Advantages of exercise in rehabilitation, treatment and prevention of altered morphological features in knee osteoarthritis. A narrative review

Histology and Histopathology

Volumn 29, Issue 6, 2014, Pages 707-719

  Musumeci, Giuseppe ^a   Loreto, Carla ^a   Imbesi, Rosa ^a   Trovato, Francesca Maria ^a   Giunta, Angelo Di ^b   Lombardo, Claudia ^a   Castorina, Sergio ^a,b   Castrogiovanni, Paola ^a  

^a UNIVERSITY OF CATANIA   (Italy)

^b Fondazione Mediterranea GB Morgagni   (Italy)

Author keywords

Exercise; Knee osteoarthritis; Prevention; Rehabilitation

Indexed keywords

HUMAN; KINESIOTHERAPY; KNEE; OSTEOARTHRITIS, KNEE; PATHOLOGY;

EXERCISE THERAPY; HUMANS; KNEE JOINT; OSTEOARTHRITIS, KNEE;

EID: 84899719477     PISSN: 02133911     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (100)

1. Bartels E.M., Lund H., Hagen K.B., Dagfinrud H., Christensen R. and Danneskiold-Samse B. (2007). Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst. Rev. 4, CD005523.
2. Bennell K.L. and Hinman R.S. (2011). A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J. Sci. Med. Sport. 14, 4-9.
3. Berbert A.A., Kondo C.R., Almendra C.L., Matsuo T. and Dichi I. (2005). Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Nutrition 21, 131-136.
4. Brismee J.M., Paige R.L., Chyu M.C., Boatright J.D., Hagar J.M., McCaleb J.A., Quintela M.M., Feng D., Xu K.T. and Shen C.L. (2007). Group and home-based Tai Chiin elderly subjects with knee osteoarthritis: a randomized controlled trial. Clin. Rehabil. 21, 99-111.
5. Bonnet C.S. and Walsh D.A. (2005). Osteoarthritis, angiogenesis and inflammation. Rheumatology (Oxford) 44, 7-16.
6. Callahan L.F., Mielenz T., Freburger J., Shreffler J., Hootman J., Brady T., Buysse K. and Schwartz T. (2008). A randomized controlled trial of the people with arthritis can exercise program: Symptoms, function, physical activity, and psychosocial outcomes. Arthritis Rheum. 59, 92-101.
7. Catalano D., Trovato G.M., Pace P., Martines G.F. and Trovato F.M. (2013). Mediterranean diet and physical activity: An intervention study. Does olive oil exercise the body through the mind? Int. J. Cardiol. 68, 4408-4409.
8. Cardile V., Musumeci G., Sicurezza E., Caggia S., Rusu M.C., Leonardi R. and Loreto C. (2013). TRAIL and its receptors DR5 and DcR2 expression, in Orthodontic Tooth Movement. Histol Histopathol. 28, 933-940.
9. Chua S.D. Jr, Messier S.P., Legault C., Lenz M.E., Thonar E.J. and Loeser R.F. (2008). Effect of an exercise and dietary intervention on serum biomarkers in overweight and obese adults with osteoarthritis of the knee. Osteoarth. Cartil. 16, 1047-1053.
10. Cicerale S., Lucas L.J. and Keast R.S. (2012). Antimicrobial, antioxidant and anti-inflammatory phenolic activities in extra virgin olive oil. Curr. Opin. Biotechnol. 23, 129-135.
11. Eckstein F., Hudelmaier M. and Putz R. (2006). The effects of exercise on human articular cartilage. J. Anat. 208, 491-512.
12. Egloff C., Hügle T. and Valderrabano V. (2012). Biomechanics and pathomechanisms of osteoarthritis. Swiss Med. Wkly. 142, w13583.
13. Ernst E. (2000). Complementary and al ternat ive medicine in rheumatology. Baillieres Best. Pract. Res. Clin. Rheumatol. 14, 731-749.
14. Farr J.N., Going S.B., McKnight P.E., Kasle S., Cussler E.C. and Cornett M. (2010). Progressive resistance training improves overall physical activity levels in patients with early osteoarthritis of the knee: A randomized controlled trial. Phys. Ther. 90, 356-366.
15. Foroughi N., Smith R.M., Lange A.K., Baker M.K., Fiatarone Singh M.A. and Vanwanseele B. (2011). Lower limb muscle strengthening does not change frontal plane moments in women with knee osteoarthritis: A randomized controlled trial. Clin. Biomech. (Bristol, Avon) 26, 167-174.
