Knee osteoarthritis: A systematic Review on different Exercise therapy Interventions on K.A.M: Different Exercise Therapy Interventions on K.A.M

Muhammada  Mahnoor; Muhammad  Waseem Akhtar; Quratulain  Maqsood; Arslan  Saeed; Mahmood  Alam Durrani; Danish  Hassan; Muhammad  Ramzan; Wajeeha Zia

doi:10.54393/pbmj.v5i5.416

Authors

Muhammada Mahnoor DPT, MPhil, Department of rehabilitation Sciences, Akhtar Saeed Medical and Dental College Lahore Pakistan,
Muhammad Waseem Akhtar PhD MPhil, DPT,Department of rehabilitation Sciences, Akhtar Saeed Medical & Dental College Lahore Pakistan,
Quratulain Maqsood MS in Molecular Biology and Forensic Sciences, Department of Centre for Applied Molecular Biology, University of the Punjab, Lahore Pakistan,
Arslan Saeed Physical Therapy Department, JIPS, Lahore
Mahmood Alam Durrani Department of Rehabilitation Sciences, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
Danish Hassan Assistant professor , Riphah college of rehabilitation and allied health sciences ,Riphah International University
Muhammad Ramzan DPT, Mphil, Department of rehabilitation Sciences, Akhtar Saeed Medical and Dental College Lahore Pakistan,
Wajeeha Zia Riphah international university

DOI:

https://doi.org/10.54393/pbmj.v5i5.416

Keywords:

Alignment, Exercise Interventions, Knee osteoarthritis, Knee Adduction Movement.

Abstract

Exercise therapy can be part of a conservative treatment plan for knee osteoarthritis. Knee adduction moments (KAMs) are thought to be reduced with exercise therapy. A large study looked at exercise therapy's effect on KAM and other physical factors in persons with knee osteoarthritis. Methods: Searches were performed on the following electronic databases: MEDLINE, Google Scholar, Cochrane Central, EMBASE, and OpenGrey. Study participants with knee osteoarthritis undergoing structured exercise therapy were randomized controlled trials. For every study, we conducted independent analyses to extract data and analyze the bias risks. We calculated the mean differences and 95% confidence intervals for each outcome. Results: In the three studies that involved 233 participants, there were no significant differences in KAMs between intervention and control groups. Two of the studies observed improvements in physical function after exercise therapy and one of them demonstrated significant reductions in pain. All three trials favor the intervention group in terms of muscle strength and torque. Conclusions: A change in knee adduction time was not associated with the therapeutic benefits of exercise therapy. Exercise therapy for knee osteoarthritis may not be effective if there is no momentary adduction. Dynamic joint loading may result from a shift in neuromuscular control after exercise therapy

References

Bokaeian HR, Esfandiarpour F, Zahednejad S, Mohammadi HK, Farahmand F. Effects of an Exercise Therapy Targeting Knee Kinetics on Pain, Function, and Gait Kinetics in Patients With Knee Osteoarthritis: A Randomized Clinical Trial. Adapt Phys Activ Q. 2021 Mar 30;38(3):377-395. doi: 10.1123/apaq.2020-0144.

Cheung RTH, Ho KKW, Au IPH, An WW, Zhang JHW, Chan ZYS et al. Immediate and short-term effects of gait retraining on the knee joint moments and symptoms in patients with early tibiofemoral joint osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2018 Nov;26(11):1479-1486. doi: 10.1016/j.joca.2018.07.011.

Edd SN, Bennour S, Ulrich B, Jolles BM, Favre J. Modifying Stride Length in Isolation and in Combination With Foot Progression Angle and Step Width Can Improve Knee Kinetics Related to Osteoarthritis; A Preliminary Study in Healthy Subjects. J Biomech Eng. 2020 Jul 1;142(7):074505. doi: 10.1115/1.4046713.

Erhart-Hledik JC, Mahtani GB, Asay JL, Migliore E, Nguyen MM, Andriacchi TP et al. Changes in knee adduction moment wearing a variable-stiffness shoe correlate with changes in pain and mechanically stimulated cartilage oligomeric matrix levels. J Orthop Res. 2021 Mar;39(3):619-627. doi: 10.1002/jor.24770.

Hall M, Bennell KL, Wrigley TV, Metcalf BR, Campbell PK, Kasza J et al. The knee adduction moment and knee osteoarthritis symptoms: relationships according to radiographic disease severity. Osteoarthritis Cartilage. 2017 Jan;25(1):34-41. doi: 10.1016/j.joca.2016.08.014.

Huang C, Chan PK, Chiu KY, Yan CH, Yeung SS, Fu SN. Exploring the relationship between pain intensity and knee moments in participants with medial knee osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord. 2021 Aug 12;22(1):685. doi: 10.1186/s12891-021-04587-w.

Hunt MA, Charlton JM, Krowchuk NM, Tse CTF, Hatfield GL. Clinical and biomechanical changes following a 4-month toe-out gait modification program for people with medial knee osteoarthritis: a randomized controlled trial. Osteoarthritis Cartilage. 2018 Jul;26(7):903-911. doi: 10.1016/j.joca.2018.04.010.

Hunt MA, Charlton JM, Felson DT, Liu A, Chapman GJ, Graffos A et al. Frontal plane knee alignment mediates the effect of frontal plane rearfoot motion on knee joint load distribution during walking in people with medial knee osteoarthritis. Osteoarthritis Cartilage. 2021 May;29(5):678-686. doi: 10.1016/j.joca.2021.02.003.

Jackson B, Gordon KE, Chang AH. Immediate and short-term effects of real-time knee adduction moment feedback on the peak and cumulative knee load during walking. J Orthop Res. 2018 Jan;36(1):397-404. doi: 10.1002/jor.23659.

Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA. Combined effects of knee brace, laterally wedged insoles, and toe-out gait on knee adduction moment and fall risk in moderate medial knee osteoarthritis patients. Prosthet Orthot Int. 2019 Apr;43(2):148-157. doi: 10.1177/0309364618796849.

Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA. Combined effects of knee brace, laterally wedged insoles and toe-in gait on knee adduction moment and balance in moderate medial knee osteoarthritis patients. Gait Posture. 2018 Mar;61:243-249. doi: 10.1016/j.gaitpost.2018.01.024.

Kudo K, Nagura T, Harato K, Kobayashi S, Niki Y, Matsumoto M et al. Correlation between static limb alignment and peak knee adduction angle during gait is affected by subject pain in medial knee osteoarthritis. Knee. 2020 Mar;27(2):348-355. doi: 10.1016/j.knee.2019.11.008.

Li S, Ng WH, Abujaber S, Shaharudin S. Effects of resistance training on gait velocity and knee adduction moment in knee osteoarthritis patients: a systematic review and meta-analysis. Sci Rep. 2021 Aug 9;11(1):16104. doi: 10.1038/s41598-021-95426-4.

Mochizuki T, Omori G, Nishino K, Tanaka M, Tanifuji O, Koga H et al. The medial inclination of the proximal tibia is associated with the external knee adduction moment in advanced varus knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2022 Feb;30(2):574-583. doi: 10.1007/s00167-020-06323-8.

Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA et al. Effects of simple knee sleeves on pain and knee adduction moment in early unilateral knee osteoarthritis. Proc Inst Mech Eng H. 2019 Nov;233(11):1132-1140. doi: 10.1177/0954411919874614.

Fantini Pagani C, Funken J, Heinrich K, Ellermann A, Schmidt-Wiethoff R, Potthast W. Predicting the knee adduction moment after high tibial osteotomy in patients with medial knee osteoarthritis using dynamic simulations. Knee. 2020 Jan;27(1):61-70. doi: 10.1016/j.knee.2019.08.003.

Paterson KL, Bennell KL, Wrigley TV, Metcalf BR, Kasza J, Hinman RS. Effects of footwear on the knee adduction moment in medial knee osteoarthritis: classification criteria for flat flexible vs stable supportive shoes. Osteoarthritis Cartilage. 2017 Feb;25(2):234-241. doi: 10.1016/j.joca.2016.10.001.

Pereira LC, Runhaar J, Favre J, Jolles BM, Bierma-Zeinstra S. Association between changes in the knee adduction moment and changes in knee pain and function in response to non-surgical biomechanical interventions for medial knee osteoarthritis: a systematic review. Eur J Phys Rehabil Med. 2021 Dec;57(6):948-958. doi: 10.23736/S1973-9087.21.06828-3.

Paterson KL, Kasza J, Bennell KL, Wrigley TV, Metcalf BR, Campbell PK et al. Moderators and mediators of effects of unloading shoes on knee pain in people with knee osteoarthritis: an exploratory analysis of the SHARK randomised controlled trial. Osteoarthritis Cartilage. 2018 Feb;26(2):227-235. doi: 10.1016/j.joca.2017.11.002.

Richards R, van den Noort JC, Dekker J, Harlaar J. Gait Retraining With Real-Time Biofeedback to Reduce Knee Adduction Moment: Systematic Review of Effects and Methods Used. Arch Phys Med Rehabil. 2017 Jan;98(1):137-150. doi: 10.1016/j.apmr.2016.07.006.

Robert-Lachaine X, Dessery Y, Belzile ÉL, Turmel S, Corbeil P. Three-month efficacy of three knee braces in the treatment of medial knee osteoarthritis in a randomized crossover trial. J Orthop Res. 2020 Oct;38(10):2262-2271. doi: 10.1002/jor.24634.

Schuster E, Routson RL, Hinchcliff M, Benoff K, Suri P, Richburg C et al. A novel walking cane with haptic biofeedback reduces knee adduction moment in the osteoarthritic knee. J Biomech. 2021 Jan 4;114:110150. doi: 10.1016/j.jbiomech.2020.110150.

Ulrich B, Hoffmann L, Jolles BM, Favre J. Changes in ambulatory knee adduction moment with lateral wedge insoles differ with respect to the natural foot progression angle. J Biomech. 2020 Apr 16;103:109655. doi: 10.1016/j.jbiomech.2020.109655.

Verlaan L, Boekesteijn RJ, Oomen PW, Liu WY, Peters MJM, Emans PJ et al. Knee adduction moments are not increased in obese knee osteoarthritis patients during stair negotiation. Gait Posture. 2019 Sep;73:154-160. doi: 10.1016/j.gaitpost.2019.07.192.

Wang S, Chan PPK, Lam BMF, Chan ZYS, Zhang JHW, Wang C et al. Sensor-Based Gait Retraining Lowers Knee Adduction Moment and Improves Symptoms in Patients with Knee Osteoarthritis: A Randomized Controlled Trial. Sensors (Basel). 2021 Aug 19;21(16):5596. doi: 10.3390/s21165596.

Whelton C, Thomas A, Elson DW, Metcalfe A, Forrest S, Wilson C et al. Combined effect of toe out gait and high tibial osteotomy on knee adduction moment in patients with varus knee deformity. Clin Biomech (Bristol, Avon). 2017 Mar;43:109-114. doi: 10.1016/j.clinbiomech.2017.02.009.

Yamagata M, Taniguchi M, Tateuchi H, Kobayashi M, Ichihashi N. The effects of knee pain on knee contact force and external knee adduction moment in patients with knee osteoarthritis. J Biomech. 2021 Jun 23;123:110538. doi: 10.1016/j.jbiomech.2021.110538.