The effect of Total resistance exercise vs. aquatic training on self-reported knee instability, pain, and stiffness in women with knee osteoarthritis: a randomized controlled trial

Shirin Assar; Farzaneh Gandomi; Mahsa Mozafari; Freshteh Sohaili

doi:10.1186/s13102-020-00175-y

The effect of Total resistance exercise vs. aquatic training on self-reported knee instability, pain, and stiffness in women with knee osteoarthritis: a randomized controlled trial

BMC Sports Sci Med Rehabil. 2020 Apr 29:12:27. doi: 10.1186/s13102-020-00175-y. eCollection 2020.

Authors

Shirin Assar¹, Farzaneh Gandomi², Mahsa Mozafari³, Freshteh Sohaili⁴

Affiliations

¹ 1Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermananshah, Iran.
² 2Department of Corrective Exercises and Sport Injuries, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran.
³ 3Department of Sport Biomechanics, Faculty of Physical Education and Sport Sciences, Bu-Ali-Sina University, Hamedan, Iran.
⁴ 4Department of Sport Physiology, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran.

Abstract

Background: Knee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities. High prevalence (60-80%) has been reported for KI amongst the patients with knee osteoarthritis (KOA). In this line, the present study targeted the effect of two interventions on self-reported KI and affected factors.

Methods: In this single blind, randomized, and controlled trial, 36 patients with radiographic grading (Kellgren-Lawrence ≥ II) of KOA were selected. Patients were divided into three groups namely, aquatic (n = 12), Total Resistance exercises (TRX) (n = 12) and control (n = 12) by random. Then both 8-week TRX and aquatic exercises were carried out by experimental groups. The following measure were taken before and after interventions: Pain by visual analog scale (VAS), balance by Berg Balance Scale (BBS), quadriceps strength by dynamometer, knee flexion range of motion (ROM) by inclinometer, knee stiffness with Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and self-reported KI with Felson's questionnaire.

Results: The results demonstrated that KI, VAS, BBS improved over time both in TRX and aquatic groups significantly (p < 0.05), but WOMAC_(stiffness), knee flexion ROM, and quadriceps strength were significantly improved over time only for TRX (p < 0.05). Post hoc test, also, showed that there were significant differences between interventions and control groups (p < 0.05) for the VAS, KI, BBS, but for WOMAC_(stiffness), a significant difference was observed only between TRX and control groups (p = 0.05).

Conclusions: Although TRX and aquatic interventions had a similar effect on the patients' balance, pain and KI, TRX had more effect on WOMAC_(stiffness), quadriceps strength, and knee flexion ROM than aquatic exercises.

Trial registration: This study was registered in the Iranian Clinical Trial Center with the number IRCT20181222042070N1, http://www.irct.ir/trial/36221, registered 02 February 2019.

Keywords: Aquatic exercises; Osteoarthritis; Self-reported knee instability; TRX.