Exercise and Pain Sensitivity in Knee Osteoarthritis

Conditions

Knee Osteoarthritis

Brief summary

A commonly administered conservative non-pharmacological treatment for OA is exercise, with beneficial effects in terms of reduced pain and disability. While the link between exercise and reduced disability is mediated by e.g. increased muscle strength and endurance, the analgesic mechanisms related to exercise are unexplored. knee OA patients have both peripheral and central sensitization of pain mechanisms resulting in hyperalgesia. Thus, targeted pain treatment in these patients may focus on both peripheral and central mechanisms but it unknown if exercise affects either of these mechanisms. It is hypothesized that in knee OA patients exercise reduces the pain sensitivity

Bandak E, Boesen M, Bliddal H, Daugaard C, Hangaard S, Bartholdy C, Damm Nybing J, Kubassova O, Henriksen M.

2021-01-1320 citations

10.1016/j.knee.2020.12.022

Exercise-induced pain changes associate with changes in muscle perfusion in knee osteoarthritis: exploratory outcome analyses of a randomised controlled trial.

Bandak E, Boesen M, Bliddal H, Riis RGC, Nielsen SM, Klokker L, Bartholdy C, Nybing JD, Henriksen M.

2019-10-279 citations

10.1186/s12891-019-2858-8

No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial

Marius Henriksen, Louise Klokker, Cecilie Bartholdy, Tanja Schjoedt-Jorgensen, Elisabeth Bandak et al. (6 authors)

BMJ Open Sport & Exercise Medicine2017-03-0118 citations

10.1136/bmjsem-2017-000230

A Standardized “Rescue” Exercise Program for Symptomatic Flare-up of Knee Osteoarthritis: Description and Safety Considerations

Cecilie Bartholdy, Louise Klokker, Elisabeth Bandak, Henning Bliddal, Marius Henriksen

Journal of Orthopaedic and Sports Physical Therapy2016-09-2928 citations

10.2519/jospt.2016.6908

Interventions

OTHERExercise

Physiotherapy supervised exercise training. 60 minutes 3 times per week

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

BASIC_SCIENCE

Masking

SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

40 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Age above 40 years * Clinical diagnosis of tibiofemoral osteoarthritis * Radiographic verification of diagnosis (Kellgren&Lawrence 2 or 3) * Ability to participate in examinations * Ability to participate in exercise sessions * 20≤ Body Mass Index (BMI) ≤35 kg/m2 * Ability to comply with rules about concomitant medication and therapy * Speak, read and write Danish

Exclusion criteria

* Participation in exercise training for the knee osteoarthritis within 3 months of enrollment * Counterindications for exercise * Pregnant or breastfeeding * Current or previous autoimmune disease * History of surgical joint replacement in the lower limbs * Planned surgery * Current or previous diagnosis or signs of cardiovascular disease * Neurological disorders * Alcohol or drug abuse * Diabetes * Psychiatric disorders * Regional pain syndromes * Regional pain caused by lumbar or cervical nerve root compression * Counterindications to MR scan * Counterindications to MR contrast

Design outcomes

Primary

Measure	Time frame	Description
Change from baseline in mechanical pain sensitivity	Baseline and at 12 weeks	Pain thresholds and temporal summation of pain

Secondary

Measure	Time frame	Description
Change from baseline in proinflammatory cytokines and biomarkers of cartilage breakdown in blood and urine	Baseline and at 12 weeks	—
Change from baseline in patient reported pain and function	Baseline and at 12 weeks	KOOS questionnaire
Change from baseline in functional pain test	Baseline and at 12 weeks	Pain is assessed during continuous tradmill walking at self-selected pace for 20 minutes.
Change from baseline in imaged based quantification of inflammation in the knee	Baseline and at 12 weeks	Contrast enhanced MRI imaging used to quantify inflammation (DYNAMICA software)

Countries

Denmark

Outcome results

None listed