/limitations such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Physical Activity Scale for the Elderly (PASE) were performed prior to the therapeutic exercise program. At 6 months from baseline follow-up clinical measurements of knee strength and motion were performed. At 1-year from baseline, imaging of the knee cartilage, knee alignment, and the WOMAC and PASE questionnaires were completed. RESULTS: The central region of the medial femoral condyle (cMF) had a median volume of cartilage loss of 3.8%. The other 3 knee tibiofemoral articular surfaces had minimal median cartilage volume change. Individuals were dichotomized into progressors (n=6) and non-progressors (n=7) based on the standard error of measurement (SEM) of cartilage volume change for the cMF. Progressors were younger, had a larger body mass index, had a higher Kellgren-Lawrence grade in the medial compartment of the knee, and had a greater increase in knee varus alignment from baseline to 1-year follow-up. The progressors also had frontal plane hip and knee kinetics during baseline gait analysis that potentially increase medial knee joint loading. CONCLUSION: The loss of cMF cartilage volume was highly variable and the median loss of cartilage was within the range previously reported. Seven of the 13 individuals did not have cMF cartilage volume loss greater than the SEM. Change in cartilage volume of the cMF may be influenced to a greater extent by personal factors than by completion of a therapeutic exercise program. Additional research is needed to decipher the interactions among therapeutic exercise and personal characteristics that impact knee cartilage loss. J Orthop Sports Phys Ther, Epub 4 September 2011. doi:10.2519/jospt.2011.3633. |
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Authors:
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Jason D Woollard; Alexandra B Gil; Patrick J Sparto; C Kent Kwoh; Sara R Piva; Shawn Farrokhi; Christopher M Powers; G Kelley Fitzgerald |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-4 |
Journal Detail:
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Title: The Journal of orthopaedic and sports physical therapy Volume: - ISSN: 1938-1344 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7908150 Medline TA: J Orthop Sports Phys Ther Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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