Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Keskussairaalantie 19, 40620, Jyväskylä, Finland.
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Osteoporos Int. 2017 Apr;28(4):1323-1333. doi: 10.1007/s00198-016-3875-1. Epub 2016 Dec 29.
It is uncertain whether subjects with mild knee osteoarthritis, and who may be at risk of osteoporosis, can exercise safely with the aim of improving hip bone strength. This RCT showed that participating in a high-impact exercise program improved femoral neck strength without any detrimental effects on knee cartilage composition.
No previous studies have examined whether high-impact exercise can improve bone strength and articular cartilage quality in subjects with mild knee osteoarthritis. In this 12-month RCT, we assessed the effects of progressive high-impact exercise on femoral neck structural strength and biochemical composition of knee cartilage in postmenopausal women.
Eighty postmenopausal women with mild knee radiographic osteoarthritis were randomly assigned into the exercise (n = 40) or control (n = 40) group. Femoral neck structural strength was assessed with dual-energy X-ray absorptiometry. The knee cartilage region exposed to exercise loading was measured by the quantitative MRI techniques of T2 mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Also, an accelerometer-based body movement monitor was used to evaluate the total physical activity loading on the changes of femoral neck strength in all participants. Training effects on the outcome variables were estimated by the bootstrap analysis of covariance.
A significant between-group difference in femoral neck bending strength in favor of the trainees was observed after the 12-month intervention (4.4%, p < 0.01). The change in femoral neck bending strength remained significant after adjusting for baseline value, age, height, and body mass (4.0%, p = 0.020). In all participants, the change in bending strength was associated with the total physical activity loading (r = 0.29, p = 0.012). The exercise participation had no effect on knee cartilage composition.
The high-impact training increased femoral neck strength without having any harmful effect on knee cartilage in women with mild knee osteoarthritis. These findings imply that progressive high-impact exercise is a feasible method in seeking to prevent hip fractures in postmenopausal women whose articular cartilage may also be frail.
患有轻度膝关节骨关节炎且可能有骨质疏松风险的患者，能否安全地进行旨在改善髋骨强度的运动仍不确定。这项 RCT 表明，参加高强度冲击运动计划可改善股骨颈强度，而对膝关节软骨成分没有任何不利影响。
以前没有研究检查过高强度冲击运动是否可以改善轻度膝关节骨关节炎患者的骨强度和关节软骨质量。在这项为期 12 个月的 RCT 中，我们评估了渐进式高强度冲击运动对绝经后妇女股骨颈结构强度和膝关节软骨生化成分的影响。
80 名患有轻度膝关节放射学骨关节炎的绝经后妇女被随机分配到运动（n=40）或对照组（n=40）。使用双能 X 射线吸收法评估股骨颈结构强度。通过 T2 映射和软骨延迟钆增强 MRI（dGEMRIC）的定量 MRI 技术测量暴露于运动负荷的膝关节软骨区域。此外，还使用基于加速度计的身体运动监测器来评估所有参与者的总身体活动负荷对股骨颈强度变化的影响。通过协方差的 bootstrap 分析来估计训练对结局变量的影响。
经过 12 个月的干预，受训者的股骨颈弯曲强度出现了显著的组间差异，有利于受训者（4.4%，p<0.01）。调整基线值、年龄、身高和体重后，股骨颈弯曲强度的变化仍然显著（4.0%，p=0.020）。在所有参与者中，弯曲强度的变化与总身体活动负荷相关（r=0.29，p=0.012）。运动参与对膝关节软骨成分没有影响。
高强度训练增加了股骨颈强度，而对患有轻度膝关节骨关节炎的女性的膝关节软骨没有任何有害影响。这些发现表明，渐进式高强度冲击运动是一种可行的方法，旨在预防绝经后妇女的髋部骨折，而这些妇女的关节软骨也可能脆弱。
