Effects of Therapeutic Exercise on Functional Performance, Self-Reported Outcomes and Physical Activity in Female Patients with Knee Osteoarthritis.

摘要

Those who are affected by osteoarthritis (OA) of the knee have shown decreased levels of functional capacity and quality of living. This disability has been linked to decreased levels of strength and physical activity caused by pain or fatigue. Resistance training and increased levels of physical activity have shown to improve these deficits. However, an efficient way to treat a large number of patients by increasing physical activity levels has not yet been determined. Furthermore, it is unknown if a simple, body weight-based exercise program is capable of achieving similar gains as previously-developed, machine-based programs. This thesis examined the effects of a group-based, eight-week therapeutic exercise regimen on functional performance, self-reported outcomes and physical activity levels in elderly female patients with knee OA.;The study design for this pilot project was that of an observational study with an embedded case series. Seven patients (mean age = 56.0+/-5.42) were included in the group exercise regimen. The exercise regimen was performed once a week and included body weight exercises, balancing, and walking. Self-reported outcomes and pain were measured via the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Numeric Pain Rating Scale (NPRS). Functional performance was measured by use of the chair stand test (CST), timed up and go test (TUG), stair climb test (SCT), and the six-minute walk test (6MW). Physical activity levels were measured by use of accelerometers and the UCLA activity scale. All measures were collected one week previous to the eight-week exercise regimen and one week following the exercise regimen.;Overall, WOMAC (34.57+/-15.52 to 23.42+/-11.96) and NPRS (5.43+/-1.81 to 2.29+/-2.93) scores improved as a result of the exercise regimen. Also, the CST (10.21+/-1.07 reps to 12.00+/-1.61 reps), TUG (9.65+/-1.42s to 8.23+/-1.44s), SCT (13.03+/-0.70s to 11.6+/-1.07s) and 6MW (454.09+/-59.77m to 504.21+/-54.64m) functional performance measures all improved as a result of the exercise regimen. All measures of self-reported outcomes, pain, and functional performance showed moderate to large effect sizes. However, only the NPRS, CST, and SCT had associated confidence intervals that did not cross zero. In general, physical activity levels did not show overall improvements as a result of the intervention. Only improvements seen in moderate levels of physical activity (211.08+/-;68.57 min to 272.21+/-;97.05 min) were distinguishable from the intervention.;In conclusion, the implementation of an eight-week therapeutic exercise regimen resulted in gains in functional performance and self-reported outcomes. However, these gains did not translate to improvements in physical activity levels. This type of intervention shows promise in improving symptoms for women with knee OA.