Article

Different strengthening exercises are generally prescribed to
overcome the undesirable effects of decreased muscular function on the
osteoarthritic joint. Although a few studies have shown the effects of
strengthening on the muscle structure in healthy individuals, the literature
lacks relevant data concerning knee osteoarthritis.
OBJECTIVE: To evaluate the
effects of different exercises on quadriceps muscle strength and structure in
persons with knee osteoarthritis. DESIGN: A randomized controlled study. SETTING: Physical medicine and rehabilitation department of a university hospital.
POPULATION: Sixty-one patients with knee osteoarthritis were randomly assigned
into 6 exercise groups (isometric right/left, isotonic right/left, isokinetic
right/left). METHODS: Subjects were evaluated for pain and functional status with
use of the visual analog pain scale, Western Ontario and McMaster Universities
Arthritis Index, 50-step walking, and single-leg stance tests before and after 15
sessions of physical therapy. Isokinetic tests were performed at 60 degrees per
second. Ultrasonographic measurements for pennation angle, fascicle length, and
muscle thickness were performed from the vastus lateralis muscles bilaterally.
RESULTS: Increased knee extensor strength was observed bilaterally in the
isometric group (P < .01). In the same group, fascicle length and muscle
thickness on the strengthened side (P < .01) and fascicle length on the
contralateral side (P < .05) were increased. In the isokinetic group, muscle
thickness bilaterally and fascicle length on the contralateral side increased
(all P < .05). In the isotonic group, muscle thickness increased bilaterally (P <
.05). CONCLUSION: These findings showed that isometric quadriceps training
resulted in bilateral strengthening and that accompanying increase in muscle
thickness and fascicle length in the same group was consistent with the strength
improvement. In this study we evaluated the effects of different strength
training on muscle strength and architecture in patients with knee osteoarthritis
by using isokinetic measurements and ultrasound. Our results suggest that
exercises may influence the muscle architecture in patients with knee
osteoarthritis. To our knowledge, this study is the first to demonstrate the
effects of cross-education on muscle architecture.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc.
All rights reserved.

Langue : ANGLAIS