ECSS Paris 2023: OP-MH22
INTRODUCTION: Knee osteoarthritis (KOA) is associated with physical function limitations, including muscle weakness, which is also a possible modifiable risk factor for falls. Exercise is one of the key components of management in KOA, with potential to relieve pain and improve physical function. Exercise does not appear to be harmful to articular cartilage, but the effects of moderate intensive exercise on cartilage structure are not well known. Therefore, the objective of this study was to investigate the effects of combined resistance and moderate-impact training on tibiofemoral cartilage structure and lower limb muscle strength in postmenopausal women with mild KOA. METHODS: Postmenopausal women (n=409, aged 55-75 years) were recruited based on a newspaper advertisement and a phone interview. According to the inclusion and exclusion criteria, 103 volunteer postmenopausal women with radiologically confirmed grade 1 or 2 KOA, following to the Kellgren-Lawrence grading system, participated in the baseline measurements. After that they were randomly assigned to a multicomponent exercise group (n=51) and a home exercise group (n=52). The 8-month intervention included supervised progressive resistance and moderate-impact step aerobics training three times a week alternating with two-week periods. The home exercise group's training was standard rehabilitative training for KOA three times a week. Tibiofemoral articular cartilage was evaluated using quantitative magnetic resonance imaging. The structure of cartilage was assessed using gray-level co-occurrence matrix texture analysis of T2 relaxation time maps, sensitive to the collagen network arrangement and tissue hydration. Maximal isometric knee extension and flexion strength were measured. Measurements were performed at baseline and after the 8-month intervention. RESULTS: During the 8-month intervention, training compliance was 72% and mean training frequency was 2.2 (SD 0.6) times per week in the multicomponent exercise group, and 44% and 1.3 (SD 1.0) in the home exercise group. After the intervention, there were no statistically significant intergroup differences in the tibiofemoral cartilage structure between the multicomponent exercise group (n=47) and the home exercise group (n=43). The mean maximal isometric knee extension strength improved 15% (49 N, 95% CI: 30 to 68) and flexion strength improved 12% (22 N, 95% CI: 9 to 35) significantly more in the multicomponent exercise group compared to the home exercise group. CONCLUSION: Progressive resistance and moderate-impact training did not induce harmful changes in tibiofemoral cartilage microstructure, as reflected by texture analysis, in postmenopausal women with mild KOA. However, this type of moderate intensive resistance and impact training can promote lower limb muscle strength, which is important in maintaining physical function and activity in everyday life with KOA, and in preventing the risk of falls and resulting fractures in ageing.
Read CV Johanna VesantoECSS Paris 2023: OP-MH22
INTRODUCTION: Knee osteoarthritis (KOA) is considered a whole-joint disease that is amenable to prevention and treatment in the early stages. In KOA, there are well-described progressive degenerative changes in the articular cartilage and presence of lower lean body mass. Furthermore, KOA and sarcopenia frequently coexist in aging populations, and the two diseases share common risk factors and biomechanical interactions. The objective of this study was to investigate the effects of a multicomponent exercise regimen on biochemical composition of tibiofemoral articular cartilage and lean body mass in postmenopausal women with mild KOA. METHODS: This RCT included 103 postmenopausal 55- to 75-year-old female participants with radiographic Kellgren-Lawrence grade 1 or 2 KOA in tibiofemoral joint. Multicomponent exercise group participated in a progressive multicomponent exercise regimen which included moderate impact step aerobics and resistance training alternating every 2 weeks, three times a week for 8 months. The home exercise group conducted standard rehabilitative home exercise program for KOA three times a week, focusing on functional exercises to maintain lower extremity flexibility and muscle function. Quantitative magnetic resonance imaging (qMRI) using 3 Tesla magnetic resonance system was used to assess changes in the biochemical composition of tibiofemoral cartilage. T2 relaxation time mapping was used to assess collagen