The efficacy of home based progressive strength training in older adults with knee osteoarthritis: A randomized controlled trial

Objective. To test the effects of a high intensity home-based progressive s trength training program on the clinical signs and symptoms of osteoarthrit is (OA) of the knee. Methods. Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 mon th home based progressive strength training program or a nutrition educatio n program (attention control). Thirty-eight patients completed the trial wi th an adherence of 84% to the intervention and 65% to the attention control . The primary outcome was the Western Ontario and McMaster Universities Ost eoarthritis (WOMAC) index pain and physical function subscales. Secondary o utcomes included clinical knee examination, muscle strength, physical perfo rmance measures, and questionnaires to measure quality of life variables. Results. Patients in the strength training group who completed the trial ha d a 71% improvement in knee extension strength in the leg reported as most painful versus a 3% improvement in the control group (p < 0.01). In a modif ied intent to treat analysis, self-reported pain improved by 36% and physic al function by 38% in the strength training group versus 11 and 21%, respec tively, in the control group (p = 0.01 for between group comparison). In ad dition, those patients in the strength training group who completed the tri al had a 43% mean reduction in pain (p = 0.01 vs controls), a 44% mean impr ovement in self-reported physical function (p < 0.01 vs controls), and impr ovements in physical performance, quality of life, and self-efficacy when c ompared to the control group. Conclusion. High intensity, home based strength training can produce substa ntial improvements in strength, pain, physical function and quality of life in patients with knee OA.