CONCLUSIONS
Clinically, the important question that arises from our
study’s findings is whether the improvement in muscle strength and reduction of pain seen with glucosamine or ibuprofen administration during physical training justifies treatment of patients with knee OA with these medications during training. The additional gain with medication combined with training found in our study does not seem large enough for the patient, especially when seen in light of the additional cost of the medication and the additional risks of long-term NSAID use. Furthermore, since the KOOS score showed no differences between the groups, the decrease measured in the VAS does not seem convincing. In conclusion, even though an improvement in maximal
muscle strength and a small decrease in pain in patients with
OA were observed with NSAID or glucosamine treatment
during the exercise period, we do not find these beneficial effects convincing enough to recommend treatment with these medications. From a clinical perspective, we particularly do not recommend longer-term administration of NSAIDs because of the risks of AEs. Independent of administration of an NSAID,glucosamine, or placebo, similar gains in muscle mass and functional performances were obtained by patients with OA after strength training. An improved functional performance is clinically important in patients with OA because it is predictive for improved daily function and may prevent future falls and fractures.