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Effect of high-intensity strength training on knee pain and knee joint compressive forces among adults with knee osteoarthritis: the START randomized clinical trial

Brief summary, from the abstract

In this randomized trial of adults with knee osteoarthritis, high-intensity strength training did not reduce knee pain or knee joint compressive forces at 18 months any more than low-intensity training or an attention control did.

  • Blinded randomized trial of 377 community-dwelling adults aged 50 and older with knee pain and radiographic osteoarthritis, split across high-intensity training (n=127), low-intensity training (n=126), and attention control (n=124).
  • At 18 months, adjusted WOMAC pain scores (0-20 scale) showed no significant difference: high-intensity vs control (5.1 vs 4.9; P=.61) and high-intensity vs low-intensity (5.1 vs 4.4; P=.08).
  • Knee joint compressive forces during walking also did not differ significantly between groups (P=.61 and P=.85).
  • A well-designed, adequately sized trial, but it tested a specific high-intensity protocol against comparators that also involved structured activity, so it does not rule out benefit from exercise in general.
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