Isokinetic response, viscosupplementation and strength training in gonarthrosis

Abstract

Introduction: Viscosupplementation and strength training are proposed interventions in the treatment of knee osteoarthritis. Objective: To describe the isokinetic response in women with knee osteoarthritis who underwent both interventions. Methods: A double-blind, randomized clinical trial involving thirty women diagnosed with grade II and III bilateral knee osteoarthritis using the radiological criteria of Kellgren & Lawrence. The subjects were randomized into three groups of ten patients each: one group was submitted to viscosupplementation and strength training (VST), another was submitted to strength training (ST) only, and a third to viscosupplementation (VS) only. All evaluations followed the study phases defined as pre-procedure (PRE); after 48 hours of VS (POS-VS); after 12 weeks of training (POS T); and after eight weeks of detraining (POS D). Intra-articular knee infiltrations were performed with a single dose of Hylan GF-20 and isokinetic dynamometry to determine the maximum torque in knee extension and flexion. Pain was measured by the visual analogue scale (VAS). Results: The interventions promoted improvements in the isokinetic response in all three groups and in both muscle groups, with advantage for the extensor group. A significant difference was noticed in the isokinetic response of the trained groups when compared only to the viscosupplemented group (p<0.005), and the VST group showed better isokinetic response compared to the ST group. Conclusion: Combined treatment with viscosupplementation and strength training, and treatment with strength training only, presented better results in terms of isokinetic response and pain reduction than viscosupplementation alone. Level of evidence I; Therapeutic studies-Investigating the results of treatment.