16. Fransen M. and McConnell S. (2008). Exercise for osteoarthritis of the knee. Cochrane Database Syst. Rev. 4, CD004376.
17. Garnero P., Rousseau J.C. and Delmas P.D. (2000). Molecular basis and clinical use of biochemical markers of bone, cartilage, and synovium in joint diseases. Arthritis Rheum. 43, 953-968.
18. Glass N.A., Torner J.C., Frey Law L.A., Wang K., Yang T., Nevitt M.C., Felson D.T., Lewis C.E. and Segal N.A. (2013). The relationship between quadriceps muscle weakness and worsening of knee pain in the MOST cohort: a 5-year longitudinal study. Osteoarthritis Cartilage 21, 1154-1159.
19. Gupta S., Hawker G.A., Laporte A., Croxford R. and Coyte P.C. (2005). The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford). 44, 1531-1537.
20. Hayami T., Funaki H., Yaoeda K., Mitui K., Yamagiwa H., Tokunaga K., Hatano H., Kondo J., Hiraki Y., Yamamoto T., Duong le T. and Endo N. (2003). Expression of the cartilage derived anti-angiogenic factor chondromodulin-I decreases in the early stage of experimental osteoarthritis. J. Rheumatol. 30, 2207-2217.
21. Hinman R.S., Hunt M.A., Creaby M.W., Wrigley T.V., McManus F.J. and Bennell K.L. (2010). Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res. (Hoboken) 62, 1190-1193.
22. Impellizzeri D., Esposito E., Mazzon E., Paterniti I., Di Paola R., Morittu V.M., Procopio A., Britti D. and Cuzzocrea S. (2011). Oleuropein aglycone, an olive oil compound, ameliorates development of arthritis caused by injection of collagen type II in mice. J. Pharmacol. Exp. Ther. 339, 859-869.
23. Jan M.H., Lin J.J., Liau J.J., Lin Y.F. and Lin D.H. (2008). Investigation of clinical effects of high-and low-resistance training for patients with knee osteoarthritis: A randomized controlled trial. Phys. Ther. 88, 427-436.
24. John T., Stahel P.F., Morgan S.J. and Schulze-Tanzil G. (2007). Impact of the complement cascade on posttraumatic cartilage inflammation and degradation. Histol. Histopathol. 22, 781-790.
25. Kevsor J.J. (2003). Does late-life physical activity or exercise prevent or minimize disablement? A critical review of the scientific evidence. Am. J. Prev. Med. 25, 129-136.
26. Kien C.L., Bunn J.Y., Tompkins C.L., Dumas J.A., Crain K.I., Ebenstein D.B., Koves T.R. and Muoio D.M. (2013). Substituting dietary monounsaturated fat for saturated fat is associated with increased daily physical activity and resting energy expenditure and with changes in mood. Am. J. Clin. Nutr. 97, 689-697.
27. Kouri J.B. and Lavalle C. (2006). Do chondrocytes undergo "activation" and "transdifferentiation" during the pathogenesis of osteoarthritis? A review of the ultrastructural and immunohistochemical evidence. Histol. Histopathol. 21, 793-802.
28. Kraus V.B., Huebner J.L., Stabler T., Flahiff C.M., Setton L.A., Fink C., Vilim V. and Clark A.G. (2004). Ascorbic acid increase the severity of spontaneous knee osteoarthritis in a guinea pig model. Arthritis. Rheum. 50, 1822-1831.
29. Kraus V.B., Huebner J.L., DeGroot J. and Bendele A. (2010). The OARSI histopathology initiative-recommendations for histological assessments of osteoarthritis in the guinea pig. Osteoarthr. Cartil. 18, S35-S52.
30. Lahm A., Kasch R., Mrosek E., Spank H., Erggelet C., Esser J. and Merk H. (2012). Semiquantitative analysis of ECM molecules in the different cartilage layers in early and advanced osteoarthritis of the knee joint. Histol. Histopathol. 27, 609-615.
31. Lange A.K., Vanwanseele B. and Fiatarone Singh M.A. (2008). Strength training for treatment of osteoarthritis of the knee: A systematic review. Arthritis Rheum. 59, 1488-1494.
