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.

OBJECTIVE: To evaluate the efficacy of strength exercise or aerobic exercise compared to usual care on knee-related quality of life (QoL) and knee function at 4 months and 1 year in individuals with knee osteoarthritis. METHODS: A three-arm randomized controlled trial (RCT) compared 12 weeks of strength exercise or aerobic exercise (stationary cycling) to usual care supervised by physiotherapists in primary care. We recruited 168 participants aged 35-70 years with symptomatic knee osteoarthritis. The primary outcome was The Knee Injury and Osteoarthritis Outcome Score (KOOS) QoL at 1 year. Secondary outcomes were self-reported function, pain, and self-efficacy, muscle strength and maximal oxygen uptake (VO2max) at 4 months and 1 year. RESULTS: There were no differences between strength exercise and usual care on KOOS QoL (6.5, 95% CI -0.9 to 14), or for aerobic exercise and usual care (5.0, 95% CI -2.7 to 12.8), at 1 year. The two exercise groups showed better quadriceps muscle strength, and VO2max at 4 months, compared to usual care. CONCLUSION: This trial found no statistically significant effects of two exercise programs compared to usual care on KOOS QoL at 1 year in individuals with symptomatic and radiographic knee osteoarthritis, but an underpowered sample size may explain lack of efficacy between the intervention groups and the usual care group. GOV IDENTIFIER: NCT01682980.

Long-term follow-up with a smartphone application improves exercise capacity post cardiac rehabilitation: A randomized controlled trial.

BACKGROUND: Mobile health interventions, especially smartphone applications (apps), have been proposed as promising interventions for supporting adherence to healthy behaviour in patients post cardiac rehabilitation (CR). The overall aim of the study was to examine the effect of individualized follow-up with an app for one year on peak oxygen uptake (VO2peak) in patients completing CR. DESIGN: The study was designed as a single-blinded multicentre randomized controlled trial. METHODS: The intervention group (IG) received individualized follow-up enabled with an app for one year, while the control group (CG) received usual care. The primary outcome was difference in VO2peak. Secondary outcomes included exercise performance (time to exhaustion, peak incline (%) and peak velocity (km/h)), bodyweight, resting blood pressure, lipid profile, triglycerides, exercise habits, health-related quality of life, health status and self-perceived goal achievement. RESULTS: In total, 113 patients completing CR (73.4% with coronary artery disease, 16.8% after valve surgery and 9.8% with other heart diseases) were randomly allocated to the IG or CG. Intention to treat analyses showed a statistically significant difference in VO2peak between the groups at follow-up of 2.2 ml/kg/min, 95% confidence interval 0.9-3.5 (p < 0.001). Statistically significant differences were also observed in exercise performance, exercise habits and in self-perceived goal achievement. CONCLUSIONS: Individualized follow-up for one year with an app significantly improved VO2peak, exercise performance and exercise habits, as well as self-perceived goal achievement, compared with a CG in patients post-CR. There were no statistically significant differences between the groups at follow-up in the other outcome measures evaluated.

The performance and aerobic endurance effects of high-intensity versus moderate-intensity continuous running.

The aim of the present study was to investigate the performance and aerobic endurance effects of high-intensity (HICR) versus moderate-intensity continuous running (MICR), which were nonmatched for total work. Twenty healthy recreational athletes (aged 28 ± 5 years) were randomly assigned to an HICR, MICR, or no-intervention control (C) group. The HICR group (n = 7) performed a 20-min strenuous, almost exhausting, run above lactate threshold (LT) at ∼88% of maximal heart rate (HRmax), whereas the MICR group (n = 7) performed a 40-min run at ∼80% HRmax. Both the HICR and MICR groups performed 3 intervention sessions a week, in addition to ∼60% of their regular aerobic exercise, for 10 weeks. The C group (n = 6) performed regular physical exercise throughout the study. Time to exhaustion, during a ∼4-8-min ramp test procedure, was significantly increased by 23% and 24% (P < 0.01) following HICR or MICR, respectively, with no significant difference in the change in time to exhaustion (P = 1.00) at pre- to post-training between the 2 training modalities (HICR and MICR). In the HICR group, maximal oxygen consumption and velocity at LT increased significantly by 5.0% and 6.8% (P < 0.01), respectively. The MICR group increased relative maximal oxygen consumption (mL·kg-1·min-1) significantly by 4.7% (P < 0.05), whereas the pulmonary respiratory gas-exchange ratio was significantly decreased at a submaximal workload by 4.2% (P < 0.01), indicating enhanced fat oxidation. No performance or physiological effects were observed in the C group. The present study indicates that even with a substantially lower total energy turnover, HICR can be as performance enhancing as MICR. Moreover, HICR can increase maximal aerobic power, whereas MICR may enhance fat oxidation.