title: Resistive Exercise for Arthritic Cartilage Health (REACH): a randomized double-blind, sham-exercise controlled trial.
abstract: BACKGROUND
  This article provides the rationale and methodology, of the first randomised controlled trial to our knowledge designed to assess the efficacy of progressive resistance training on cartilage morphology in women with knee osteoarthritis.Development and progression of osteoarthritis is multifactorial, with obesity, quadriceps weakness, joint malalignment, and abnormal mechanical joint forces particularly relevant to this study. Progressive resistance training has been reported to improve pain and disability in osteoarthritic cohorts. However, the disease-modifying potential of progressive resistance training for the articular cartilage degeneration characteristic of osteoarthritis is unknown. Our aim was to investigate the effect of high intensity progressive resistance training on articular cartilage degeneration in women with knee osteoarthritis.
  
  
  METHODS
  Our cohort consisted of women over 40 years of age with primary knee osteoarthritis, according to the American College of Rheumatology clinical criteria. Primary outcome was blinded measurement of cartilage morphology via magnetic resonance imaging scan of the tibiofemoral joint. Secondary outcomes included walking endurance, balance, muscle strength, endurance, power, and velocity, body composition, pain, disability, depressive symptoms, and quality of life.Participants were randomized into a supervised progressive resistance training or sham-exercise group. The progressive resistance training group trained muscles around the hip and knee at 80% of their peak strength and progressed 3% per session, 3 days per week for 6 months. The sham-exercise group completed all exercises except hip adduction, but without added resistance or progression. Outcomes were repeated at 3 and 6 months, except for the magnetic resonance imaging scan, which was only repeated at 6 months.
  
  
  CONCLUSIONS
  Our results will provide an evaluation of the disease-modifying potential of progressive resistance training for osteoarthritis.
  
  
  BACKGROUND
  ANZCTR Reference No. 12605000116628.
authors.affiliation: Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia. angela.lange@usyd.edu.au
authors.forename: Angela K
authors.initials: AK
authors.lastname: Lange
authors.forename: Benedicte
authors.initials: B
authors.lastname: Vanwanseele
authors.forename: Nasim
authors.initials: N
authors.lastname: Foroughi
authors.forename: Michael K
authors.initials: MK
authors.lastname: Baker
authors.forename: Ronald
authors.initials: R
authors.lastname: Shnier
authors.forename: Richard M
authors.initials: RM
authors.lastname: Smith
authors.forename: Maria A Fiatarone
authors.initials: MA
authors.lastname: Singh
mesh_terms: D000328:Adult; D001823:Body Composition; D002358:Cartilage, Articular / Q000473:pathology*; D004311:Double-Blind Method; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009119:Muscle Contraction; D053580:Muscle Strength; D020370:Osteoarthritis, Knee / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D010809:Physical Fitness; D052097:Quadriceps Muscle / Q000503:physiopathology; D055070:Resistance Training