Author(s): KONOLA, V., VESANTO, J., PARKKARI, J., MULTANEN, J., MUNUKKA, M., KALAJA, M., VASANKARI, T., NEVALAINEN, M., NISSI, M.J., CASULA, V., HAUTALA, A.J., KAUTIAINEN, H., NIEMINEN, M.T., HEINONEN, A., Institution: UNIVERSITY OF JYVÄSKYLÄ, Country: FINLAND, Abstract-ID: 1864

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.