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Rehabilitation Physiology Lab


Fisher NM. Effects of Three Exercise Rehabilitation Programs on the Relationship between Muscular Strength and Efficiency in Knee Osteoarthritis. Arthritis Rheum 52(9)Suppl:S434, 2005.

Purpose: Several types of exercise rehabilitation programs are recommended for individuals with knee osteoarthritis (OA), including resistance training (RT), aerobic training (AT) and water exercise (WE). The Purpose of this study was to examine the effects of these programs on muscle strength and net mechanical efficiency.
Methods:
Study design: Pre and post intervention.
Sample: A total of 34 patients with symptomatic knee OA (grade 2 or 3 on the Kellgren and Lawrence scale) were studied. Subjects with a mean age of 69.9 +/- 7.2 yrs, mean height of 172.7 +/- 9.3 cm, and mean weight of 88.0 +/- 17.1 kg were divided into three groups: RT (n=11), AT (n=11), and WE (n=12).
Instruments/measurements: Measures included maximal isometric quadriceps, strength, oxygen consumption (VO2), and workrate (Watts). Maximal quadriceps strength was measured using a strain gauge. A maximal graded exercise test on a cycle ergometer was used to determine submaximal and peak aerobic capacity, as well as maximal workrate. VO2 was determined by open circuit spirometry. Subjects pedaled at 50 rpm. All exercise programs were conducted 3 times per week for 1 hour per session for 8 weeks. RT used individually prescribed and progressively increased resistances. AT used individually prescribed and progressively increased intermittent workrates. WE used a standard aquatic program with increasing intensities.
Analytic procedures: VO2 and net mechanical efficiencies (Workrate/VO2) were calculated using standard equations. Paired t-tests were used to determine within group differences from pre to post training.
Results: RT showed significant icnreases in quadriceps strength (33%), decreased VO2 at 50W (20%), and importantly, an increase in net mechanical efficiency from 15% to 23%. AT showed significant increases in quadriceps strength (25%) and maximal workrate (28%); however, VO2 at 50W (1.00 +/- 0.2 vs 1.03 +/- 0.2 L/min, p=0.333) and efficiency (22.2 +/- 4.9 vs 21.9 +/- 5.3%, p=0.394) were not significantly different from pre to post training. WE did not show statistically significant differences for any variables (quadriceps strength: p=0.358, VO2 at 50W: p=0.186, maximal workrate: p=0.169, efficiency: p=0.112).
Conclusions: Both RT and AT significantly improved quadriceps strength; however, only RT increased strength sufficiently to improve efficiency. It appears that the improved strength provided an increase in efficiency of the working muscles, thereby improving the energy cost of aerobic activity. Therefore, it seems likely that by increasing efficiency there is a decreased energy cost of daily activities, i.e. less fatigue, for individuals with knee OA.

 

OTHER ABSTRACTS

Fisher NM
, DM Dolan, C Brenner, DR Pendergast. Quantitative Effects of a Water Exercise Program on Functional and Physiological Capacity in Subjects with Osteoarthritis: a Pilot Study. Sport Sciences for Health 1(1):17-24, 2004

Graham J, N Fisher. Effects of Resistance Training on Muscle Function in Individuals with Knee Osteoarthritis. Arthritis & Rheumatism 48(9) suppl: S445, 2003.

Fisher NM and DR Pendergast. Reduced Muscle Function in Patients with Osteoarthritis . Scand J Rehab Med 29:213-221, 1997.

Fisher NM, SC White, HJ Yack, RJ Smolinski and DR Pendergast. Muscle Function and Gait in Patients with Knee Osteoarthritis before and after Muscle Rehabilitation. Disability Rehabil 19(2):47-55, 1997.

Fisher NM and DR Pendergast. Application of Quantitative and Progressive Exercise Rehabilitation to Patients with Osteoarthritis of the Knee . Journal of Back and Musculoskeletal Rehabilitation 5:33-53, 1995.

Fisher NM and DR Pendergast. Effects of a Muscle Exercise Program on Exercise Capacity in Subjects with Osteoarthritis . Arch Phys Med Rehabil 75(7):792-797, 1994.

Fisher NM, VD Kame, L Rouse and DR Pendergast. Quantitative Evaluation of a Home Exercise Program on Muscle and Functional Capacity of Patients with Osteoarthritis. Am J Phys Med Rehabil 73:413-420, 1994.

Fisher NM, GE Gresham and DR Pendergast. Quantitative Progressive Exercise Rehabilitation (QPER) for Osteoarthritis of the Knee . Physical Medicine and Rehabilitation Clinics of North America 5(4):785-802, 1994.

Leddy JJ, NM Fisher, RJ Smolinski, YK Barodawala, P Pandya and DR Pendergast. Effects of Exercise Rehabilitation on Muscle Function, Activity and Joint Spaces in Patients with Osteoarthritis. Med Sci Sports Exerc 26(suppl):S142, 1994.

Fisher NM, GE Gresham and DR Pendergast. Effects of a quantitative progressive rehabilitation program applied unilaterally to the osteoarthritic knee. Arch Phys Med Rehabil 74(12):1319-1326, 1993.

Fisher NM, GE Gresham, M Abrams, J Hicks, D Horrigan and DR Pendergast. Quantitative effects of physical therapy on muscular and functional performance in subjects with osteoarthritis of the knees . Arch Phys Med Rehabil 74(8):840-847, 1993.

Fisher NM, SC White, JH Yack, RJ Smolinski and DR Pendergast. Muscle Function and Gait in Patients with Knee Osteoarthritis before and after Muscle Rehabilitation. Arch Phys Med Rehabil 73(10):972, 1992.

Fisher NM, DR Pendergast, GE Gresham and E Calkins. Muscle rehabilitation: its effect on muscular and functional performance of patients with knee osteoarthritis . Arch Phys Med Rehabil 72(6):367-374, 1991.

Pendergast DR, VD Kame Jr, L Rouse and NM Fisher. Quantitative Evaluation of a Physical Therapy Supervised Home Exercise Program on Muscle and Functional Capacity of Patients with Osteoarthritis. Arch Phys Med Rehabil 72:792, 1991.

Fisher NM, VD Kame Jr and DR Pendergast. Effects of Muscle Rehabilitation on Cardiovascular Fitness in Patients with Osteoarthritis. Gerontologist 31(Special Issue II):9, 1991.

Fisher NM, DR Pendergast and GE Gresham. Reduced Muscle and Functional Performance in Patients with Osteoarthritis. Arch Phys Med Rehabil 71:783, 1990.

Fisher NM, DR Pendergast and GE Gresham. Progressive Quantitative Rehabilitation of Patients with Osteoarthritis. Arch Phys Med Rehabil 71:762, 1990.

Gresham GE, NM Fisher, DR Pendergast and E Calkins. Quantitative Quadriceps Strengthening in Osteoarthritis of the Knees. Arch Phys Med Rehabil 69:725, 1988.