32. Le Graverand M.P., Eggerer J., Vignon E., Otterness I.G., Barclay L. and Hart D.A. (2002). Assessment of specific mRNA levels in cartilage regions in a lapine model of osteoarthritis. J. Orthop. Res. 20, 535-544.
33. Lee M.S., Pittler M.H. and Ernst E. (2008). Tai Chifor osteoarthritis: a systematic review. Clin. Rheumatol. 27, 211-218.
34. Leonardi R., Rusu M.C., Loreto F., Loreto C. and Musumeci G. (2011). Immunolocalization and expression of lubricin in the bilaminar zone of the human temporomandibular joint disc. Acta Histochem. 114, 1-5.
35. Leonardi R., Musumeci G., Sicurezza E. and Loreto C. (2012a). Lubricin in human temporomandibular joint disc: an immunohistochemical study. Arch. Oral. Biol. 57, 614-619.
36. Leonardi R., Loreto C., Talic N., Caltabiano R. and Musumeci G. (2012b). Immunolocalization of lubricin in the rat periodontal ligament during experimental tooth movement. Acta Histochem. 114, 700-704.
37. Lin C.W., Taylor D., Bierma-Zeinstra S.M. and Maher C.G. (2010). Exercise for osteoarthritis of the knee. Phys. Ther. 90, 839-842.
38. Loreto C., Lo Castro E., Musumeci G., Loreto F., Rapisarda G., Rezzani R., Castorina S., Leonardi R. and Rusu M.C. (2012). Aquaporin 1 expression in human temporomandibular disc. Acta. Histochem. 114, 744-748.
39. Lorenz H. and Richter W. (2006). Osteoarthritis: Cellular and molecular changes in degenerating cartilage. Prog. Histochem. Cytochem. 40, 135-163.
40. Mankin H.J., Dorfman H., Lippiello L. and Zarins A. (1971). Biochemical and metabolic abnormalities in articular cartilage from osteoarthritic human hips. II. Correlation of morphology with biochemical and metabolic data. J. Bone Joint Surg. Am. 53(3), 523-537.
41. Mazieres B., Thevenon A., Coudeyre E., Chevalier X., Revel M. and Rannou F. (2008). Adherence to, and results of, physical therapy programs in patients with hip or knee osteoarthritis. Development of French clinical practice guidelines. Joint Bone Spine 75, 589-596.
42. Messier S.P., Loeser R.F., Mitchell M.N., Valle G., Morgan T.P., Rejeski W.J. and Ettinger W.H. (2000). Exercise and weight loss in obese older adults with kneeosteoarthritis: a preliminary study. J. Am. Geriatr. Soc. 48, 1062-1072.
43. Messier S.P., Legault C., Mihalko S., Miller G.D., Loeser R.F., DeVita P., Lyles M., Eckstein F., Hunter D.J., Williamson J.D. and Nicklas B.J. (2009). The Intensive Diet and Exercise for Arthritis (IDEA) trial: design and rationale. BMC Musculoskelet. Disord. 10, 93.
44. Miosge N., Hartmann M., Maelicke C. and Herken R. (2004). Expression of collagen type I and type II in consecutive stages of human osteoarthritis. Histochem. Cell Biol. 122, 229-236.
45. Mobasheri A., Csaki C., Clutterbuck A.L., Rahmanzadeh M. and Shakibaei M. (2009). Mesenchymal stem cells in connective tissue engineering and regenerative medicine: applications in cartilage repair and osteoarthritis therapy. Histol. Histopathol. 24, 347-366.
46. Musumeci G. (2013a). The role of AQP1 in knee Osteoarthritis (OA): A contemporary review. OA. Arthritis. Feb 1, 2.
47. Musumeci G. (2013b). The role of lubricin in normal and pathological joint tissue: A contemporary review. OA Anatomy. 1, 2.
48. Musumeci G., Loreto C., Clementi G., Fiore C.E. and Martinez G. (2011a). An in vivo experimental study on osteopenia in diabetic rats. Acta. Histochem. 113, 619-625.
49. Musumeci G., Loreto C., Carnazza M.L. and Martinez G. (2011b). Characterization of apoptosis in articular cartilage derived from the knee joints of patients with osteoarthritis. Knee Surg. Sports Traumatol. Arthrosc. 19, 307-133.
