# Strength Training for Knee Osteoarthritis - Savonia AMK

> Physiotherapy and exercise are central in treatment. Movement, muscle strength and stretching exercises are important for self-management, and in many cases, patients need guidance from a physiotherapist.

## Background
Knee osteoarthritis is the most common joint disease and the leading cause of knee pain in adults. Risk factors include obesity, aging, genetic predisposition, knee injuries, and long-term heavy joint loading. The condition affects the entire joint, causing changes in cartilage, bone, joint capsule, and surrounding muscles, which lead to pain, stiffness, and reduced function.

## Study Methodology
This article presents a mini literature review conducted by students at Savonia University of Applied Sciences as part of the "Professional in Physiotherapy" course. The review examined randomized controlled trials (RCTs) published between 2015 and 2025 that investigated strength training interventions for knee osteoarthritis.

The search was conducted in the PubMed database using the keywords “knee osteoarthritis” AND “strength training” AND “randomized controlled trial.” Methodological quality was assessed using the PEDro (Physiotherapy Evidence Database) scale.

## Reviewed Studies
The review included three studies published between 2020 and 2023:

*   **Øiestad et al. (2023):** Compared strength training, aerobic exercise, and usual care. (PEDro score: 7/10)
*   **Vincent & Vincent (2020):** Investigated concentric versus eccentric resistance training. (PEDro score: 7/10)
*   **Holm et al. (2020):** Added strength training to neuromuscular exercise and education. (PEDro score: 8/10)

## Key Findings
*   **Effectiveness:** Strength training consistently improved muscle strength and often reduced pain.
*   **Safety:** Interventions were found to be safe, with rare adverse events.
*   **Functional Outcomes:** Short-term improvements were observed in physical functions such as sit-to-stand and stair-climb performance.
*   **Long-term Challenges:** Sustaining improvements in quality of life and mobility beyond the intervention period remains difficult.
*   **Specific Approaches:** Eccentric-focused training may reduce pain during daily tasks, while combination programs (neuromuscular exercise, education, and strength training) offer comprehensive benefits.

## Conclusion
Strength training is a core component of rehabilitation for knee osteoarthritis. While exercise effectively reduces pain and increases strength, it must be tailored to the individual. Future research is required to determine the optimal intensity, frequency, and duration of exercise to ensure lasting improvements in quality of life. Physiotherapists remain essential in supporting patient adherence and integrating exercise into daily life.

## Authors
*   Eetu Korpinen, physiotherapy student, Savonia University of Applied Sciences
*   Tino Kulmala, physiotherapy student, Savonia University of Applied Sciences
*   Aleksi Koistinen, physiotherapy student, Savonia University of Applied Sciences
*   Eero Kilpeläinen, physiotherapy student, Savonia University of Applied Sciences
*   Marja Äijö PT, PhD, principal lecturer of gerontology and rehabilitation, Savonia University of Applied Sciences

## References
*   Holm, P. M., Schrøder, H. M., Wernbom, M., & Skou, S. T. (2020). Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care – a randomized controlled trial. *Osteoarthritis and Cartilage*, 28(6), 744–754. https://doi.org/10.1016/j.joca.2020.02.839
*   PEDro 2025. PEDro scale. Physiotherapy Evidence Database. Centre for Evidence-Based Physiotherapy. https://pedro.org.au/english/resources/pedro-scale/
*   Pohjolainen, T. 2024. Polven nivelrikko. Lääkärikirja Duodecim. https://www.terveyskirjasto.fi/dlk01081
*   Øiestad, B. E., Årøen, A., Røtterud, J. H., Østerås, N., Jarstad, E., Grotle, M., & Risberg, M. A. (2023). The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. *BMC Musculoskeletal Disorders*, 24(1), 714. https://doi.org/10.1186/s12891-023-06831-x
*   Vincent, K. R., & Vincent, H. K. (2020). Concentric and eccentric resistance training comparison on physical function and functional pain outcomes in knee osteoarthritis: A randomized controlled trial. *American Journal of Physical Medicine & Rehabilitation*, 99(10), 932–940. https://doi.org/10.1097/PHM.0000000000001450