High- Versus Low-Dose Exercise Therapy for Knee Osteoarthritis

LettersJuly 2023High- Versus Low-Dose Exercise Therapy for Knee OsteoarthritisJesper Knoop, PhD, Joost Dekker, PhD, Marike van der Leeden, PhD, Martin van der Esch, PhD, Raymond W.J.G. Ostelo, PhDJesper Knoop, PhDVrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, the NetherlandsSearch for more papers by this author, Joost Dekker, PhDAmsterdam UMC, Amsterdam, the NetherlandsSearch for more papers by this author, Marike van der Leeden, PhDAmsterdam UMC and Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, the NetherlandsSearch for more papers by this author, Martin van der Esch, PhDAmsterdam Rehabilitation Research Centre, Reade, and Amsterdam University of Applied Sciences, Amsterdam, the NetherlandsSearch for more papers by this author, Raymond W.J.G. Ostelo, PhDVrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, the NetherlandsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L23-0140 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: We read Torstensen and colleagues' article (1) with great interest. We compliment the authors on a thoroughly well-designed randomized controlled trial in which 2 doses of exercise therapy were compared in patients with knee osteoarthritis. Although both groups improved in all outcomes, the results did not support the authors' hypothesis that high-dose exercise is superior to low-dose exercise—similar to results from 2 other recent trials (2, 3). The authors describe some potential explanations for their findings.First, they suggest that central sensitization may play a role in the effect of exercise therapy, regardless of its dose.Second, ...References1. Torstensen TA, Østerås H, LoMartire R, et al. High- versus low-dose exercise therapy for knee osteoarthritis. A randomized controlled multicenter trial. Ann Intern Med. 2023;176:154-165. [PMID: 36689746] doi:10.7326/M22-2348 LinkGoogle Scholar2. de Zwart AH, Dekker J, Roorda LD, et al. High-intensity versus low-intensity resistance training in patients with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 2022;36:952-967. [PMID: 35331018] doi:10.1177/02692155211073039 CrossrefMedlineGoogle Scholar3. Messier SP, Mihalko SL, Beavers DP, et al. Effect of high-intensity strength training on knee pain and knee joint compressive forces among adults with knee osteoarthritis: the START randomized clinical trial. JAMA. 2021;325:646-657. [PMID: 33591346] doi:10.1001/jama.2021.0411 CrossrefMedlineGoogle Scholar4. Edelaar LM, van Dieën JH, van der Esch M, et al. Nonlinear relationship between isokinetic muscle strength and activity limitations in patients with knee osteoarthritis: results of the Amsterdam-Osteoarthritis cohort. J Rehabil Med. 2017;49:598-605. [PMID: 28661545] doi:10.2340/16501977-2252 CrossrefMedlineGoogle Scholar5. Dekker J, Sears SF, Åsenlöf P, et al. Psychologically informed health care. Transl Behav Med. 2023;13:289-296. [PMID: 36694354] doi:10.1093/tbm/ibac105 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Jesper Knoop, PhD; Joost Dekker, PhD; Marike van der Leeden, PhD; Martin van der Esch, PhD; Raymond W.J.G. Ostelo, PhDAffiliations: Vrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, the NetherlandsAmsterdam UMC, Amsterdam, the NetherlandsAmsterdam UMC and Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, the NetherlandsAmsterdam Rehabilitation Research Centre, Reade, and Amsterdam University of Applied Sciences, Amsterdam, the NetherlandsVrije Universiteit Amsterdam and Amsterdam UMC, Amsterdam, the NetherlandsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L23-0140. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHigh- Versus Low-Dose Exercise Therapy for Knee Osteoarthritis Tom Arild Torstensen , Håvard Østerås , Riccardo LoMartire , Georg Mørtvedt Rugelbak , Wilhelmus Johannes Andreas Grooten , and Björn Olov Äng High- Versus Low-Dose Exercise Therapy for Knee Osteoarthritis Tom Arild Torstensen , Håvard Østerås , Riccardo LoMartire , Georg Mørtvedt Rugelbak , Wilhelmus Johannes Andreas Grooten , Björn Olov Äng Metrics Current IssueJuly 2023Volume 176, Issue 7KeywordsExercise therapyKneesOsteoarthritisRandomized trials ePublished: 18 July 2023 Issue Published: July 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...