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Neuromuscular exercise post partial medial meniscectomy: randomized controlled trial |
Hall M, Hinman RS, Wrigley TV, Roos EM, Hodges PW, Staples MP, Bennell KL |
Medicine and Science in Sports and Exercise 2015 Aug;47(8):1557-1566 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
PURPOSE: This study aimed to evaluate the effects of a 12-wk, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy (APM) within the past 3 to 12 months. METHODS: An assessor-blinded, randomized controlled trial including people age 30 to 50 yr with no to mild pain after medial APM was conducted. Participants were randomly allocated to either a 12-wk neuromuscular exercise program that targeted neutral lower limb alignment or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal-paced walking and during one-leg sit-to-stand. Secondary outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures. RESULTS: Of 62 randomized participants, 60 (97%) completed the trial. There were no significant between-group differences in the change in peak knee adduction moment during normal-paced walking (mean difference (95% confidence interval) 0.22 (-0.11 to 0.55) Nm/body weight x height %, p = 0.19) or during one-leg sit-to-stand (-0.01 (-0.33 to 0.31) Nm/body weight x height %, p = 0.95). There were also no significant between-group differences for any of the secondary outcomes. CONCLUSIONS: In patients 3 to 12 months after a medial APM, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression. (Australia and New Zealand Clinical Trials Registry number ACTRN12612000542897).
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