The Knee, ISSN: 1873-5800, Vol: 20, Issue: 6, Page: 581-90

Oxidative stress and inflammatory responses following an acute bout of isokinetic exercise in obese women with knee osteoarthritis

Germanou, Evangelia I; Chatzinikolaou, Athanasios; Malliou, Paraskevi; Beneka, Anastasia; Jamurtas, Athanasios Z; Bikos, Christos; Tsoukas, Dimitrios; Theodorou, Apostolos; Katrabasas, Ioannis; Margonis, Konstantinos; Douroudos, Ioannis; Gioftsidou, Asimenia; Fatouros, Ioannis G


Obesity is associated with osteoarthritis and it is accompanied by chronic inflammation and elevated oxidative stress. Strengthening-type exercise is used in knee osteoarthritis (KOA) rehabilitation. This study determined how acute isokinetic exercise influences inflammatory responses of obese middle-aged women with KOA.


Ten obese women with KOA and 10 age/weight-matched controls performed an isokinetic exercise protocol. Assessment of performance (knee extensor/flexor torque), muscle soreness (DOMS), knee flexibility (KJRM), and pain, and blood collection were performed pre-exercise, post-exercise, and at 24 h post-exercise. Blood was analyzed for creatine kinase activity (CK), lactate dehydrogenase activity (LDH), CRP, leukocytes, uric acid, IL-6, TBARS, lipid hydroperoxides (LPX), protein carbonyls (PC), oxidized (GSH) and reduced glutathione (GSSG), total antioxidant capacity (TAC), catalase activity, and glutathione peroxidase activity (GPX).


Physical function remained unaltered by exercise (only torque at 90°/s decreased at 24 h). Exercise increased DOMS throughout recovery but KJRM and pain remained unchanged. CK, LDH, and uric acid increased similarly in both groups. CRP remained unaffected by exercise while IL-6 increased only post-exercise. TBARS, PC, LPH, GSSG, and TAC increased only post-exercise in both groups. GSH and GSH/GSSG declined post-exercise and normalized thereafter. Catalase and GPX increased only in patients post-exercise.


Isokinetic exercise induces only a mild inflammatory response of very short duration (< 24 h) without affecting physical function and pain in KOA patients suggesting that moderate strengthening-type exercise may be safe for this patient cohort. These results indicate that KOA patients may be able to receive another exercise stimulus after only 48 h.

Clinical relevance

Isokinetic exercise produces minimal inflammation and pain in knee osteoarthritis patients, could be performed every 48 h during rehabilitation, and up-regulates patients’ antioxidant system.

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