High intensity resistance training as intervention method to knee osteoarthritis

Abstract

High intensity resistance training (HI-RT) is a treatment option for Knee Osteoarthritis (KOA). Isotonic machines (leg press, leg extension) are utilized for standardization and reproducibility reasons, but the load used during the protocol is often low, considering that elder people usually have low strength levels, training so with high intensities calculated on low loads. The physiological response of an elder woman trained with high loads on a free weight exercise, the regular barbell deadlift, with a 1 Repetition Maximum (1RM) of 100 kg, can be appreciated in this report, so that for the first time we can see the effect of a one year of high intensity resistance training program on a powerlifting exercise on a 72 year-old woman with KOA. A Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire was administered before starting the training program (T0) and after 1 year of training, as long as a control RX, to evaluate the effect of HI-RT on joint functionality and quality of life.

Keywords

Knee osteoarthritis / Resistance training / High intensity / Powerlifting / Deadlift / Joint space narrowing

References

[[1]] E.R. Vina, C.K. Kwoh. Epidemiology of osteoarthritis: literature update. Curr Opin Rheumatol, 30 (2) (2018 Mar), pp.160-167. https://doi: 10.1097/BOR.0000000000000479

[[2]] K.R. Vincent, H.K. Vincent. Resistance exercise for knee osteoarthritis. Pharm Manag PM R, 4 (5) (2012 May), pp.S45-S52. https://doi: 10.1016/j.pmrj.2012.01.019

[[3]] C. Nguyen, M.M. Lefèvre-Colau, S. Poiraudeau, F. Rannou. Rehabilitation (exercise and strength training) and osteoarthritis: a critical narrative review. Ann Phys Rehabil Med, 59 (3) (2016 Jun), pp.190-195. https://doi: 10.1016/j.rehab.2016.02.010. Epub 2016 May 5

[[4]] S.L. Goh, M.S.M. Persson, J. Stocks, et al.. Relative efficacy of different exercises for pain, function, performance and quality of life in knee and hip osteoarthritis: systematic review and network meta-analysis. Sports Med, 49 (5) (2019 May), pp.743-761. https://doi: 10.1007/s40279-019-01082-0. PMID: 30830561

[[5]] V.B. Kraus, K. Sprow, K.E. Powell, et al.. Physical activity guidelines advisory committee∗. Effects of physical activity in knee and hip osteoarthritis: a systematic umbrella review. Med Sci Sports Exerc, 51 (6) ( 2018), pp. 1324-1339. https://doi: 10.1249/MSS.0000000000001944. PMID: 31095089

[[6]] E. Wellsandt, Y. Golightly. Exercise in the management of knee and hip osteoarthritis. Curr Opin Rheumatol, 30 (2) (2018 Mar), pp.151-159. https://doi: 10.1097/BOR.0000000000000478. PMID: 29251659

[[7]] A.K. Lange, B. Vanwanseele, M.A. Fiatarone singh. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum, 59 ( 2008), pp. 1488-1494, DOI: 10.1002/art.24118

[[8]] A.K. Lange, B. Vanwanseele, M.A. Fiatarone Singh. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum, 59 (10) (2008 Oct 15), pp.1488-1494. https://doi: 10.1002/art.24118. PMID: 18821647

[[9]] A.E. Mikesky, S.A. Mazzuca, K.D. Brandt, S.M. Perkins, T. Damush, K.A. Lane. Effects of strength training on the incidence and progression of knee osteoarthritis. Arthritis Rheum, 55 (5) (2006 Oct 15), pp.690-699. https://doi: 10.1002/art.22245. PMID: 17013851

[[10]] K.R. Vincent, H.K. Vincent. Resistance exercise for knee osteoarthritis. Pharm Manag PM R, 4 (5) (2012 May), pp.S45-S52. https://doi: 10.1016/j.pmrj.2012.01.019

[[11]] M.N. Turner, D.O. Hernandez, W. Cade, C.P. Emerson, J.M. Reynolds, T.M. Best. The role of resistance training dosing on pain and physical function in individuals with knee osteoarthritis: a systematic review. Sport Health, 12 (2) (2020 Mar/Apr), pp.200-206. https://doi: 10.1177/1941738119887183

[[12]] M.S. Miller, D.M. Callahan, T.W. Tourville, et al.. Moderate-intensity resistance exercise alters skeletal muscle molecular and cellular structure and function in inactive older adults with knee osteoarthritis. J Appl Physiol, 122 (4) ( 1985), pp. 775-787. https://doi: 10.1152/japplphysiol.00830.2016. Epub 2017 Jan 12

[[13]] M.N. Turner, D.O. Hernandez, W. Cade, C.P. Emerson, J.M. Reynolds, T.M. Best. The role of resistance training dosing on pain and physical function in individuals with knee osteoarthritis: a systematic review. Sport Health, 12 (2) (2020 Mar/Apr), pp.200-206. https://doi: 10.1177/1941738119887183

[[14]] A. Ruhdorfer, W. Wirth, F. Eckstein. Association of knee pain with a reduction in thigh muscle strength - a cross-sectional analysis including 4553 osteoarthritis initiative participants. Osteoarthritis Cartilage, 25 (5) (2017 May), pp.658-666. https://doi: 10.1016/j.joca.2016.10.026

We're grateful to the Italian Powerlifting Federation (FIPL) for the supportive environment they've created, where a Master athlete can live the joy of competition being encouraged and strongly supported and appreciated. We thank colleagues of University of Pisa and San Rossore Sport Village, for their support during the production of this report. Kind support and advise from dr. Franco Impellizzeri and dr. Federico Abate D'Aga has been greatly appreciated.