50. Musumeci G., Loreto C., Carnazza M.L., Strehin I. and Elisseeff J. (2011c). OA cartilage derived chondrocytes encapsulated in poly(ethylene glycol) diacrylate (PEGDA) for the evaluation of cartilage restoration and apoptosis in an in vitro model. Histol. Histopathol. 26, 1265-1278.
51. Musumeci G., Lo Furno D., Loreto C., Giuffrida R., Caggia S., Leonardi R. and Cardile V. (2011d). Mesenchymal stem cells from adipose tissue which have been differentiated into chondrocytes in threedimensional culture express lubricin. Exp. Biol Med. 236, 1333-1341.
52. Musumeci G., Loreto C., Carnazza M.L., Coppolino F., Cardile V. and Leonardi R. (2011e). Lubricin is expressed in chondrocytes derived from osteoarthritic cartilage encapsulated in poly (ethylene glycol) diacrylate scaffold. Eur. J. Histochem. 55, e31.
53. Musumeci G., Carnazza M.L., Loreto C., Leonardi R. and Loreto C. (2012a). ß-defensin-4 (HBD-4) is expressed in chondrocytes derived from normal and osteoarthritic cartilage encapsulated in PEGDA scaffold. Acta. Histochem. 114, 805-812
54. Musumeci G., Carnazza M.L., Leonardi R. and Loreto C. (2012b). Expression of ß-defensin-4 in "an in vivo and ex vivo model" of human osteoarthritic knee meniscus. Knee. Surg. Sports Traumatol. Arthrosc. 20, 216-222.
55. Musumeci G., Leonardi R., Carnazza M.L., Cardile V., Pichler K., Weinberg A.M. and Loreto C. (2013a). Aquaporin 1 (AQP1) expression in experimentally induced osteoarthritic knee menisci: An in vivo and in vitro study. Tissue Cell 45, 145-152.
56. Musumeci G., Castrogiovanni P., Trovato F.M., Di Giunta A., Loreto C. and Castorina S. (2013b). Microscopic and macroscopic anatomical features in healthy and osteoarthritic knee cartilage. OA Anatomy 1, 30.
57. Musumeci G., Loreto C., Castorina S., Imbesi R., Leonardi R. and Castrogiovanni P. (2013c). Current concepts in the treatment of cartilage damage. A review. Ital. J. Anat. Embryol. 118, 189-203.
58. Musumeci G., Loreto C., Castorina S., Imbesi R., Leonardi R. and Castrogiovanni P. (2013d). New perspectives in the treatment of cartilage damage. Poly(ethylene glycol) diacrylate (PEGDA) scaffold. A review. Ital. J. Anat. Embryol. 118, 204-210.
59. Musumeci G., Castrogiovanni P., Loreto C., Castorina S., Pichler K. and Weinberg A.M. (2013e). Post-traumatic caspase-3 expression in the adjacent areas of growth plate injury site: A morphological study. Int. J. Mol. Sci. 14, 15767-15784.
60. Musumeci G., Loreto C., Leonardi R., Castorina S., Giunta S., Carnazza M.L., Trovato F.M., Pichler K. and Weinberg A.M. (2013f). The effects of physical activity on apoptosis and lubricin expression in articular cartilage in rats with glucocorticoid-induced osteoporosis. J. Bone Miner. Metab. 31, 274-284.
61. Musumeci G., Loreto C., Carnazza M.L., Cardile V. and Leonardi R. (2013g). Acute injury affects lubricin expression in knee menisci. An immunohistochemical study. Ann. Anat. 195, 151-158.
62. Musumeci G., Trovato F.M., Pichler K., Weinberg A.M., Loreto C. and Castrogiovanni P. (2013h). Extra-virgin olive oil diet and mild physical activity prevent cartilage degeneration in an osteoarthritis model. An "in vivo" and "in vitro" study on lubricin expression. J. Nutr. Biochem. 24, 2064-2075.
63. Musumeci G., Trovato F.M., Imbesi R. and Castrogiovanni P. (2014). Effects of dietary extra-virgin olive oil on oxidative stress resulting from exhaustive exercise in rat skeletal muscle: a morphological study. Acta Histochem. 116, 61-69.
64. Nicklas B.J., Ambrosius W., Messier S.P., Miller G.D., Penninx B.W., Loeser R.F., Palla S., Bleecker E. and Pahor M. (2004). Dietinduced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial. Am. J. Clin. Nutr. 79, 544-551.
65. Pauli C., Grogan S.P., Patil S., Otsuki S., Hasegawa A., Koziol J., Lotz M.K. and D'Lima D.D. (2011). Macroscopic and histopathologic analysis of human knee menisci in aging and osteoarthritis. Osteoarthr. Cartil. 19, 1132-1141.
