Effect of aerobic exercise of different intensity on articular cartilage metabolism in patients with knee osteoarthritis: a randomized controlled trial

Key Points

1. The high-intensity aerobic exercise group demonstrated the greatest reductions in biomarkers of cartilage metabolism, the largest improvements in clinical symptoms and functional capacity, as well as the greatest increases in cartilage thickness and volume.

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BACKGROUND & OBJECTIVE

Exercise therapy is recommended by all international guidelines as a first-line treatment for knee osteoarthritis (OA) to improve pain and physical function (1). Aerobic exercise has shown promise in alleviating OA symptoms and potentially modifying disease progression (2). However, the optimal intensity of aerobic exercise for managing knee OA remains a subject of debate and the pathways by which aerobic exercise influences cartilage metabolism in OA are not fully understood.

Therefore, the objective of this study was to investigate the effects of low-, moderate-, and high-intensity aerobic exercises on biomarkers reflecting cartilage metabolism, clinical symptoms, and functional outcomes in patients with knee OA.

Aerobic exercise has shown promise in alleviating OA symptoms and potentially modifying disease progression.

Patients with knee OA can safely undertake, and benefit from, more intense aerobic exercise than was previously thought, challenging traditional conservative exercise recommendations commonly prescribed for this population.

METHODS

• This study was a randomized controlled trial in which 120 participants with knee OA (Kellgren–Lawrence grade 2–3) were randomly assigned to one of four groups:

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