Role Of Functional Training Versus Resistance Training In Knee Osteoathritis Population- A Comparative Study
Keywords:
Knee osteoarthritis, functional training, resistance training, physical therapy, pain management, WOMAC, VAS, mobility, conservative treatmentAbstract
Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disorder affecting over 250 million individuals globally. It is characterized by progressive cartilage degeneration, joint space narrowing, osteophyte formation, and synovial inflammation, leading to chronic pain, reduced mobility, and decreased quality of life, especially in elderly populations. Conservative, non-pharmacological approaches such as exercise therapy are widely recommended for early and mid-stage OA management. Two frequently employed interventions are resistance training (RT) and functional training (FT), each with distinct objectives—RT aims to build muscle strength and reduce joint load, whereas FT focuses on improving real-world mobility, balance, and neuromuscular coordination. However, comparative data on their relative efficacy in OA rehabilitation remains limited.
Objective: This study aimed to compare the therapeutic effects of functional training and resistance training in individuals with knee OA, with a focus on pain reduction, joint function, and quality of life improvements.
Methodology: A total of 60 participants with clinically diagnosed knee OA were randomly divided into two equal groups: Group A (Functional Training + Standard Exercise) and Group B (Resistance Training + Standard Exercise). The interventions were administered over a structured rehabilitation period, and outcomes were measured pre- and post-intervention using the Visual Analogue Scale (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional assessment. Age and gender-based sub-analyses were conducted.
Results: Both interventions yielded statistically significant improvements in VAS and WOMAC scores (p < 0.05). However, the functional training group demonstrated greater reductions in pain and superior improvements in physical function compared to the resistance training group across most age and gender subgroups. Functional training also resulted in better postural control and real-life mobility outcomes.
Conclusion: While both exercise modalities effectively reduced symptoms and improved function in knee OA patients, functional training proved more beneficial in enhancing dynamic movement, balance, and task-specific performance. These findings support the incorporation of functional training as a preferred conservative intervention in knee OA rehabilitation protocols. Further research is warranted to explore long-term effects and feasibility in diverse patient populations
Downloads
References
American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee: Evidence-based guideline. 2nd ed. Rosemont (IL): AAOS; 2013.
Hame SL, Alexander RA. Knee osteoarthritis in women. Curr Rev Musculoskelet Med. 2013;6(2):182–187.
Roos EM. Joint injury causes knee osteoarthritis in young adults. Curr Opin Rheumatol. 2005;17(2):195–200.
Felson DT, Zhang Y, Hannan MT, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly: the Framingham Study. Arthritis Rheum. 1997;40(4):728–733.
Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18(1):24–33.
Neelapala R, Sathyaprakash R, Kumar S. Influence of hip muscle strength in the management of knee osteoarthritis. Indian J Physiother Occup Ther. 2017;11(1):95–100.
Cookson C, Kent P. Manual therapy for knee osteoarthritis: a systematic review. J Bodyw Mov Ther. 2015;19(3):473–486.
AbouSawan J, Jabbour G, Alzharani M. Resistance training in knee osteoarthritis: A systematic review. J Geriatr Phys Ther. 2020;43(3):168–175.
Strasser B, Schobersberger W. Evidence for resistance training as a treatment therapy in obesity. J Obes. 2011;2011:482564.
Singh NA, Clements KM, Fiatarone MA. A randomized controlled trial of progressive resistance training in depressed elders. J Gerontol A Biol Sci Med Sci. 1997;52(1):M27–M35.
Hinman RS, Bennell KL, Metcalf BR, Crossley KM. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology. 2002;41(12):1388–1394.
Core Health & Fitness. Functional Training White Paper. 2023. [Internet].
Hopes S. What is functional exercise? Medical News Today. 2022. [Internet].
Lee M, Song C, Lee K, et al. Effects of stepper exercise on fitness in older adults. J Phys Ther Sci. 2020;32(3):195–200.
Donath L, Roth R, Zahner L, Faude O. Effects of unstable vs. stable surface training on postural control: a systematic review and meta-analysis. Sports Med. 2016;46(4):591–602.
Gandbhir VN, Nagathan DS, Dhotre PS. Clinical utility of goniometric ROM measurement in knee OA assessment. Int J Orthop Sci. 2019;5(1):38–41.
Gould D, Kelly D, Goldstone L, Gammon J. Examining the use of the visual analogue scale in the assessment of pain. Nursing Times. 2001;97(30):32–36.
Pinskerova V, Vavrik P. The motion of the knee joint in relation to flexion axes. J Biomech. 2020;103:109–114.
Al-Mahmood MR, Uddin MN, Hoque N, et al. Correlation between goniometric measurements of range of motion and radiographic scores in osteoarthritis knee. J Evid Based Med Healthc. 2021;8(35):3146–3151.
Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. PM R. 2012;4(5 Suppl):S45–S52.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
