Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

TY - JOUR

T1 - Association of Exercise Therapy and Reduction of Pain Sensitivity in Patients With Knee Osteoarthritis

T2 - A Randomized Controlled Trial

AU - Henriksen, Marius

AU - Klokker, Louise

AU - Graven-Nielsen, Thomas

AU - Bartholdy, Cecilie

AU - Schjødt Jørgensen, Tanja

AU - Bandak, Elisabeth

AU - Danneskiold-Samsøe, Bente

AU - Christensen, Robin

AU - Bliddal, Henning

N1 - Copyright © 2014 by the American College of Rheumatology.

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Methods. In a randomized controlled trial, participants were assigned to 12 weeks of supervised exercise therapy (ET; 36 sessions) or a no attention control group (CG). Pressure-pain sensitivity was assessed by cuff pressure algometry on the calf of the most symptomatic leg. The coprimary outcomes were pressure-pain thresholds (PPTs) and cumulated visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per-protocol" population (participants following the protocol).Results. Sixty participants were randomized (31 in ET group, 29 in CG), and the per-protocol population included 48 participants (25 in ET group, 23 in CG). At followup, mean group differences in the change from baseline were 3.1 kPa (95% confidence interval [95% CI] 0.2, 6.0; P = 0.038) for the PPT, 2,608 mm × seconds (95% CI 458, 4,758; P = 0.019) for TS, and 6.8 points (95% CI 1.2, 12.4; P = 0.018) for KOOS pain, all in favor of ET.Conclusion. Pressure-pain sensitivity, TS, and self-reported pain are reduced among patients completing a 12-week supervised exercise program compared to a no attention CG. These results demonstrate beneficial effects of exercise on basic pain mechanisms and further exploration may provide a basis for optimized treatment.Objective. Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA.

AB - Methods. In a randomized controlled trial, participants were assigned to 12 weeks of supervised exercise therapy (ET; 36 sessions) or a no attention control group (CG). Pressure-pain sensitivity was assessed by cuff pressure algometry on the calf of the most symptomatic leg. The coprimary outcomes were pressure-pain thresholds (PPTs) and cumulated visual analog scale pain scores during constant pressure for 6 minutes at 125% of the PPT as a measure of temporal summation (TS) of pressure-pain. Secondary outcomes included self-reported pain using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Analyses were based on the "per-protocol" population (participants following the protocol).Results. Sixty participants were randomized (31 in ET group, 29 in CG), and the per-protocol population included 48 participants (25 in ET group, 23 in CG). At followup, mean group differences in the change from baseline were 3.1 kPa (95% confidence interval [95% CI] 0.2, 6.0; P = 0.038) for the PPT, 2,608 mm × seconds (95% CI 458, 4,758; P = 0.019) for TS, and 6.8 points (95% CI 1.2, 12.4; P = 0.018) for KOOS pain, all in favor of ET.Conclusion. Pressure-pain sensitivity, TS, and self-reported pain are reduced among patients completing a 12-week supervised exercise program compared to a no attention CG. These results demonstrate beneficial effects of exercise on basic pain mechanisms and further exploration may provide a basis for optimized treatment.Objective. Exercise has beneficial effects on pain in knee osteoarthritis (OA), yet the underlying mechanisms are unclear. The purpose of this study was to investigate the effects of exercise on pressure-pain sensitivity in patients with knee OA.

KW - Adult

KW - Aged

KW - Exercise Therapy

KW - Female

KW - Humans

KW - Knee Joint

KW - Male

KW - Middle Aged

KW - Osteoarthritis, Knee

KW - Pain

KW - Pain Measurement

KW - Pain Threshold

KW - Pressure

KW - Questionnaires

KW - Single-Blind Method

KW - Treatment Outcome

U2 - 10.1002/acr.22375

DO - 10.1002/acr.22375

M3 - Journal article

C2 - 24905427

SN - 0893-7524

VL - 66

SP - 1836

EP - 1843

JO - Arthritis care and research : the official journal of the Arthritis Health Professions Association

JF - Arthritis care and research : the official journal of the Arthritis Health Professions Association

IS - 12

ER -