matrix integrity and water content, and T1rho was used as a parameter sensitive to glycosaminoglycan content in the cartilage. Weight-bearing cartilage regions of interest were segmented via a semi-automated in-house MATLAB application from three sagittal slices of the medial and lateral tibial and femoral condyles for T2, and from one slice for T1rho. Lean body mass and fat percentage were assessed via dual-energy X-ray absorptiometry. Group differences were analysed using generalised linear models. RESULTS: qMRI data was available for 49 participants (age: 65 (SD 5) years, BMI: 27.8 (SD 3.9)) in the multicomponent exercise group and 45 participants (age: 65 (SD 4) years, BMI: 27.8 (SD 3.7)) in the home exercise group. The multicomponent exercise group showed 72% training compliance and a mean training frequency of 2.2 (SD 0.6) times per week, compared to 44% and 1.3 (SD 1.0) in the home exercise group. No significant differences in changes to T2 maps or T1rho were observed between the groups. Lean body mass increased 1.4% (614 g; 95% CI 222 to 1005) more in the multicomponent exercise group compared to the home exercise group. There were no significant differences between the groups in the fat percentage. CONCLUSION: This study revealed that a progressive multicomponent exercise regimen did not affect the biochemical composition of tibiofemoral cartilage and had favourable effects on lean body mass. Therefore, such regimen could offer a suitable mode of exercise for increasing lean body mass and thus preventing sarcopenia in postmenopausal women with mild KOA.
Read CV Ville-Markus KonolaECSS Paris 2023: OP-MH22
INTRODUCTION: Introduction: Approximately 10% of all musculoskeletal injuries in military personnel are ankle sprains.[1] Infantry soldiers are at a greater risk of sustaining lower extremity injuries, among them ankle sprains, compared to their colleagues from the navy, air force, and headquarters.[2] These soldiers constantly participate in physical activity practices, often on uneven ground and carrying combat equipment loads, which are risk factors for ankle sprain injury.[3] Prevention strategies with proven effectiveness in athletes have rarely been evaluated in military settings. Therefore, the aim of the study was to assess the impact of a daily, field-based exercise program on ankle sprain incidence and functional abilities in infantry recruits. METHODS: Companies from two induction cohorts were assigned to intervention (n=421) or control (n=365). The intervention companies received a 5-minute daily program comprising balance, agility, and strength exercises performed for 16 weeks. The control group continued their regular training. Outcomes were ankle sprain incidence, functional performance (hexagon hop test, Y-Balance Test), and perceived ankle instability (Cumberland Ankle Instability Tool). Assessments were conducted at baseline and at the end of basic training (follow up). Logistic regression identified factors associated with ankle sprains. RESULTS: Ankle sprains occurred in 25.2% of the control group versus 13.1% of the intervention group (p<0.001). Compliance rate for the exercise program was 68.3%. In the control group, the injured recruits presented with decreased functional performance and worsening ankle instability over time, while the uninjured recruits improved. In the intervention group, both the injured and uninjured recruits maintained levels of functional performance and perceived ankle instability. Protective factors included being in the intervention groups (odds ratio [OR]=0.37, p<0.001), no chronic ankle instability (CAI) (OR=2.01, p=0.002), and lower body mass index (BMI) (OR=1.06, p=0.048). CONCLUSION: A brief, equipment-free, daily neuromuscular training program integrated into infantry training significantly reduced ankle sprain incidence and preserved functional outcomes. Implementing a dedicated exercise program may reduce ankle sprain incidence among infantry recruits. 1. Fenn, B.P., et al., Worldwide epidemiology of foot and ankle injuries during military training: a systematic review. BMJ Mil Health, 2021. 167(2): p. 131-136. 2. Davidson, P.L., et al., Lower limb injuries in New Zealand Defence Force personnel: descriptive epidemiology. Aust N Z J Public Health, 2008. 32(2): p. 167-73. 3. Orr, J.D., J. Robbins, and B.R. Waterman, Management of chronic lateral ankle instability in military service members. Clin Sports Med, 2014. 33(4): p. 675-92.
Read CV Michal ShenharECSS Paris 2023: OP-MH22