RESEARCH ARTICLE
Physical Exercise and Weight Loss for Hip and Knee Osteoarthritis in Very Old Patients: A Systematic Review of the Literature
Jean-Laurent Le Quintrec 1, Bernard Verlhac 2, Christian Cadet 3, Philippe Bréville 4, Jean M Vetel 5, Jean B Gauvain 6, Claude Jeandel 7, Emmanuel Maheu*, 8
Article Information
Identifiers and Pagination:
Year: 2014Volume: 8
First Page: 89
Last Page: 95
Publisher ID: TORJ-8-89
DOI: 10.2174/1874312901408010089
Article History:
Received Date: 10/6/2014Revision Received Date: 16/10/2014
Acceptance Date: 16/10/2014
Electronic publication date: 28 /11/2014
Collection year: 2014
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
Abstract
Background :
Rheumatologic and geriatric scholarly organisations recommendations for the management of hip and knee osteoarthritis, which emphasise the usefulness of non-pharmacological therapies, are not scaled according to patient’s age and physical condition. We conducted a systematic review of clinical trials on exercise and weight loss in hip and knee osteoarthritis in very old patients.
Methods :
Electronic search in MEDLINE, EMBASE, PASCAL database, systematic search of the Cochrane Reviews, manual search in guidelines, meta-analyses and identified relevant articles.
Results :
We identified 83 trials, with only 2 on patients aged ≥ 75 years; we therefore lowered the mean age threshold to 70 years and found 15 trials, mainly performed in knee osteoarthritis and outpatients.
Physical exercise (8 trials):
was effective on pain and function (4 controlled trials), with a persistent effect only in case of self-rehabilitation.
Aquatic exercise (5 trials):
was as effective as land-based exercise.
Weight loss (2 trials):
only patients under diet + exercise had significant improvement on symptoms.
Conclusion :
Our systematic review confirms that international recommendations on exercise for knee osteoarthritis also apply to subjects aged 70-80 years. Long-term effectiveness requires a maintenance strategy. Specific trials on very old patients with various comorbidities are mandatory, given that these subjects are more exposed to drug-related iatrogenesis.
