A comparison of strength training, self‐management, and the combination for early osteoarthritis of the knee

Abstract

Objective To assess the relative effectiveness of combining self‐management and strength training for improving functional outcomes in patients with early knee osteoarthritis. Methods We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community‐dwelling middle‐aged adults (n = 273) ages 35–64 years with knee osteoarthritis, pain, and self‐reported physical disability completed a strength training program, a self‐management program, or a combined program. Outcomes included 5 physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and 2 self‐reported measures of pain and disability. Results A total of 201 participants (73.6%) completed the 2‐year trial. Overall, compliance was modest for the strength training (55.8%), self‐management (69.1%), and combined (59.6%) programs. The 3 groups showed a significant and large increase from pre‐ to posttreatment in all of the physical functioning measures, including leg press (d = 0.85), range of motion (d = 1.00), work capacity (d = 0.60), balance (d = 0.59), and stair climbing (d = 0.59). Additionally, all 3 groups showed decreased self‐reported pain (d = −0.51) and disability (d = −0.55). There were no significant differences among the groups. Conclusion Middle‐aged, sedentary persons with mild early knee osteoarthritis benefited from strength training, self‐management, and the combination program. These results suggest that both strength training and self‐management are suitable treatments for the early onset of knee osteoarthritis in middle‐aged adults. Self‐management alone may offer the least burdensome treatment for early osteoarthritis.