A Randomized Trial Comparing Aerobic Exercise and Resistance Exercise With a Health Education Program in Older Adults With Knee Osteoarthritis

Abstract

<h3>Objective.</h3> —To determine the effects of structured exercise programs on self-reported disability in older adults with knee osteoarthritis. <h3>Setting and Degign.</h3> —A randomized, single-blind clinical trial lasting 18 months conducted at 2 academic medical centers. <h3>Participants.</h3> —A total of 439 community-dwelling adults, aged 60 years or older, with radiographically evident knee osteoarthritis, pain, and self-reported physical disability. <h3>Invervention.</h3> —An aerobic exercise program, a resistance exercise program, and a health education program. <h3>Main Outcome Measures.</h3> —The primary outcome was self-reported disability score (range, 1-5). The secondary outcomes were knee pain score (range, 1-6), performance measures of physical function, x-ray score, aerobic capacity, and knee muscle strength. <h3>Results.</h3> —A total of 365 (83%) participants completed the trial. Overall compliance with the exercise prescription was 68% in the aerobic training group and 70% in the resistance training group. Postrandomization, participants in the aerobic exercise group had a 10% lower adjusted mean (±SE) score on the physical disability questionnaire (1.71 ±0.03 vs 1.90±0.04 units; P&lt;.001), a 12% lower score on the knee pain questionnaire (2.1±0.05 vs 2.4±0.05 units; P=.001), and performed better (mean [±SE]) on the 6-minute walk test (1507±16 vs 1349±16ft; P&lt;.001), mean (±SE) time to climb and descend stairs (12.7±0.4 vs 13.9±0.4 seconds; P=.05), time to lift and carry 10 pounds (9.1±0.2 vs 10.0±0.1 seconds; P&lt;.001), and mean (±SE) time to get in and out of a car (8.7±0.3 vs 10.6±0.3 seconds; P&lt;.001) than the health education group. The resistance exercise group had an 8% lower score on the physical disability questionnaire (1.74±0.04 vs 1.90±0.03 units; P=.003), 8% lowerpain score (2.2±0.06vs2.4±0.05 units; P=.02), greater distance on the 6-minute walk (1406±17vs1349±16ft;P=.02),faster times on the lifting and carrying task (9.3±0.1 vs 10.0±0.16 seconds; P=.001), and the car task (9.0±0.3 vs 10.6±0.3 seconds; P=.003) than the health education group. There were no differences in x-ray scores between either exercise group and the health education group. <h3>Conclusions.</h3> —Older disabled persons with osteoarthritis of the knee had modest improvements in measures of disability, physical performance, and pain from participating in either an aerobic or a resistance exercise program. These data suggest that exercise should be prescribed as part of the treatment for knee osteoarthritis.