Learning Objective #1: Describe changes in pain, muscle strength, and proprioception in adults with osteoarthritis of the knee who participated in an eight week program of exercise

Learning Objective #2: Discuss the relationships between exercise adherence and changes in pain, muscle strength, and proprioception in adults with osteoarthritis of the knee

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This study examined the relationships between adherence to an eight-week, home-based, muscle-strength-training program and improvements in knee pain, quadriceps muscle strength, knee proprioception, stiffness, and difficulty with physical activity in patients with osteoarthritis (OA) of the knee. The relationships between exercise self-efficacy, self-determinism for exercise and adherence were examined. The study used a pre-test post-test design and was guided by the Interaction Model for Client Health Behavior. A purposive sample was recruited from outpatient rheumatology clinics and through advertisement. Questionnaires on pain, stiffness, difficulty with physical activity, exercise self-efficacy, and self-determinism for exercise were completed at baseline and post-intervention. Quadriceps muscle strength and proprioception testing were performed at baseline and post-intervention. Subjects received a history and physical, knee radiographs, and instruction of strengthening exercises at baseline. Adherence was measured with a self-report diary of frequency of exercise. Telephone reinforcement calls were made at two-week intervals during the eight-week exercise period. The total average adherence rate was 82.9% with a significant decline occurring over the course of the study. Baseline to post-intervention measures of pain, quadriceps muscle strength, stiffness, and difficulty with physical activity improved significantly. There was no significant change in proprioception. There was a significant correlation between total adherence rate and improvement in stiffness. No significant correlations were found between total adherence rate and improvements in pain, quadriceps muscle strength, or difficulty with physical activity. Exercise self-efficacy declined over the course of the study and was significantly correlated to adherence. There was a significant increase in self-determinism for exercise over the course of the study but no correlation was found between self-determinism for exercise and adherence. The findings of this study indicate that strength-training exercises are associated with improvements in pain, quadriceps muscle strength, stiffness, and difficulty with physical activity. Exercise adherence was correlated with improvements in stiffness.