Strength training to reduce knee pain

For many of the estimated 67 million people who will report physician–diagnosed arthritis by the year 2030, strength training may help reduce pain and improve function.

Building on the results of short-term studies showing the benefits of strength training on knee osteoarthritis (OA), professor of health and exercise science Stephen Messier will lead a five-year study to learn what level of strength training will help older adults the most.

For the study, called Strength Training for ARthritis Trial (START), Messier is recruiting 372 adults age 55 or older with knee OA.   The study is funded by a $3.9 million grant from the National Institutes of Health.

It will be the first long-term study to test the benefits of high-intensity strength training on older adults with knee OA.

“We want to know if long term strength training can reduce knee pain, improve function and slow the progression of osteoarthritis,” Messier said.

In an earlier pilot study, Messier and his fellow researchers confirmed that older adults with knee OA could tolerate high-intensity strength training.

There is some evidence that high intensity strength training can improve thigh composition—adding more muscle and reducing fat, he said.  “The increase in muscle and decrease in fat may lower knee pain and slow the progression of the disease.”

Results of this trial will provide important guidance for clinicians in a variety of health professions who prescribe and oversee treatment and prevention of OA-related complications.

Study volunteers will be randomly assigned to one of three groups: one will use a protocol of greater resistance and lower repetitions; another group will follow a lower resistance- higher repetition format, and a third group will attend healthy living classes and do stretching exercises.

The START study expands Messier’s previous research.  The Intensive Diet and Exercise for Arthritis (IDEA) study, also funded by the National Institutes of Health, showed a 50 percent reduction in pain for older adults who combined weight loss and exercise. The START study is focused on decreasing pain and increasing function for the same population.

Not everyone can be successful losing weight, Messier said.  Strength training could provide another option for older adults with knee OA.

Messier was also the co-principal investigator of the Fitness Arthritis in Seniors Trial (FAST) and the principal investigator of the Arthritis Diet and Activity Promotion Trial (ADAPT).

Researchers on the project include Shannon Milhalko, associate professor of health and exercise science, and several professors at Wake Forest Baptist Medical Center, including Richard Loesser, M.D., professor of molecular medicine.  Messier is also working with researchers in Boston, Australia and Austria on the study.

To find out more about the study and requirements for participants, go to the clinical trials web site or e-mail

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