High- vs. Low-Dose Exercise for Knee Osteoarthritis. Which is Better?

Osteoarthritis (OA) is a chronic condition that affects millions of people worldwide. One of the most common sites of OA is the knee joint. Exercise is known to be beneficial for patients with knee OA, but the optimal exercise dose is not well-established. A clinical trial compared the effects of high-dose and low-dose exercise therapy on knee function, pain, and quality of life (QoL) in patients with long-term symptomatic knee OA. The study aimed to determine the optimal exercise dose for this patient population. The results of the study are important for clinicians and patients with knee OA who are seeking effective exercise therapy.

Clinical trial

In this study, doctors from Sweden and Norway compared two different types of exercise therapy for knee osteoarthritis. 189 patients with knee osteoarthritis and a history of pain and decreased knee function were involved in the study. The patients were randomly assigned to either high-dose therapy (98 patients) or low-dose therapy (91 patients). High-dose therapy included 11 exercises lasting 70 to 90 minutes, while low-dose therapy involved 5 exercises lasting 20 to 30 minutes. Both groups did exercises three times a week for 12 weeks under a doctor's supervision. The doctors measured the patients' knee function, pain, and quality of life during the study.

Results

Both groups showed improvement over time, but there were no significant benefits of high-dose therapy in most comparisons. One exception was the KOOS score for function in sports and recreation, where high-dose therapy was superior at the end of treatment and at the 6-month follow-up. A small benefit in QoL at 6 and 12 months was also observed.

Conclusion

The results of this trial suggest that high-dose exercise therapy is not superior to low-dose exercise therapy for most outcomes in patients with long-term symptomatic knee OA. However, high-dose therapy may be beneficial for knee function in sports and recreation and QoL. Clinicians and patients with knee OA should consider these findings when determining the appropriate exercise therapy for this patient population. Further research is needed to determine the optimal exercise dose for knee OA patients.

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