Exercises for Knee Osteoarthritis and Joint Pain

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Various exercise modalities, including blended exercises, mind-body exercises like Tai Chi and yoga, and conventional therapeutic exercises, have shown significant benefits in managing knee osteoarthritis. These exercises not only reduce pain and improve function but also have the potential to modulate brain pathways associated with pain perception. Future research should continue to explore the optimal exercise regimens and their long-term effects on KOA management.

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that significantly impacts the quality of life by causing pain and functional limitations. While pharmacological treatments are common, non-pharmacological interventions, particularly exercise, have shown promising results in managing KOA symptoms. This article explores various exercise modalities and their effectiveness in alleviating pain and improving function in individuals with knee osteoarthritis.

Pain Neuroscience Education and Blended Exercises

A study protocol investigated the combination of pain neuroscience education (PNE) with a blended exercise program, including aerobic, resistance, neuromuscular, breathing, stretching, and balance exercises, along with diet education. The study aims to determine if this combination provides greater pain relief and functional improvement compared to PNE or blended exercises alone. The inclusion of exercise booster sessions (EBS) via telerehabilitation is also being evaluated for its potential to enhance outcomes and adherence in KOA patients1.

Mind-Body and Physical Exercises

Different exercise modalities, such as Tai Chi, Baduanjin, and stationary cycling, have been studied for their effects on KOA. These exercises not only reduce pain but also modulate the dorsolateral prefrontal cortex (DLPFC), which plays a crucial role in pain modulation. Increased connectivity between the DLPFC and other brain regions was associated with pain reduction and improved function, highlighting the potential of neuroimaging biomarkers in predicting the therapeutic effects of these exercises2 7.

Manual Physical Therapy and Conventional Exercises

Manual physical therapy combined with range-of-motion, strengthening, and cardiovascular exercises has been shown to be more effective than placebo in improving function, reducing pain and stiffness, and increasing walking distance in KOA patients. This approach emphasizes the importance of a comprehensive rehabilitation program that includes both active and passive exercises3.

Pilates vs. Conventional Therapeutic Exercises

A comparative study found that Pilates training was more effective than conventional therapeutic exercises (CTE) in reducing pain and disability in KOA patients. Participants in the Pilates group showed significant improvements in joint position sense, functional performance, and overall pain and disability scores compared to those in the CTE group4.

Internet-Based Exercise Programs

The iBEAT-OA study protocol explores the efficacy of a web-based exercise program for treating knee osteoarthritis. This program aims to provide a cost-effective and accessible treatment option that can be delivered digitally, potentially benefiting a large population of KOA patients. The study will assess various health-related outcomes, including pain, function, and muscle strength5.

Yoga and Strengthening Exercises

The YOGA trial is a randomized controlled trial comparing the effectiveness of a yoga program with a strengthening exercise program in patients with symptomatic knee osteoarthritis. Yoga, as a mind-body exercise, has the potential to improve flexibility, muscle strength, balance, and fitness, thereby reducing OA symptoms. The trial aims to provide robust evidence on the efficacy of yoga in managing knee OA6.

Hatha Yoga Therapy

An integrated approach of hatha yoga therapy combined with therapeutic exercises has shown better improvements in walking pain, range of knee flexion, walking time, tenderness, swelling, crepitus, and knee disability compared to therapeutic exercises alone. This suggests that hatha yoga can be an effective adjunct therapy for KOA8.

Biomechanically-Based Yoga Exercises

A biomechanically-based yoga exercise program designed to minimize knee adduction moment has demonstrated significant improvements in pain, self-reported physical function, and mobility in women with knee osteoarthritis. This program was found to be more effective than traditional leg strengthening exercises and no-exercise control groups9.

Wuqinxi Exercise Program

The Wuqinxi (WQX) exercise program, a traditional Chinese exercise, has been effective in maintaining or improving pain, knee extensor and flexor strength, and overall function in older adults with KOA. The program achieved high adherence and showed lasting effects even after the intervention period10.