• Sajida Dilawar Assistant Professor Physiotherapy JSMU
  • Amna Yaseen Lecturer Baqai institute of physical therapy rehabilitation medicine Baqai medical university
  • Sumaira Riffat Lecturer Department of physiology Sindh medical college Jinnah Sindh medical university
  • Shazia Abdul Hamid Khalfe Vice principal & assistant professor Isra university of rehabilitation sciences Isra university


Gait, quads drill, biomechanics, isometric exercise, cryotherapy, rheumatic disorder


Background and Aim: With the advancing of age knee osteoarthritis has become the common musculoskeletal condition among males and females, various treatment strategies have been applied to improve the patient symptoms therefore the aim of this study is to compare the effectiveness of low resistance versus high resistance exercises along with stretching exercises on pain, physical function, & walking time in knee osteoarthritis.

Methodology: Considering the pre-assessment inclusion criteria, a total no of 170 participants were enrolled in the study and divided into 5 groups by random apportion. Group A received a high resistance exercise, group B received low resistance exercises, group C high resistance exercises and stretching exercises, group D low resistance exercises and stretching exercises and group E received only stretching exercises for 3 weeks. After that pain, function and walking time were reassessed.

Study Design: Experimental study, randomized control trial.

Results: The intergroup results were significant with a p-value of <0.001. We assumed that all 5 groups’ interventions in the current study show a clinically meaningful reduction in pain and enhanced the level of functional activities. Effects of various exercise training are the same in all groups. Therefore, no significant difference has been noted.

Conclusion: The all 5 groups’ high resistance exercise along with stretching, low resistance exercise along with stretching, high resistance exercise, low resistance exercise, and stretching exercise reduced pain and improved functional activity in patients with knee osteoarthritis.


Józsa LG. Human tendons: anatomy, physiology and pathology. Human kinetics. 1997.

Jenkins G, Tortora GJ. Anatomy and physiology. Wiley-Blackwell; 2011

Mei-Hwa Jan, PT, MS. Investigation of Clinical Effects of High- and Low-Resistance Training for Patients with Knee Osteoarthritis: A Randomized Controlled Trial. PTJ . 2008;88(4): 427-436.

Zakir A, Ahmed SI, Aziz S. Effectiveness of manual therapy versus exercise therapy for the management of knee osteoarthritis in Karachi Pakistan. Int J Physiother. 2016;3(1): 86-93.

Anna L, Mark E. Epidemiology and Burden of Osteoarthritis. Br Med Bull. 2013;105(1): 185-199.

Muhammad NI, Haidri FR. Frequency of factors associated with knee osteoarthritis. J Pak Med Assoc. 2011;61(8): 786-789.

The AAOS clinical practice guideline, “Treatment of Osteoarthritis of the Knee” 2nd edition.

Brown GA. AAOS clinical practice guideline: treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition. J Am Acad Orthop Surg. 2013 Sep;21(9):577-9. doi: 10.5435/JAAOS-21-09-577. PMID: 23996989.

Alshami AM. Knee osteoarthritis related pain: a narrative review of diagnosis and treatment. Int J Health Sci. 2014;8(1):85-104.

Iwamoto J, Sato Y, Takeda T, Matsumoto H. Effectiveness of exercise for osteoarthritis of the knee: A review of the literature. World J Orthop. 2011;2(5):37-42.

Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. DtschArztebl Int. 2010;107(9):152-162.

Goh, SL., Persson, M.S.M., Stocks, J. et al. Relative Efficacy of Different Exercises for Pain, Function, Performance and Quality of Life in Knee and Hip Osteoarthritis: Systematic Review and Network Meta-Analysis. Sports Med 49, 743–761 (2019).

Nejati P, Farzinmehr A, Moradi LM. The effects of exercise therapy on knee OA: a randomized clinical trial. Med J Islam Repub Iran. 2015;29:186.

Iwamoto J, Sato Y, Takeda T, Matsumoto H. Effectiveness of exercise for osteoarthritis of the knee: A review of the literature. World J Orthop. 2011;2(5):37-42.

Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. PM&R. 2012;4(5):45-52.

Nguyen. C, Lefèvre-Colau. M.M, et.al, Rehabilitation (exercise and strength training) and osteoarthritis: A critical narrative review, Annals of Physical and Rehabilitation Medicine,59(3);2016:190-195

Afonso, J.; Ramirez-Campillo, R.; Moscão, J.; Rocha, T.; Zacca, R.; Martins, A.; Milheiro, A.A.; Ferreira, J.; Sarmento, H.; Clemente, F.M. Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare 2021, 9, 427.

Latham N, Liu CJ. Strength training older adults: the benefits for osteoarthritis. ClinGeriatr Med. 2010;26(3):445-59.

Gajwani HG, Borkar P. High resistance verses low resistance training on pain in patients with knee osteoarthritis. Int J Health Sci Res. 2017; 7(12):91-98.

Burrows NJ, Booth J, Sturnieks DL, Barry BK. Acute resistance exercise and pressure pain sensitivity in knee osteoarthritis: A randomised crossover trial. Osteoarthritis Cartilage. 2014;22(3):407-14.

Vincent KR, Montero C, Vincent HK. Progressive enhanced eccentric or concentric resistance exercise training for knee osteoarthritis. Osteoarthritis Research Society International (OARSI). 2013 World Congress on Osteoarthritis, April 18-21, 2013 Osteoarthritis Cartilage, 21:S275.

Hernandez HJ, McIntosh V, Leland A, Harris-Love MO. Progressive resistance exercise with eccentric loading for the management of knee osteoarthritis. Front Med (Lausanne). 2015;2:45.

McClinton, S. M., Cobian, D. G., & Heiderscheit, B. C. Physical Therapist Management of Anterior Knee Pain. Curr Rev Musculoskelet Med. 2020;13(6):776-787.

Krauss, I., Mueller, G., Haupt, G. et al. Effectiveness and efficiency of an 11-week exercise intervention for patients with hip or knee osteoarthritis: a protocol for a controlled study in the context of health services research. BMC Public Health 16, 367 (2016).

Thompson AR, Christopherson Z, Marshall LM, Carlson HL, Carlson NL. A pilot randomized controlled trial for aerobic and strengthening exercises on physical function and pain for hip osteoarthritis. Pm&r. 2020 Mar;12(3):229-37.

Lai Z, Zhang Y, Lee S, Wang L. Effects of strength exercise on the knee and ankle proprioception of individuals with knee osteoarthritis. Res Sports Med. 2018 Apr-

Jun;26(2):138-146. doi: 10.1080/15438627.2018.1431541. Epub 2018 Jan 24. PMID: 29366340.



How to Cite

Dilawar, S. . ., Yaseen, A., Riffat, S. ., & Abdul Hamid Khalfe, S. (2022). EFFECTIVENESS OF HIGH RESISTANCE VERSUS LOW RESISTANCE EXERCISES ALONG WITH STRETCHING EXERCISES IN KNEE OSTEOARTHRITIS. Pakistan Journal of Rehabilitation, 11(2), 50–58. Retrieved from http://ojs.zu.edu.pk/ojs/index.php/pjr/article/view/1421

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.