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: Hamstring injury management often combines targeted resistance training with progressive running, yet the relative demands of these tasks are not well understood. A clearer understanding of musculotendinous force and strain across exercises and running speeds may help clinicians and practitioners make more informed decisions when selecting exercises for prevention and rehabilitation. METHODS: Twenty active adults (10 male, 10 female) completed two trials of four treadmill running conditions (walk, jog, 75 percent of maximal speed, and maximal speed). Participants also performed two sets of seven resistance training exercises using six repetitions and a perceived exertion of at least 8 out of 10. Magnetic resonance imaging, surface electromyography, and three‑dimensional motion capture data were integrated using musculoskeletal modelling to estimate musculotendinous force and strain of the biceps femoris long head (BFlh), semimembranosus (SM), and semitendinosus (ST) during each task. RESULTS: The bilateral Romanian deadlift (RDL) produced the highest peak forces for BFlh and SM, significantly exceeding all other tasks (p < 0.001). Four exercises generated peak BFlh forces comparable to maximal sprinting: unilateral hamstring bridge, unilateral eccentric hip extension, unilateral slider, and the Nordic hamstring exercise. Peak strain was highest in the RDL and unilateral hamstring bridge across all three muscles (p < 0.001). The Nordic hamstring exercise and slider produced the lowest strain values (p < 0.001). Task demands ranged from loads lower than walking (e.g hip thrust) to loads exceeding maximal sprinting, depending on the muscle and task. CONCLUSION: Running at progressively increasing speeds and widely used resistance training exercises produce a broad spectrum of hamstring musculotendinous forces and strains. Meaningful differences were observed between exercises and between muscles, indicating that no single task provides a uniform mechanical stimulus across the hamstring group. The RDL and unilateral hamstring bridge elicited the greatest force and strain, whereas the Nordic hamstring exercise and slider produced lower strain despite moderate force demands. These findings offer practical guidance for exercise selection by highlighting how specific tasks target different loading characteristics. This information can assist clinicians and practitioners in aligning exercise choice with the mechanical demands required for rehabilitation and injury prevention programs.
Read CV Ryan TimminsECSS Paris 2023: OP-MH22