TY - JOUR
T1 - Strength training in addition to neuromuscular exercise and education in individuals with knee osteoarthritis the effects on pain and sensitization
AU - Mikal Holm, Pætur
AU - Kjær Petersen, Kristian
AU - Wernbom, Mathias
AU - Schrøder, Henrik Morville
AU - Arendt-Nielsen, Lars
AU - Skou, Søren T.
N1 - Center for Neuroplasticity and Pain (CNAP) is supported by the Danish National Research Foundation (DNRF121)
PY - 2021/10
Y1 - 2021/10
N2 - Abstract Background There is a lack of evidence of the relative effects of different exercise modes on pain sensitization and pain intensity in individuals with knee osteoarthritis (KOA). Methods Ninety individuals with radiographic and symptomatic KOA, ineligible for knee replacement surgery, were randomized to 12 weeks of twice-weekly strength training in addition to neuromuscular exercise and education (ST+NEMEX-EDU) or neuromuscular exercise and education alone (NEMEX-EDU). Outcomes were bilateral, lower-leg, cuff pressure pain- and tolerance thresholds (PPT, PTT), temporal summation (TS), conditioned pain modulation (CPM), self-reported knee pain intensity, and number of painful body sites. Results After 12 weeks of exercise, we found significant differences in increases in PPT (-5.01 kPa (-8.29 to -1.73, p=0.0028)) and PTT (-8.02 kPa (-12.22 to -3.82, p=0.0002)) in the KOA leg in favor of ST+NEMEX-EDU. We found no difference in effects between groups on TS, CPM or number of painful body sites. In contrast, there were significantly greater pain-relieving effects on VAS mean knee pain during the last week (-8.4 mm (-16.2 to -0.5, p=0.0364) and during function (-16.0 mm (-24.8 to -7.3, p=0.0004)) in favor of NEMEX-EDU after 12 weeks of exercise. Conclusion Additional strength training reduced pain sensitization compared to neuromuscular exercise and education alone, but also attenuated the reduction in pain intensity compared to neuromuscular exercise and education alone. The study provides the first dose- and type-specific insight into the effects of a sustained exercise period on pain sensitization in KOA. Future studies are needed to elucidate the role of different exercise modes.
AB - Abstract Background There is a lack of evidence of the relative effects of different exercise modes on pain sensitization and pain intensity in individuals with knee osteoarthritis (KOA). Methods Ninety individuals with radiographic and symptomatic KOA, ineligible for knee replacement surgery, were randomized to 12 weeks of twice-weekly strength training in addition to neuromuscular exercise and education (ST+NEMEX-EDU) or neuromuscular exercise and education alone (NEMEX-EDU). Outcomes were bilateral, lower-leg, cuff pressure pain- and tolerance thresholds (PPT, PTT), temporal summation (TS), conditioned pain modulation (CPM), self-reported knee pain intensity, and number of painful body sites. Results After 12 weeks of exercise, we found significant differences in increases in PPT (-5.01 kPa (-8.29 to -1.73, p=0.0028)) and PTT (-8.02 kPa (-12.22 to -3.82, p=0.0002)) in the KOA leg in favor of ST+NEMEX-EDU. We found no difference in effects between groups on TS, CPM or number of painful body sites. In contrast, there were significantly greater pain-relieving effects on VAS mean knee pain during the last week (-8.4 mm (-16.2 to -0.5, p=0.0364) and during function (-16.0 mm (-24.8 to -7.3, p=0.0004)) in favor of NEMEX-EDU after 12 weeks of exercise. Conclusion Additional strength training reduced pain sensitization compared to neuromuscular exercise and education alone, but also attenuated the reduction in pain intensity compared to neuromuscular exercise and education alone. The study provides the first dose- and type-specific insight into the effects of a sustained exercise period on pain sensitization in KOA. Future studies are needed to elucidate the role of different exercise modes.
UR - http://www.scopus.com/inward/record.url?scp=85107583250&partnerID=8YFLogxK
U2 - 10.1002/ejp.1796
DO - 10.1002/ejp.1796
M3 - Journal article
SN - 1090-3801
VL - 25
SP - 1898
EP - 1911
JO - European Journal of Pain
JF - European Journal of Pain
IS - 9
ER -