High-intensity versus low-intensity resistance training in patients with knee osteoarthritis: A randomized controlled trial

Arjan H. de Zwart, Joost Dekker, Leo D. Roorda, Martin van der Esch, Paul Lips, Natasja M. van Schoor, Annemiek C. Heijboer, Franktien Turkstra, Martijn Gerritsen, Arja Häkkinen, Kim Bennell, Martjin P. M. Steultjens, Willem F. Lems, Marike van der Leeden

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)

Abstract

Objectives: To assess whether (i) high-intensity resistance training (RT) leads to increased muscle strength compared to low-intensity RT in patients with knee osteoarthritis (OA); and (ii) RT with vitamin D supplementation leads to increased muscle strength compared to placebo in a subgroup with vitamin D deficiency. Design: Randomized controlled trial Setting: Outpatient rehabilitation centre Subjects: Patients with knee OA Interventions: 12 weeks of RT at high-intensity RT (70–80% of 1-repetition maximum (1-RM)) or low-intensity RT (40–50% of 1-RM) and 24 weeks of vitamin D (1200 International units vitamin D3 per day) or placebo supplementation. Main measures: Primary outcome measure was isokinetic muscle strength. Other outcome measure for muscle strength was the estimated 1-RM. Secondary outcome measures were knee pain and physical functioning. Results: 177 participants with a mean age of 67.6 ± 5.8 years were included, of whom 50 had vitamin D deficiency. Isokinetic muscle strength (in Newton metre per kilogram bodyweight) at start, end and 24 weeks after the RT was 0.98 ± 0.40, 1.11 ± 0.40, 1.09 ± 0.42 in the high-intensity group and 1.02 ± 0.41, 1.15 ± 0.42, 1.12 ± 0.40 in the low-intensity group, respectively. No differences were found between the groups, except for the estimated 1-RM in favour of the high-intensity group. In the subgroup with vitamin D deficiency, no difference on isokinetic muscle strength was found between the vitamin D and placebo group. Conclusions: High-intensity RT did not result in greater improvements in isokinetic muscle strength, pain and physical functioning compared to low-intensity RT in knee OA, but was well tolerated. Therefore these results suggest that either intensity of resistance training could be utilised in exercise programmes for patients with knee osteoarthritis. No synergistic effect of vitamin D supplementation and RT was found, but this finding was based on underpowered data.
Original languageEnglish
Pages (from-to)952-967
Number of pages16
JournalClinical rehabilitation
Volume36
Issue number7
Early online date2022
DOIs
Publication statusPublished - Jul 2022

Keywords

  • Aged
  • Humans
  • Middle Aged
  • Muscle Strength/physiology
  • Osteoarthritis, Knee/rehabilitation
  • Pain
  • Resistance Training/methods
  • Vitamin D Deficiency
  • knee osteoarthritis
  • muscle strength
  • resistance training
  • vitamin D

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