Neuromuscular exercise post partial medial meniscectomy: randomized controlled trial

A 12-week neuromuscular training program does not reduce mediolateral knee load distribution (key predictor of osteoarthritis structural disease progression) compared with no exercise in patients aged 30 to 50 years with no-to-mild pain after medial arthroscopic partial meniscectomy

Hall M, Hinman RS, Wrigley TV, Roos EM, Hodges PW, Staples MP, Bennell KL

Med Sci Sports Exerc 2015

PURPOSE: This study aimed to evaluate the effects of a 12-wk, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy (APM) within the past 3–12 months.

METHODS: An assessor-blinded, randomized controlled trial including people age 30–50 yr with no to mild pain after medial APM was conducted. Participants were randomly allocated to either a 12-wk neuromuscular exercise program that targeted neutral lower limb alignment or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal-paced walking and during one-leg sit-to-stand. Secondary outcomes included additional measures of knee joint load distribution, patient-reported outcomes, maximal knee and hip muscle strength, and physical function measures.

RESULTS: Of 62 randomized participants, 60 (97%) completed the trial. There were no significant between-group differences in the change in peak knee adduction moment during normal-paced walking (mean difference (95% confidence interval), 0.22 (j0.11 to 0.55) NIm/body weight height %, P =0.19) or during one-leg sit-to-stand (j0.01 (j0.33 to 0.31) NIm/body weight height %, P = 0.95). There were also no significant between-group differences for any of the secondary outcomes.

CONCLUSIONS: In patients 3–12 months after a medial APM, a neuromuscular exercise program did not alter the peak knee adduction moment, a key predictor of osteoarthritis structural disease progression.

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