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A periodized training attenuates thigh intermuscular fat and improves muscle quality in patients with knee osteoarthritis: results from a randomized controlled trial

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Abstract

Objective

To analyze the influence of a 14-week periodized circuit training (CT) protocol on thigh intermuscular fat and muscle quality (force per unit area of lean tissue) in patients with knee osteoarthritis (KOA).

Design

Randomized controlled trial

Methods

Sixty-one selected participants with KOA grades 2 and 3, 40–65 years old, and BMI < 30 kg/m2 were randomized into three groups: CT, conventional strength training (ST), and educational protocol (EP). The CT and ST protocols consisted of 14-week training protocols conducted 3 times a week. The CT group performed exercises stratified as light, moderate, and intense, arranged progressively in a circuit model. The ST group performed conventional strength exercises, and the EP group participated in lectures twice a month about healthy lifestyles. Baseline and follow-up (week 0 and week 14) evaluations were conducted for thigh intermuscular fat (computed tomography), knee extension maximal isometric voluntary contraction (MIVC), and muscle quality (knee extension MIVC/muscle mass cross-sectional area).

Results

Only the CT group presented significant reductions in thigh intermuscular fat (p = 0.003) and significantly lower values in week 14 compared with the EP (p = 0.032). Both trained groups presented significant increases in muscle mass area (p=0.002 for CT and p=0.008 for ST) and increments in knee extension MIVC (p=0,033 for CT nd p=0.019 for ST) in week 14 compared with the EP and increases in muscle quality (p = 0.004 and 0.042).

Conclusion

It can be concluded that a 14-week periodized CT protocol attenuates thigh intermuscular fat and improves muscle quality in patients with KOA.

Trial registration

ClinicalTrials.gov, NCT02761590; https://clinicaltrials.gov/ct2/show/NCT02761590

Key Points

•Fourteen weeks of periodized circuit training attenuates thigh intermuscular fat in patients with knee osteoarthritis.

•Circuit training is as effective as strength training for improving muscle mass, strength, and quality.

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Acknowledgements

The authors would like to thank Hugo Alexandre Puretachi and Oswaldo Jorge Neto, radiologist technicians at University Hospital of the Federal University of São Carlos, for performing the radiography and computed tomography examinations.

Funding

This work was financially supported by the São Paulo Research Foundation (FAPESP process numbers 2016/05047-3 and 2013/00798-2) and the Coordination for the Improvement of Higher Education Personnel (CAPES).

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Authors and Affiliations

  1. Department of Physical Therapy, Federal University of São Carlos (UFSCar), Washington Luís Rd, 235 km - SP-310, São Carlos, SP, 13565-905, Brazil

    Aline Castilho de Almeida, Jessica Bianca Aily, Maria Gabriela Pedroso & Stela Marcia Mattiello

  2. Integrated Health Institute, Federal University of Mato Grosso do Sul (UFMS), Costa e Silva Av., Campo Grande, MS, 79070-900, Brazil

    Glaucia Helena Gonçalves

  3. Department of Computer Science, Federal University of São Carlos (UFSCar), Washington Luís Rd, 235 km - SP-310, São Carlos, SP, 13565-905, Brazil

    Jonas de Carvalho Felinto & Ricardo José Ferrari

  4. Department of Physical Therapy, São Paulo State University (UNESP), 305 Roberto Simonsen St., Presidente Prudente, SP, 19060-900, Brazil

    Carlos Marcelo Pastre

Authors
  1. Aline Castilho de Almeida
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  2. Jessica Bianca Aily
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  3. Maria Gabriela Pedroso
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  4. Glaucia Helena Gonçalves
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  5. Jonas de Carvalho Felinto
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  7. Carlos Marcelo Pastre
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  8. Stela Marcia Mattiello
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Contributions

All authors contributed to the study conception and design. ACA, CMP, and SMM conceptualized the circuit training protocol; ACA, MGP, and JBA conducted the pilot study. ACA, MGP, JBA, and SMM established the selection criteria; GHG was in charge of the sample size calculation, randomization, and data analyses conceptualization. JCF and RJF conducted the computed tomography scan analyses. All authors read and made comments on previous drafts of the manuscript and approved the final manuscript.

Corresponding author

Correspondence to Aline Castilho de Almeida.

Ethics declarations

This study was approved by the Research in Human Ethics Committee of the Federal University of São Carlos-SP. Participants were informed about the procedures prior to participation in the study; after agreeing to participate, informed consent was obtained and the rights of subjects were protected. This study was conducted according to Resolution 466/12 norms of the National Health Council on research involving humans and complies with the Declaration of Helsinki [30].

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de Almeida, A.C., Aily, J.B., Pedroso, M.G. et al. A periodized training attenuates thigh intermuscular fat and improves muscle quality in patients with knee osteoarthritis: results from a randomized controlled trial. Clin Rheumatol 39, 1265–1275 (2020). https://doi.org/10.1007/s10067-019-04892-9

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  • DOI: https://doi.org/10.1007/s10067-019-04892-9

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