Ejercicio terapéutico en el agua en mujeres con artrosis de rodilla

Laburpena

ABSTRACT Resumen Osteoarthritis(OA) is one of the most prevalent pathologies in the populations that affects joints, this include among it´s clinical related disturbances the cartilage degradation, sinovial membrane inflamation and remodelation of subcondral bone. This pathology has a relevant impact on quality of life and physical functionality for the patients, generating high social cost. The prevalence of OA is higher in women and increases its incidence in older age, being the knee osteoarthritis the most prevalent one. Among risk factors, being overweight or obesity and female gender are among those most important ones. Among the therapeutic approaches for knee OA, therapeutic exercise has shown improvements on strength and motor control on the knee, with repercussions on stability. Addtionally, therapeutic exercise has shown significant reductions on symptoms and reducing the pathology progression. The main objective for this dissertation was to increase the knowledge about no pharmacology treatments for knee OA. The specific objectives were: describe the clinical profile of women with knee OA clasifing them by phenotype related to BMI, perceived health status and physical capacities related to functional status in women older than 60 years. Secondly, to compare the results of a aquatic exercise program vs land –based on sleep quality and functionality in women with knee OA and menopause. Thirdly, to evaluate the results of two different aquatic exercise programs on cardiorespiratory capacity, cardsiac frequency and fatigue on knee OA menopause women. To achieve those objectives, three experiments were developped. The obtained results shown that a phenotype related to BMI is characterized by a functionality status. Additionaly, we found significant differences among groups in WOMAC values, being higher in overweight and obesity patients. In the case of women with significant impaired function ths was related with higher impaired physical function and pain dimensions, movility and health status. A first randomized controlled clinical trial has developped were we analyzed the effects between a therapeutic aquatic program compared with a land-based program. The results obtained shown significant improvements on sleep quality, functionality and perceived health status. A second randomized controlled clinical trial focussed on results after an intervention of 8 weeks comparing aquatic dance vs an standarized aquatic program. We found significant improvements in function and cardiorespiratory capacity, with a reduction on cardiac frequency and fatigue after exercise. The improvements continued after 3 months of follow up in the aquatic dance group. In conclusion, the results of this dissertation show that BMI determines the reduction on physical and functional status on women with knee OA. Additionally, we found improvements after exercise in favor to aquatic based and to therapeutic dance when compared with other modalities. Those changes were maintained after three months after intervention.