Efficacy of 2 Non-weight-bearing Interventions, Proprioception Training Versus Strength Training, for Patients with Knee Osteoarthritis: a Randomized Clinical Trial

Study Design: Randomized clinical trial.

Objective: To investigate the clinical and functional efficacy of 2 different non-weight-bearing exercise regimens, proprioceptive training (PrT) versus strength training (ST), for patients with knee osteoarthritis (OA).

Background: Both strength and proprioceptive training are important interventions for individuals with knee OA. The benefits of weight-bearing exercises are generally recognized in the clinical setting. However, exercising in a standing or weight-bearing position may aggravate symptoms in patients with knee OA.

Methods And Measures: One hundred eight patients were randomly assigned to the PrT, ST, or no exercise (control) group for an 8-week intervention. Both the PrT and ST interventions consisted of non-weight-bearing exercises. Western Ontario and McMaster Universities Osteoarthritis Index-pain (WOMAC-pain) and -function scores, walking time on 3 different terrains, knee strength, and absolute knee reposition error were assessed before and after intervention. Data were analyzed using mixed-model ANOVAs.

Results: Both PrT and ST significantly improved WOMAC-pain and -function score after intervention (P<.008). The improvement secondary to ST in the WOMAC-function scores (17.2 points) and for knee extension strength (10.3-14.9 Nm) was greater than the minimally clinically important difference for these measurements. The PrT group demonstrated greater improvement in walking time on a spongy surface and knee reposition error than the other 2 groups. No improvements were apparent in the control group.

Conclusion: Both types of non-weight-bearing exercises (PrT and ST) significantly improved outcomes in this study. PrT led to greater improvements in proprioceptive function, while ST resulted in a greater increase in knee extensor muscle strength.