Resistive Exercise for Arthritic Cartilage Health (REACH)

The Effect of 6 Month High Intensity Progressive Resistance Training on Knee Articular Cartilage Morphology in Female Osteoarthritic Patients

Female subjects over the age of 40 will be recruited and randomised into a progressive resistance training (PRT) or sham-exercise group. The PRT group will train at 80% of their peak strength, using Keiser pneumatic resistance machines, and progress approximately 3% per session. Strength will be re-assessed fortnightly. Exercises will target muscles around the hip and knee. The sham-exercise group will train on the same equipment as the PRT group except hip adduction, but without added resistance or progression. Both groups will train 3 days per week for roughly 45 minutes for 6 months. It is hypothesised that high intensity PRT will decelerate the tibial and femoral cartilage degeneration in the knee affected most by OA. Primary Outcome: Articular cartilage morphology following 6 months high intensity progressive resistance training Secondary Outcomes: Muscle and fat cross-sectional area (CSA) (pre and post) Muscle strength, power, endurance, and contraction velocity (pre, 3 months, & post) Medications (pre, 3 months, & post) Body composition (pre, 3 months, & post) Balance; Physical function (pre, 3 months, & post) Questionnaires (pre, 3 months, & post) Habitual exercise (PASE) -WOMAC index (pain, stiffness and functional ability) Depressive symptoms (Depression Scale) -Quality of life (SF36) Confidence performing physical activity (Ewart) -Demographics

Inclusion Criteria: Female Aged over 40 years old Primary Osteoarthritis in at least one knee using standard criteria of the American College of Rheumatology (ACR) criteria for classification of clinical osteoarthritis Ambulatory without human assistance Willingness to be randomised to experiential or control group Ability to attend scheduled exercise and testing sessions Exclusion Criteria: Regular exercise of any kind over the past 3 months (>1dpw). Secondary osteoarthritis (traumatic or post-surgical), rheumatic disease, gouty or septic arthritis, Paget's disease, pseudogout, major congenital abnormalities, hemochromatosis, Wilson's disease and other rare forms of arthritis Joint injury, injection or surgery within the past 6 months or knee joint replacement Contraindications to MRI/Exercise