None listed
Conditions
Brief summary
The role of skeletal muscle in the management of knee osteoarthritis (OA) is increasingly recognised in that muscle strengthening exercises form a core part of its clinical management. However, the mechanism behind how the pain-relieving effects of strengthening exercises occur is not known. Moreover, not everyone with knee OA achieves pain relief after strengthening exercises. We also do not know enough about the factors that may stop a person from commencing an exercise program. This study aims to address these gaps in knowledge by studying different states which may predict who responds to strengthening exercise. The states studied will include different intensities of strengthening exercises, stages of knee OA, baseline pain levels, baseline inflammation levels and muscle characteristics. The study will involve participants with early and late knee osteoarthritis who will be randomized to perform high and low-intensity muscle strengthening exercises in a cross-over trial design. The outcomes studied include pain response before and after muscle strengthening exercises, and baseline inflammation and muscle characteristics.
Interventions
The intervention is resistance exercise in a randomized cross-over trial design.
The study will involve 3 study visits. Study visit 1 will involve an invitation to complete self-assessment questionnaires, physical and clinical assessments, familiarization with the leg press machine, pain pressure threshold procedure and a 1-repetition maximum (1-RM) test. Participants will undergo a 1-repetition maximum test (1-RM) to test the maximum weight a participant can lift in a single repetition, for th
The intervention is resistance exercise in a randomized cross-over trial design. The study will involve 3 study visits. Study visit 1 will involve an invitation to complete self-assessment questionnaires, physical and clinical assessments, familiarization with the leg press machine, pain pressure threshold procedure and a 1-repetition maximum (1-RM) test. Participants will undergo a 1-repetition maximum test (1-RM) to test the maximum weight a participant can lift in a single repetition, for the leg-press exercise. Participants will be randomized to perform 3 sets of either high-intensity or low-intensity resistance exercise during Study Visit 2 using a seated leg-press exercise machine, as determined from their 1-RM test from Study Visit 1. High-intensity leg press exercises will be performed at 75%-85% of 1-RM for 3 sets of 8 repetitions, whereas low-intensity leg-press exercises will be performed at 30-40% of 1-RM for 3 sets of 15 repetitions. During the final study visit (Study Visit 3), the subject will perform the alternative resistance exercise. The minimum washout period between the study visits is 10 days. Pain pressure threshold and immediate mood assessments will be performed before and after leg-press exercises. Study visit 1 is estimated to take around 4 hours, whereas study visits 2 and 3 are estimated to take around 2 hours. Participants will be requested to perform a 5-minute period of warm-up which will consist of either walking or stationary cycling before their leg strength measurements and the leg-press exercises. The exercise intervention will be delivered individually face-to-face, by the principal investigator who is a physician.
Sponsors
University of Sydney
Study design
Allocation
Randomised controlled trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. For the early knee OA group, subjects should be diagnosed as having knee OA using the Kellgren-Lawrence grade(KLG) grade, with KLG 1-2 as a criteria on plain radiograph of the knee. 2. For the late knee OA group, subjects should be diagnosed as having knee OA using the Kellgren-Lawrence grade (KLG) grade, with KLG 4 as a criteria on plain radiograph of the knee. The additional criteria for participants in the late knee OA group is that they should be scheduled for total knee arthroplasty 3. Able to complete questionnaires in English 4. Able and willing to complete study assessments 5. Able and willing to provide written consent to participate in the study
Exclusion criteria
• Documented history of systemic inflammatory or autoimmune diseases • Documented history of skeletal muscle pathological diseases such as myopathies and myositis • History of diabetes, significant cardiovascular, neurological or psychiatric disease, cervical or lumbar root compression syndromes and widespread regional pain syndromes (e.g. fibromyalgia) • History of lower extremity joint replacement in the study limb • Women who are pregnant or lactating or of child-bearing potential who are not willing to avoid pregnancy during the study period • Systolic Blood pressure > 200mmHg and / or diastolic blood pressure > 120mmHg • Current use of oral steroid medications • Unable to discontinue non-steroidal anti-inflammatory medication use
Outcome results
None listed