The effect of exercise to improve the performance of the muscles of the lower limbs to reduce pain in the knee joint in patients with osteoarthritis of the knee

Uvod: Osteoartroza je progresivna, degenerativna bolezen sinovialnih sklepov. Za artrozo so značilni lokalizirani predeli izgube sklepnega hrustanca na področju sinovialnih sklepov. Artrozo spremljajo podhrustančne spremembe kosti, tvorba kostnih izrastkov na področju obrobja sklepov, zadebelitev sklepne ovojnice ter vnetje sinovialne ovojnice. Prisotna je oslabelost mišic in ohlapnost ligamentov. Primarna simptoma osteoartroze sta bolečina v prizadetem sklepu ter jutranja okorelost. Telesna vadba je del fizioterapevtske obravnave posameznika z osteoartrozo kolenskega sklepa, ki igra pomembno vlogo pri zmanjšanju bolečine in izboljšanju mobilnosti posameznika. Namen: Namen diplomskega dela je, da na podlagi pregleda literature ugotovimo vpliv različnih vrst vadbe za izboljšanje zmogljivosti mišic spodnjih udov in s tem posledično zmanjšati bolečino v kolenskem sklepu pri pacientih z artrozo kolena. Metode dela: Literaturo smo iskali v podatkovni zbirki PubMed, članki so ocenjeni po PEDro lestvici. Uporabljene so bile naslednje ključne besede in besedne zveze: osteoarthritis AND physiotherapy, knee osteoarthritis AND quariceps, osteoarthritis AND quadriceps strengthening exercise AND pain, quadriceps exercise AND pain. Rezultati: V pregled literature smo na podlagi vključitvenih in izključitvenih kriterijev vključili sedem randomiziranih kontroliranih raziskav, napisanih v angleškem jeziku. V raziskavah so izvajali vadbo za izboljšanje zmogljivosti mišic spodnjih udov. Vaba je trajala od 6 do 12 tednov. V vseh raziskavah so ocenjevali bolečino, medtem ko je bila v šestih raziskavah ocenjena tudi zmogljivost mišic spodnjih udov. Rezultati raziskav so pokazali, da je vadba za izboljšanje zmogljivosti mišic spodnjih udov vplivala na zmanjšanje bolečine, manj pa se kaže kot učinkovita pri izboljšanju zmogljivosti mišic spodnjih udov. Razprava in zaključek: Na podlagi rezultatov lahko potrdimo, da ima vadba za izboljšanje zmogljivosti mišic spodnjih udov pomembno vlogo pri obravnavi pacientov z osteoartrozo kolena zaradi pozitivnega učinka tako na bolečino kot mišično zmogljivost, vendar zaradi neprimerljivosti raziskav ne moremo podati jasnih zaključkov o najučinkovitejšem vadbenem programu in najbolj optimalnih parametrih vadbenih programov.Introduction: Osteoarthritis is a progressive, degenerative disease of the synovial joints. Arthrosis is characterised by localised areas of articular cartilage loss in the synovial joints. Arthrosis is accompanied by subchondral bone changes, bone spur formation at the joint margins, thickening of the joint capsule and inflammation of the synovial capsule. Muscle weakness and ligament laxity are present. The primary symptoms of osteoarthritis are pain in the affected joint and morning stiffness. Exercise is part of physiotherapy treatment, which plays an important role in reducing the reduction in improving the mobility of the individual. Purpose: The aim of this thesis is to determine the impact of different types of exercise on improving lower limb muscle performance and, consequently, reducing knee joint pain in patients with knee arthrosis based on a literature review. Methods used: We searched literature using the PubMed database, and articles were rated according to the PEDro scale. The following English keywords and phrases have been used: osteoarthritis AND physiotherapy, knee osteoarthritis AND quadriceps, osteoarthritis AND quadriceps strengthening exercise AND pain, quadriceps exercise AND pain. Results: We included seven studies written in English in the literature review based on inclusion and exclusion criteria. Studies have been carried out to improve the performance of lower limb muscles. Exercise lasted 6 to 12 weeks. All studies assessed pain, while six studies also assessed muscle performance. Study results have shown that exercise aimed at improving lower limb muscle performance effectively reduces pain, but is less effective in improving lower limb muscle performance. Discussion and conclusion: Based on the results, we can confirm that exercise aimed at improving lower limb muscle performance plays an important role in the treatment of patients with knee osteoarthritis due to its positive effect on both pain as well as muscle performancehowever, due to the non-comparability of the studies, we cannot draw clear conclusions regarding the most effective exercise programme and the most optimal exercise programme parameters