title: A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee.
abstract: OBJECTIVE
  To assess the relative effectiveness of combining self-management and strength training for improving functional outcomes in patients with early knee osteoarthritis.
  
  
  METHODS
  We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community-dwelling middle-aged adults (n = 273) ages 35-64 years with knee osteoarthritis, pain, and self-reported physical disability completed a strength training program, a self-management program, or a combined program. Outcomes included 5 physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and 2 self-reported measures of pain and disability.
  
  
  RESULTS
  A total of 201 participants (73.6%) completed the 2-year trial. Overall, compliance was modest for the strength training (55.8%), self-management (69.1%), and combined (59.6%) programs. The 3 groups showed a significant and large increase from pre- to posttreatment in all of the physical functioning measures, including leg press (d = 0.85), range of motion (d = 1.00), work capacity (d = 0.60), balance (d = 0.59), and stair climbing (d = 0.59). Additionally, all 3 groups showed decreased self-reported pain (d = -0.51) and disability (d = -0.55). There were no significant differences among the groups.
  
  
  CONCLUSIONS
  Middle-aged, sedentary persons with mild early knee osteoarthritis benefited from strength training, self-management, and the combination program. These results suggest that both strength training and self-management are suitable treatments for the early onset of knee osteoarthritis in middle-aged adults. Self-management alone may offer the least burdensome treatment for early osteoarthritis.
authors.affiliation: Department of Psychology, George Mason University, Fairfax, Virginia, USA. pmcknigh@gmu.edu
authors.forename: Patrick E
authors.initials: PE
authors.lastname: McKnight
authors.forename: Shelley
authors.initials: S
authors.lastname: Kasle
authors.forename: Scott
authors.initials: S
authors.lastname: Going
authors.forename: Isidro
authors.initials: I
authors.lastname: Villanueva
authors.forename: Michelle
authors.initials: M
authors.lastname: Cornett
authors.forename: Josh
authors.initials: J
authors.lastname: Farr
authors.forename: Jill
authors.initials: J
authors.lastname: Wright
authors.forename: Clara
authors.initials: C
authors.lastname: Streeter
authors.forename: Alex
authors.initials: A
authors.lastname: Zautra
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D019468:Disease Management; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy*; D055070:Resistance Training / Q000379:methods*; D012648:Self Care / Q000379:methods*