The Effects of Aerobic and Resistance Exercise Therapy with and without Weight Bearing on the Outcomes of Stem Cell Therapy for Knee Osteoarthritis: A Randomized Clinical Trial

Background. The objective of this trial was to evaluate the effect of two exercise programs on patients undergoing the implantation of intraarticular stem cells. Objectives. We performed a randomized trial on sixteen patients under 65 years old with moderate knee OA after stem cell therapy. Methods. Patients were randomly divided into two groups of exercise therapy: weight-bearing (WB) and non-weight-bearing (non-WB). This program lasted 12 weeks, with follow-ups at 1 and 3 months. Primary outcomes were knee pain (visual analog scale (VAS)) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)). Secondary outcomes included: standing time, walking distance, pain-free walking distance, time to jelling, and a subscale of stiffness and pain of WOMAC. Results. Fifteen patients were retained. No adverse effect was reported. There was a significant improvement in pain and physical function in both groups compared to the baseline. VAS: from 55±7.6 to zero (effect size of 1.34), total WOMAC: from 93.75±1.39 to 30.87±5.22 at 1-month and 21.87±6.99 at 3-month (1.88 and 2.73, respectively). For secondary outcomes, walking distance (from 750.0±267.26 meter to 2000.0±0.0 meter and 2500.0±0.0 meter, respectively, and time to jelling (at 3 months, from 5.00±0.0 minute to 35.00±16.90 minute) improved significantly better in WB group. Conclusion. Both types of exercises were safe and improved primary and secondary outcomes. WB exercise has additional benefits of more pain reduction and functional improvement.