Article

OBJECTIVE: To assess the level of scientific evidence and the place in the
rehabilitation framework of isokinetic muscle strengthening (IMS) for knee
osteoarthritis (OA). METHODS:
A systematic review of the English literature in
MEDLINE via PubMed, the Cochrane Library, and PEDro databases for only randomized
comparative trials. Data that were sufficiently homogeneous underwent
comprehensive meta-analysis. Methodological assessment was done by using the
CLEAR scale for non-pharmacologic trials. RESULTS: We identified articles for 9
trials (696 patients). All trials were of low to moderate quality. Tolerance of
IMS was considered good. Improvement in muscle strength was better with an IMS
program than no treatment or an isometric exercise but did not differ with an
aerobic program. We found an important effect for pain (standardized mean
difference 1.218 [95% CI 0.899-1.54], P<0.001) and functional Lequesne index
(1.61 [0.40-2.81], P=0.009) and a moderate effect for the Western Ontario and
McMaster Universities Osteoarthritis Index subscore C for disability (0.58
[0.04-1.11], P=0.03). CONCLUSIONS: IMS is an effective way to propose dynamic
muscle strengthening for knee OA rehabilitation and has a significant effect on
pain and disability. Because of the weak methodology and the great heterogeneity
of studies, particularly in IMS protocol and outcome measures, insufficient data
are available to provide guidelines about efficacy and strategy. Future clinical
trials are needed, but more attention should be paid to the methods of such
studies to clarify the role of IMS in the therapeutic armamentarium of knee OA.
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Langue : ANGLAIS