Intensity of exercise for the treatment of osteoarthritis

Brosseau L, MacLeay L, Robinson V, Wells G, Tugwell P.

School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, CANADA, K1H 8M5.

BACKGROUND: Therapeutic exercise is used as one modality to treat people with osteoarthritis (OA).

OBJECTIVES: To evaluate the effectiveness of therapeutic exercise of differing intensities on objective and subjective measures of disease activity in people with OA.

SEARCH STRATEGY: We searched MEDLINE, EMBASE, Pedro, Current Contents, Sports Discus and CINAHL up to and including December 2002. The Cochrane Field of Rehabilitation and Related Therapies and the Cochrane Musculoskeletal Review Group were also contacted for a search of their specialized registers. Handsearching was conducted on all retrieved articles for additional studies.

SELECTION CRITERIA: Comparative controlled studies, such as randomized controlled trials, controlled clinical trials, cohort studies or case/control studies, of therapeutic exercises compared to control or active interventions in people with OA were eligible. No language restrictions were applied. Abstracts were also accepted. DATA

COLLECTION AND ANALYSIS: Two independent reviewers identified potential articles from the literature search. These reviewers extracted data using pre-defined extraction forms. Consensus was reached on all data extraction. The two reviewers used a five point scale to assess the quality of the selected articles. Randomization, double-blinding and description of withdrawals were assessed.

MAIN RESULTS: One study involving 39 participants met the inclusion criteria. The review indicates that there were no significant differences between high intensity and low intensity aerobic exercise on participants with OA of the knee for functional status, gait, pain and aerobic capacity (~~Mangione 1999~~).

REVIEWER’S CONCLUSIONS: Both high intensity and low intensity aerobic exercise appear to be equally effective in improving a patient’s functional status, gait, pain and aerobic capacity for people with OA of the knee. Further research involving a greater number of subjects, and a larger number of studies involving a control group is needed to further substantiate these results.

Cochrane Database Syst Rev. 2003;(2):CD004259

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