The Effects of Aerobic and Resistance Exercise Therapy with and without Weight Bearing on the Outcomes of Stem Cell Therapy for Knee Osteoarthritis: A Randomized Clinical Trial

Background:

The objective of this trial was to evaluate the effect of two exercise programs on patients undergoing the implantation of intraarticular stem cells.

Objectives:

We performed a randomized trial on sixteen patients under 65 years old with moderate knee OA after stem cell therapy.

Methods:

Patients were randomly divided into two groups of exercise therapy: weight-bearing (WB) and non-weight-bearing (non-WB). This program lasted 12 weeks, with follow-ups at 1 and 3 months. Primary outcomes were knee pain (visual analog scale (VAS)) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)). Secondary outcomes included: standing time, walking distance, pain-free walking distance, time to jelling, and a subscale of stiffness and pain of WOMAC.

Results:

Fifteen patients were retained. No adverse effect was reported. There was a significant improvement in pain and physical function in both groups compared to the baseline. VAS: from 55±7.6 to zero (effect size of 1.34), total WOMAC: from 93.75±1.39 to 30.87±5.22 at 1-month and 21.87±6.99 at 3-month (1.88 and 2.73, respectively). For secondary outcomes, walking distance (from 750.0±267.26 meter to 2000.0±0.0 meter and 2500.0±0.0 meter, respectively, and time to jelling (at 3 months, from 5.00±0.0 minute to 35.00±16.90 minute) improved significantly better in WB group.

Conclusion:

Both types of exercises were safe and improved primary and secondary outcomes. WB exercise has additional benefits of more pain reduction and functional improvement.