In this issue, we will discuss exercise intensity selection for osteoarthritis.
Osteoarthritis is classified as a chronic disease and can occur in the hip, knee, hand, and spine.The cartilage in the joints is damaged and painful most of the time, and non-pharmacological therapies such as exercise therapy may be chosen to manage the chronic pain.The review to be presented will be one that examines the choice of exercise intensity, which may be helpful to those who deal with it.
The study
We were reviewing six randomized controlled trials with 656 participants.Five studies (620 participants) involved patients with knee osteoarthritis, and one study (36 participants) involved patients with osteoarthritis of the knee or hip.
More women than men were included in these studies. (3:7)
Measured on a scale of 0-20 points (the lower the better, the less pain), those who took the high intensity exercise program rated 0.84 points lower on the scale than those who took the low intensity exercise program.Patients who took the low-intensity exercise program rated their pain at 6.6 points.On a scale of 0 to 68 points (the lower the better the functionality), those who took the high-intensity exercise program rated it 2.65 points lower than those who took the low-intensity exercise program.Those who did the low-intensity exercise program rated their pain at 20.4 points.On a visual analog scale of 0 to 200 mm (higher is better functionality), those who took the high-intensity exercise program rated their quality of life 4.3 mm higher (6.5 to 15.2 mm) than those who took the low-intensity exercise program.Patients who took the low-intensity exercise program rated their quality of life 66.7 mm higher.
The number of people adversely affected by high-intensity exercise increased by 2%, with 17/100 people reporting.
-39/100 people reported adverse effects associated with a high intensity exercise program.
-22/100 people reported adverse effects associated with a low-intensity exercise program.
Adverse events were incompletely reported for each group because they were not systematically monitored.None of the included studies reported serious adverse events.Evidence based on the results of these studies is that high intensity exercisers with osteoarthritis may experience slight improvement in knee pain and function at the end of the exercise program (8-24 weeks) compared to low intensity exercise programs.It is not clear whether high-intensity exercise improves quality of life or increases the number of people who experience adverse events.
Reviewer's conclusion
We found very low to low quality evidence of no significant clinical benefit of high intensity compared to low intensity exercise programs in improving pain and physical function in the short term. There was not enough evidence to determine the effectiveness of different types of intensity exercise programs.
It is unclear whether high-intensity exercise programs may cause more detrimental effects than low-intensity exercise programs. This must be assessed by further research. Withdrawals due to adverse events were not adequately monitored and were not systematically reported by each group. Due to the risk of bias, inconsistency, and imprecision, we downgraded the evidence to low or very low.
The few studies comparing high-intensity and low-intensity exercise programs for osteoarthritis highlight the need for further research investigating the dose-response relationship of exercise programs. In particular, further research is needed to establish the minimum intensity exercise program required for clinical efficacy and the maximum intensity that can be tolerated by patients. Larger studies should comply with the Consolidated Reporting and Testing Standards (CONSORT) checklist and systematically report harm data to assess the potential impact of maximum intensity exercise programs in people with joint injuries.
Regnaux JP, Lefevre-Colau MM, Trinquart L, Nguyen C, Boutron I, Brosseau L, Ravaud P. High-intensity versus low-intensity -intensity physical activity or exercise in people with hip or knee osteoarthritis. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD010203. DOI: 10.1002/14651858.CD010203.
Conclusion
The conclusion was that there may be a slight expectation of change in pain and functional aspects in people who are subjected to a high intensity exercise program.So, let's switch to a high-intensity exercise program! I don't think it's a good idea to switch to a high-intensity exercise program, but rather than doing a low-intensity program endlessly, I wonder if we can get the same results by changing the menu.If I let them get used to it in stages and then move on to a high intensity exercise program, I might be able to create a situation similar to this conclusion.However, what I found problematic was that even if I wanted to enforce these programs, I wondered how I would be able to manage incidents and deal with complaints. This is the point.Even if the consent of the individual is obtained, if some inconvenience arises, it may become a problem that will be voiced from various places, so I would like to practice this matter while considering it.
