Patients with knee osteoarthritis often have weakness of their hip abductor muscles.  Knee osteoarthritis patients have also been shown to have altered biomechanics at the hip, leading to abnormal loading on the medial side of their knee joint.  This increase in loading is thought to result in an increased knee adductor moment during gait because of weak hip abductors.

Several studies have shown that TheraBand elastic resistance exercise can decrease pain and increase function in patients with knee osteoarthritis.

The home exercise program included side lying and standing hip abduction strengthening, progressing to elastic bands.  After 8 weeks, the osteoarthritis group significantly increased their hip abduction strength to reach the level equal to the non-arthritis group.  In addition, the patients significantly improved their functional performance and reduced their knee pain. Interestingly, however, while the patients improved their strength, pain and function, their knee adduction moment remained the same.  The authors concluded that hip strengthening exercises in patients with knee osteoarthritis can increase hip strength and function, but do not improve joint knee joint loading.

While the elastic-resisted exercises were performed in both weight-bearing and non-weight-bearing positions, it’s possible that different exercises may be necessary to improve the hip adductor moment.  Nonetheless, the results of this study agree with other studies showing that Thera-Band exercise bands can be used effectively to reduce pain and increase strength and function in knee osteoarthritis patients.

Be sure and discuss your spinal and non-spinal conditions, as many of the exercises we can prescribe are able to help a wide variety of problems, especially associated with the inevitability of joint degeneration. 

REFERENCE: Sled EA, Khoja L, Deluzio KJ, Olney SJ, Culham EG. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: a clinical trial. Phys Ther. 2010 Jun;90(6):895-904. Epub 2010 Apr 8.

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Muscular power and reaction time are also important components of function and injury prevention for older adults; specifically, reduced strength of ankle dorsiflexion is associated with an increased risk of falls (Skelton et al. 2002; Whipple et al. 1987). In addition, decreased reaction time is associated with increased falls and motor vehicle accidents in older adults. Power training, which is essentially strength training performed at higher velocities, is becoming increasingly popular for older adult exercise programs.  Many studies have shown that strength training exercises can increase strength and function in older adults, but few if any have examined effects of ankle power training on performance or injury prevention in older adults. In addition, few studies have directly compared elastic and isotonic resistance training programs.

Canadian researchers investigated the effects of power training with Thera-Band® exercise bands compared to machine-based resistance training for ankle dorsiflexor and plantarflexor muscles. They wanted to see if there was a difference in reaction time, movement speed, muscular strength and power after a 12 week training program. They randomly assigned 62 women over 70 years old with mobility limitations to a Thera-Band group, machine group, or control group that performed only upper body flexibility exercise. The machine group performed 8-10 repetitions of ankle dorsiflexion and plantarflexion against 80% of 1RM resistance level. The Thera-Band group performed 3 sets of 8 repetitions on dorsiflexion and plantarflexion as well. Both groups performed the concentric phase “as fast as possible” and the eccentric phase in a slow and controlled manner for 2 to 3 seconds. Both groups progressed the resistance after 2 to 3 weeks.

The women completing the power training program with Thera-Band resistance significantly improved their movement speed in a “braking task” similar to applying the brake in a car. This finding is important, according to the authors, because slower reaction and movement times are associated with increased risk of motor vehicle accident, as well as increased risk of falls and decreased functional performance. All groups (including the control group) significantly improved in strength and power.

The authors concluded, “Training with elastic bands represents a low-cost, practical form of exercise that would be considered an addition to programs designed to address mobility limitations in older adults.”  This study suggests that power training with Thera-Band elastic bands can help improve reaction time and movement speed in older adults, which may have important implications in reducing injury risk and improving functional performance.

REFERENCE: Webber SC, Porter MM. Effects of ankle power training on movement time in mobility-impaired older women. Med Sci Sports Exerc. 2010 Jul;42(7):1233-40.

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