Connective tissue adaptation and changes in functional ability of individuals with osteoarthritis of the knee in response to an exercise program

The major purpose of this study was to determine the effects of a program of exercise on the disease process of osteoarthritis of the knee. Biochemical and clinical parameters were used.;Thirty subjects with a mean age of 69.5 years with documented primary osteoarthritis of the knee were randomized into exercise and minimal treatment groups. Subjects in the exercise group participated in a one hour exercise session three times a week for 12 weeks. An (abbreviated) educational program consisting of content related to health, exercise, and arthritis was incorporated weekly into one of the exercise sessions. The minimal treatment group participated in a weekly one hour educational program related to health, exercise, and arthritis. They did not, however, participate in the exercise program. Data collected before, and after the 12 week intervention stage. Biochemical markers in synovial fluid were used to measure cartilage degradation; keratan sulfate quantified by Enzyme Linked Innunosorbent Assay (ELISA) for proteoglycan degradation and hydroxyproline quantified by High Performance Liquid Chromatography (HPLC) as a marker for collagen degradation.;Clinical parameters measured were pain, range of motion of the knee, activity level, walking ability, radiographs of the knee, health status measured by the Arthritis Impact Measurement Scales (AIMS), heart rate and Rating of Perceived Exertion (RPE).;There was no significant change in keratan sulfate nor hydroxyproline in the synovial fluid of either group, suggesting that this program of exercise does not stimulate cartilage degradation. The exercise group demonstrated a significant decrease in pain both at the time of testing and during the prior week. There was no radiographic evidence for joint changes, nor was there a change in joint range of motion.;Both the exercise and minimal treatment groups demonstrated a significant improvement in health status. There was no significant change in activity level, walking ability nor in parameters of aerobic fitness; heart rate and rating of perceived exertion.;These data would suggest that older individuals can exercise without an exacerbation of their disease and get an improvement in symptoms. The level of exercise contributes to health but does not significantly alter aerobic fitness.