Concentric or eccentric physical activity for patients with symptomatic osteoarthritis of the knee: a randomized prospective study

Marie-Charlotte Trojani; Fréderic Chorin; Pauline Gerus; Véronique Breuil; Constance Michel; Sandrine Guis; David Bendahan; Christian Roux

doi:10.1177/1759720X221102805

Concentric or eccentric physical activity for patients with symptomatic osteoarthritis of the knee: a randomized prospective study

Ther Adv Musculoskelet Dis. 2022 Jul 7:14:1759720X221102805. doi: 10.1177/1759720X221102805. eCollection 2022.

Authors

Marie-Charlotte Trojani¹, Fréderic Chorin², Pauline Gerus², Véronique Breuil¹, Constance Michel³, Sandrine Guis⁴, David Bendahan³, Christian Roux¹

Affiliations

¹ Department of Rheumatology, Nice University Hospital, Université Côte d'Azur, Nice, France.
² LAMHESS Laboratory, HEALTHY Graduate School, Université Côte d'Azur, Nice, France.
³ Center for Biological and Medical Magnetic Resonance, Faculty of Medicine of La Timone, Aix Marseille University, CNRS (UMR 7339), Marseille, France.
⁴ Department of Rheumatology, Conception Hospital, Marseille, France.

Abstract

Background: Knee osteoarthritis-related pain limits physical function and leads to functional disability. Physical activity is one of the central recommendations for the management of knee osteoarthritis. Although concentric muscle activities are often preferred to eccentric ones, the corresponding rationale remains controversial.

Objective: To explore the effect of a 6-week exercise program on function, pain, and performance in patients with symptomatic knee osteoarthritis.

Methods: Patients with symptomatic knee osteoarthritis were included in the prospective EX-ART project (Walking performance in osteoARThritic subjects: effect of an ECCentric muscle strengthening program) and randomized in a 6-week rehabilitation program including either eccentric or concentric activities. Metrics of interest chosen as end points measured before and after the rehabilitation were WOMAC score, pain, and muscular performance (quadriceps power P_MAX and contraction strength M_MAX). MRI was also used to assess muscle volume and fat infiltration changes.

Results: 30 patients were included in each group; mean age was 74 (±7.6); 69% were women. At week 6, both groups showed a significant improvement in the WOMAC without difference between the two groups (p = 0.7). No difference between the two groups was identified for the pain reduction (p = 0.7). A significant improvement in the change in P_MAX and M_MAX at high velocity (p = 0.001 and p = 0.002) was observed in the eccentric group only. A vastus medialis hypertrophy was quantified in the eccentric group only (p = 0.002), whereas fat infiltration in the quadriceps muscles was unchanged.

Conclusion: Physical activity, whether eccentric or concentric, has a benefit on function and pain in patients with symptomatic knee osteoarthritis. A few differences have been identified between the two types of rehabilitation. More particularly, a gain in muscle performance and vastus medialis volume was found with eccentric rehabilitation only.

Registration: www.ClinicalTrials.gov, registration number NCT03167502.

Keywords: concentric; eccentric; knee; osteoarthritis; quadriceps; rehabilitation.

Associated data

ClinicalTrials.gov/NCT03167502