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· DOS Abstracts
The effect on knee-joint load of analgesic use
compared with neuromuscular exercise in patients
with knee osteoarthritis: a randomized, single-blind,
controlled trial
Anders Holsgaard-Larsen, Brian Clausen, Jens Søndergaard, Robin Christensen,
Thomas P. Andriacchi, Ewa M. Roos
Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense
University Hospital, Institute of Clinical Research, University of Southern Denmark;
Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science
and Clinical Biomechanics, University of Southern Denmark; Research Unit for General
Practice, Institute of Public Health, University of Southern Denmark; Musculoskeletal
Statistics Unit, e Parker Institute, Bispebjerg & Frederiksberg Hospital; Departments
of Mechanical Engineering and Orthopaedic Surgery, Stanford University, Stanford,
California, USA; Research Unit for Musculoskeletal Function and Physiotherapy, Institute
of Sports Science and Clinical Biomechanics, University of Southern Denmark
Background:
Although pain-reducing pharmacologic agents are widely used treatments
for knee osteoarthritis (OA) they also have adverse effects and may increase knee-joint
load which has a central role in symptoms and OA progression
Purpose / Aim of Study:
To investigate the effect of a NEuro- Muscular EXercise
(NEMEX) therapy program compared with instructions in optimized analgesics and anti-
inflammatory drug use (PHARMA), on measures of knee-joint load in people with mild
to moderate knee OA. We hypothesized that knee joint loading during walking would be
reduced more by NEMEX than by PHARMA.
Materials and Methods:
Single-blind, RCT comparing NEMEX therapy twice a week
with PHARMA. Participants with mild-to-moderate medial tibiofemoral knee osteoar-
thritis were randomly allocated (1:1) to one of two 8-week treatments. Primary outcome
was change in knee load during walking (Knee Index, a composite score from all three
planes based on 3D movement analysis) after 8 weeks of intervention. Secondary out-
comes were frontal peak knee adduction moment (KAM), Knee Injury and Osteoarthritis
Outcome Scores (KOOS) and functional performance tests.
Findings / Results:
93 (57% women, 58 ± 8 years with a BMI of 27 ± 4 (mean ± SD))
were randomized to the NEMEX group (n = 47) or the PHARMA (n = 46); data from
44(94%) and 41(89%) participants respectively, were available at follow- up. We found
no statistically significant or clinically relevant difference in the primary outcome knee
joint load as evaluated by the Knee Index -0.07 [-0.17; 0.04]. Secondary outcomes
largely supported this primary finding.
Conclusions:
No difference in joint load modifying effects during walking from a neu-
romuscular exercise program versus information on the recommended use of analgesics
and anti-inflammatory drugs was observed.
No conflicts of interest reported
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