Michelle Hall1, Rana S Hinman, Tim V Wrigley, Ewa M Roos, Paul W Hodges, Margaret P Staples, Kim L Bennell. 1. 1Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, University of Melbourne, Melbourne, Victoria, AUSTRALIA; 2Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, DENMARK; 3Department of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, St. Lucia, Brisbane, Queensland, AUSTRALIA; and 4Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Cabrini Institute, Malvern, Victoria, AUSTRALIA.
Abstract
PURPOSE: This study aimed to evaluate the effects of a 12-wk, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy (APM) within the past 3-12 months. METHODS: An assessor-blinded, randomized controlled trial including people age 30-50 yr with no to mild pain after medial APM was conducted. Participants were randomly allocated to either a 12-wk neuromuscular exercise program that targeted neutral lower limb alignment or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal-paced walking and during one-leg sit-to-stand. Secondary outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS:Of 62 randomized participants, 60 (97%) completed the trial. There were no significant between-group differences in the change in peak knee adduction moment during normal-paced walking (mean difference (95% confidence interval), 0.22 (-0.11 to 0.55) N·m/body weight × height %, P =0.19) or during one-leg sit-to-stand (-0.01 (-0.33 to 0.31) N·m/body weight × height %, P = 0.95). There were also no significant between-group differences for any of the secondary outcomes. CONCLUSIONS: In patients 3-12 months after a medial APM, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression. (Australia and New Zealand Clinical Trials Registry, #ACTRN12612000542897.).
RCT Entities:
PURPOSE: This study aimed to evaluate the effects of a 12-wk, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy (APM) within the past 3-12 months. METHODS: An assessor-blinded, randomized controlled trial including people age 30-50 yr with no to mild pain after medial APM was conducted. Participants were randomly allocated to either a 12-wk neuromuscular exercise program that targeted neutral lower limb alignment or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal-paced walking and during one-leg sit-to-stand. Secondary outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: Of 62 randomized participants, 60 (97%) completed the trial. There were no significant between-group differences in the change in peak knee adduction moment during normal-paced walking (mean difference (95% confidence interval), 0.22 (-0.11 to 0.55) N·m/body weight × height %, P =0.19) or during one-leg sit-to-stand (-0.01 (-0.33 to 0.31) N·m/body weight × height %, P = 0.95). There were also no significant between-group differences for any of the secondary outcomes. CONCLUSIONS: In patients 3-12 months after a medial APM, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression. (Australia and New Zealand Clinical Trials Registry, #ACTRN12612000542897.).
Authors: Clare E Safran-Norton; James K Sullivan; James J Irrgang; Hannah M Kerman; Kim L Bennell; Gary Calabrese; Leigh Dechaves; Brian Deluca; Alexandra B Gil; Madhuri Kale; Brittney Luc-Harkey; Faith Selzer; Derek Sople; Peter Tonsoline; Elena Losina; Jeffrey N Katz Journal: BMC Musculoskelet Disord Date: 2019-11-04 Impact factor: 2.362