Article

The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee

School of Nursing, Medical College of Georgia, Augusta, GA 30912, USA.
Archives of Physical Medicine and Rehabilitation (Impact Factor: 2.44). 10/2002; 83(9):1187-95. DOI: 10.1053/apmr.2002.33988
Source: PubMed

ABSTRACT To compare 16 weeks of isometric versus dynamic resistance training versus a control on knee pain and functioning among patients with knee osteoarthritis (OA).
Randomized clinical trial.
Outpatient setting.
A total of 102 volunteer subjects with OA of the knee randomized to isometric (n=32) and dynamic (n=35) resistance training groups or a control (n=35).
Strength exercises for the legs, 3 times weekly for 16 weeks. Dynamic group: exercises across a functional range of motion; isometric: exercises at discrete joint angles.
The time to descend and ascend a flight of 27 stairs and to get down and up off of the floor. Knee pain was assessed immediately after each functional task. The Western Ontario and McMaster Universities Osteoarthritis Index was used to assess perceived pain, stiffness, and functional ability.
In the isometric group, time to perform all 4 functional tasks decreased (P<.05) by 16% to 23%. In the dynamic group, time to descend and ascend stairs decreased by 13% to 17%. Both groups decreased knee pain while performing the functional tasks by 28% to 58%. Other measures of pain and functioning were significantly and favorably affected in the training groups. The improvements in the 2 training groups as a result of their respective therapies were not significantly different. The control group did not change over the duration of the study.
Dynamic or isometric resistance training improves functional ability and reduces knee joint pain of patients with knee OA.

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    • "Topp et al. concluded that regular resistance training may " attenuate the impact and impulsive loads through the knee joint " , not only by increasing the strength of the muscles surrounding the knee (see Section 3.1.3) but also by increasing the intra-and intermuscular coordination of the knee extensor muscles (Topp et al., 2002). This may influence the " timing of the eccentric contraction " of the quadriceps during weight-bearing activities, resulting in lower impact and impulsive loadings being transmitted through the joint (see also Section 3.1.3). "
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    • "Reduced joint movement may result in less pain during and after the resistance training [5] [15]. "
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    • "From one study (Ettinger et al 1997) we took the trial arm that examined resistance training versus a control group. From another study we took the trial arm that examined isokinetic exercise (group I) versus control (Huang et al 2005), and in one study (Fransen et al 2001) we classified the 'group therapy' as Code 2. One study examined two different strength training programs (Topp et al 2002). The mean effects of these programs were combined and compared with the control group. "
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