66. Pichler K., Loreto C., Leonardi R., Reuber T., Weinberg A.M., Musumeci G. (2013a). RANKL is downregulated in bone cells by physical activity (treadmill and vibration stimulation training) in rat with glucocorticoid-induced osteoporosis. Histol. Histopathol. 28, 1185-1196.
67. Pichler K., Musumeci G., Vielgut I., Martinelli E., Sadoghi P., Loreto C. and Weinberg A.M. (2013b). Towards a better understanding of bone bridge formation in the growth plate-an immunohistochemical approach. Connective Tissue Res. 54, 408-415.
68. Pisters M.F., Veenhof C., van Meeteren N.L., Ostelo R.W., de Bakker D.H., Schellevis F.G. and Dekker J. (2007). Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review. Arthritis Rheum. 57, 1245-1253.
69. Pritzker K.P. and Aigner T. (2010). Terminology of osteoarthritis cartilage and bone histopathology-a proposal for a consensus. Osteoarthritis Cartil. 18, S7-S9.
70. Reinold M.M., Wilk K.E., Macrina L.C., Dugas J.R. and Cain E.L. (2006). Current concepts in the rehabilitation following articular cartilage repair procedures in the knee. J. Orthop. Sports Phys. Ther. 36, 774-794.
71. Roddy E., Zhang W., Doherty M., Arden N.K., Barlow J., Birrell F., Carr A., Chakravarty K., Dickson J., Hay E., Hosie G., Hurley M., Jordan K.M., McCarthy C., McMurdo M., Mockett S., O'Reilly S., Peat G., Pendleton A. and Richards S. (2005). Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee--the MOVE consensus. Rheumatology (Oxford) 44, 67-73.
72. Ruan M.Z., Patel R.M., Dawson B.C., Jiang M.M. and Lee B.H. (2013). Pain, motor and gait assessment of murine osteoarthritis in a cruciate ligament transection model. Osteoarthritis Cartilage 21, 1355-1364.
73. Sakakibara Y., Miura T., Iwata H., Kikuchi T., Yamaguchi T., Yoshimi T. and Itoh H. (1994). Effect of high-molecular weight sodium hyaluronate on immobilized rabbit knee. Clin. Orthop. 299, 282-292.
74. Schencking M., Wilm S. and Redaelli M. (2013). A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis: a pilot trial. J. Integr. Med. 11, 17-25.
75. Schrager M.A., Metter E.J., Simonsick E., Ble A., Bandinelli S., Lauretani F. and Ferrucci L. (2007). Sarcopenic obesity and inflammation in the InCHIANTI study. J. Appl. Physiol. 102, 919-925.
76. Schroeppel J.P., Crist J.D., Anderson H.C. and Wang J. (2011). Molecular regulation of articular chondrocyte function and its significance inosteoarthritis. Histol. Histopathol. 26, 377-394.
77. Schumacher B.L., Schmidt T.A., Voegtline M.S., Chen A.C. and Sah R.L. (2005). Proteoglycan 4 (PRG4) synthesis and immunolocalization in bovine meniscus. J. Orthop. Res. 23, 562-568.
78. Shibakawa A., Aoki H., Masuko-Hongo K., Kato T., Tanaka M., Nishioka K. and Nakamura H. (2003). Presence of pannus-like tissue on osteoarthritic cartilage and its histological character. Osteoarthritis Cartilage 11, 133-140.
79. Silva L.E., Valim V., Pessanha A.P., Oliveira L.M., Myamoto S., Jones A. and Natour J. (2008). Hydrotherapy versus conventional landbased exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial. Phys. Ther. 88, 12-21.
80. Siniorakis E. Arvanitakis S., Zarreas E., Saridakis M., Balanis A., Tzevelekos P., Bokos G. and Limberi S. (2013). Mediterranean diet: natural salicylates and other secrets of the pyramid. Int. J. Cardiol. 166, 538-953.
81. Sinusas K. (2012). Osteoarthritis: diagnosis and treatment. Am. Fam. Physician 85, 49-56.
82. Sowers M.R. and Karvonen-Gutierrez C.A. (2010). The evolving role of obesity in knee osteoarthritis. Curr. Opin. Rheumatol. 22, 533-537.
