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Strength Training May Slow Knee Arthritis

Lower body exercises can reduce the rate of space narrowing in the knee joint.

Weakness in the quadriceps muscles (front side of the upper legs) is one of the many risk factors for knee osteoarthritis (OA). Narrowing of the spaces between bones in the knee joint is a sign that the arthritic condition actually exists. However, researchers from the Indiana University School of Medicine and Indiana University-Purdue University, working together, found that lower body strength training over a long period of time may address both problems. The results of their combined study appeared in a recent issue of Arthritis Care & Research.

Strength Training Versus Range of Motion.

A total of 221 subjects, with an average age of 69, who had been diagnosed with OA in the knees were randomly assigned to either a strength training or range-of-motion group. The participants exercised three times a week for 12 weeks at the National Institute of Fitness and Sport. The strength training program included leg presses, leg curls, seated chest presses, and seated rows - three sets of eight-12 repetitions for each exercise. Those in the range-of-motion group exercised for about an hour, including a warm-up and cool-down period. Flexibility movements targeted the neck, shoulders, trunk, elbows, wrists, hips, knees, and ankles. Upper and lower body exercises were included in both groups to provide balanced training.

After the formal program, the participants gradually made a transition to similar exercise protocols at home, where the strength-training group performed wall squats, leg curls, and wall pushups. (See illustrations this page.)

The subjects were monitored for two-and-a-half years after participating in the initial trials. Although both groups lost lower-extremity strength over the 30-month period, the rate of loss was significantly slower among those who participated in the strength-training program than it was in the range-of-motion exercise group. The strength-training subjects also showed 26 percent less narrowing in the knee joint space, which indicated that their arthritis was progressing at a slower pace than those in the control group.

Follow-Up Data.

The authors of the study presented follow-up data at a November meeting of the American College of Rheumatology. "We found that there was a significant benefit of exercise, especially in people with a normal knee alignment and among those who tended toward a knock-kneed posture," explains Steven A. Mazzuca, PhD, one of the lead authors. "But we also found that exercise had no effect on the rate of OA progression in subjects whose knees were aligned at a bow-legged angle." Further studies are needed to determine why resistance training did not have a beneficial effect on this condition.

WALL SQUATS
  1. Stand facing a wall with your feet about 24 inches from the wall.
  2. Reach out and place your hands on the wall.
  3. Bend your elbows, lean forward, support your body weight with your arms, and hold the position for 3-5 seconds.
  4. Slowly push against the wall to return to the starting position. Repeat 8-12 times.
Excercise, Health, Wall, Pushups
LEG CURLS
  1. Stand close to a wall and lean back so that your entire back is in contact with the wall.
  2. Slowly bend your knees and lower your hips to a modified squat position (upper legs at about a 45-degree angle to the floor).
  3. Hold for five seconds and return to the starting position. Repeat 8-12 times.
  4. Do not perform if you have a knee injury that could be aggravated by this exercise.
Excercise, Health, Wall, Pushups
WALL PUSHUPS
  1. Stand with a light weight (3-5 pounds) attached to (or wrapped around) the lower leg just above the ankle.
  2. Hold onto a table, appliance, or piece of furniture for support.
  3. Bend your knee and bring the weighted leg up toward your buttocks.
  4. Pause at the top, slowly return to the starting position, and complete 8-12 repetitions before performing the exercise with the other leg.
Excercise, Health, Wall, Pushups

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Previous studies have shown that strength training can reduce the symptoms of knee OA in the short term and maintain or increase muscle mass. But the Indiana investigation was unusual because it involved an extended period of exercise for the older adults. The take-home message from Dr. Mazzuca is clear: "Exercise should be seen as an effective treatment for the symptoms of osteoarthritis."

 

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