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A comparison of the efficacy of nonweight-bearing and weight-bearing exercise programmes on function and pain pressure thresholds in knee osteoarthritis: a randomised study
Moreira VMPS, da Silva Soares F, Hattori WT, Dionisio VC
European Journal of Physiotherapy 2021;23(3):171-178
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; 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*

AIM: To establish what type of intervention (nonweight-bearing (NWB) or weight-bearing (WB)) was more effective in enhancing muscle strength and knee function and in increasing pressure pain thresholds (PPT) points close and distant from the knee (hyperalgesia) in persons with mild and moderate knee osteoarthritis (KOA). METHOD(S): Thirty persons (62 +/- 9 years) with mild or moderate KOA and knee pain for 6 months or more were randomly stratified according to sex and KOA severity to groups of intervention: WB or NWB. The intervention was performed three times a week over 8 weeks, focussing on progressive strength exercise. One-repetition maximum strength (1-RM) test, the Western Ontario and McMaster Universities (WOMAC) function scale and PPT points close and distant from the knee were evaluated before and after the intervention. RESULT(S): Both interventions promoted improvement in 1-RM test (NWB exercise (IC 63 to 88), p = 0.001; WB exercise (IC 57 to 122), p = 0.007), functional capacity (NWB exercise (IC 10 to 29.4), p = 0.001; WB exercise (IC 10 to 45), p = 0.001), PPT points close to the knee (NWB exercise (IC 5.42 to 8.93), p = 0.001; WB exercise (IC 3.97 to 8.47), p = 0.001) and PPT points distant from the knee (NWB exercise (IC 4.38 to 7.70), p = 0.001; WB exercise (IC 3.75 to 7.31), p = 0.002). There were no statistical differences between them. CONCLUSION(S): The WB and NWB interventions were effective in improving muscle strength, knee function, and PPT points close and distant from the knee (hyperalgesia) in persons with mild and moderate KOA, with no significant differences between them. TRIAL REGISTRATION: Clinical trial registration number RBR-5t95n5; date of registration July 15, 2013.

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