83. Stephen P. and Messier S.P. (2010). Diet and exercise for obese adults with knee osteoarthritis. Clin. Geriatr. Med. 26, 461-477.
84. Toda Y. (2001). The effect of energy restriction, walking, and exercise on lower extremity lean body mass in obese women with osteoarthritis of the knee. J. Orthop. Sci. 6, 148-154.
85. Tok F., Aydemir K., Peker F., Safaz I., Taflkaynatan M.A. and Ozgül A. (2011). The effects of electrical stimulation combined with continuous passive motion versus isometric exercise on symptoms, functional capacity, quality of life and balance in knee osteoarthritis: randomized clinical trial. Rheumatol. Int. 31, 177-181.
86. Urquhart D.M., Tobing J.F., Hanna F.S., Berry P., Wluka A.E., Ding C. and Cicuttini F.M. (2011). What is the effect of physical activity on the knee joint? A systematic review. Med. Sci. Sports Exerc. 43, 432-442.
87. Vanwanseele B., Lucchinetti E. and Stussi E. (2002). The effects of immobilization on the characteristics of articular cartilage: current concepts and future directions. Osteoarth. Cartil. 10, 408-419.
88. Veje K., Hyllested-Winge J.L. and Ostergaard K. (2003). Topographic and zonal distribution of tenascin in human articular cartilage from femoral heads: normal versus mild and severe osteoarthritis. Osteoarthritis Cartilage 11, 217-127.
89. Vincent K.R. and Vincent H.K. (2012). Resistance exercise for knee osteoarthritis. PM R. 4, S45-S52.
90. Vincent K.R., Conrad B.P., Fregly B.J. and Vincent H.K. (2012a). The pathophysiology of osteoarthritis: A mechanical perspective on the knee joint. PM R. 4, S3-S9.
91. Vincent H.K., Heywood K., Connelly J. and Hurley R.W. (2012b). Obesity and weight loss in the treatment and prevention of osteoarthritis. PM. R. 4, S59-S67.
92. Waldman S.D., Spiteri C.G., Grynpas M.D., Pilliar R.M., Hong J. and Kandel R.A. (2003). Effect of biomechanical conditioning on cartilaginous tissue formation in vitro. J. Bone Joint Surg. Am. 85-A, 101-105.
93. Wang C., Collet J.P. and Lau J. (2004). The effect of Tai Chion health outcomes in patients with chronic conditions: a systematic review. Arch. Intern. Med. 164, 493-501.
94. Wang C., Schmid C.H., Hibberd P.L., Kalish R., Roubenoff R., Rones R. and McAlindon T. (2009). Taichi is effective in treating knee osteoarthritis: A randomized controlled trial. Arthritis Rheum. 61, 1545-1553.
95. You T. and Nicklas B.J. (2006). Chronic inflammation: role of adipose tissue and modulation by weight loss. Curr. Diabetes Rev. 2, 29-37.
96. You T. and Nicklas B.J. (2008). Effects of exercise on adipokines and the metabolic syndrome. Curr. Diab. Rep. 8, 7-11.
97. Zhang W., Moskowitz R.W., Nuki G., Abramson S., Altman R.D., Arden N., Bierma-Zeinstra S., Brandt K.D., Croft P., Doherty M., Dougados M., Hochberg M., Hunter D.J., Kwoh K., Lohmander L.S. and Tugwell P. (2007). OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage 15, 981-1000.
98. Zhang W., Moskowitz R.W., Nuki G., Abramson S., Altman R.D., Arden N., Bierma-Zeinstra S., Brandt K.D., Croft P., Doherty M., Dougados M., Hochberg M., Hunter D.J., Kwoh K., Lohmander L.S. and Tugwell P. (2008). OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 16, 137-162.
99. Zhang W., Nuki G., Moskowitz R.W., Abramson S., Altman R.D., Arden N.K., Bierma-Zeinstra S., Brandt K.D., Croft P., Doherty M., Dougados M., Hochberg M., Hunter D.J., Kwoh K., Lohmander L.S. and Tugwel l P. (2010). OARSI recommendat ions for the management of hip and knee osteoarthritis. Part III. Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 18, 476-499.
100. Zochling J., March L., Lapsley H., Cross M., Tribe K. and Brooks P. (2004). Use of complementary medicines for osteoarthritis-a prospective study. Ann. Rheum. Dis. 63, 549-554.