Rehabilitative exercise scheduling: Effects on balance, functional movement performance, and pain perception in middle‐aged women with knee pain: A randomized controlled trial

Abstract Background The scheduling of clinical rehabilitative exercise should combine best possible delivery of exercise with the most efficient use of time, facilities, equipment, and personnel. However, it is not clear whether distribution of a fixed amount of exercise volume is more efficient over a longer time period in a week (distributed manner) than over a shorter time period in a week (massed manner). Objective To evaluate the effects of distributed versus massed within‐ and between‐session exercise scheduling on balance, exercise performance, and pain perception in middle‐aged women with knee pain. Participants Thirty‐four middle‐aged female volunteers (mean age ± SD, 56.0 ± 5.2 years old; mean weight ± SD, 66.9 ± 7.6 kg; mean body mass index [BMI] ± SD, 27.7 ± 2.8 kg/m 2 ) were randomly assigned to one of the three groups consisting of Rehabilitative Massed Scheduling (RMS); Rehabilitative Distributed Scheduling (RDS); or Control group (CG). Main Outcome Measures Isometric strength, balance, functional movement performance, and pain perception were assessed at baseline (pre), at week 8 (mid), and 1 week after the full 12 weeks (post) of exercise training or no intervention (CG). Results Significant improvements in balance, functional movement performance, and pain perception were found after both RDS and RMS after 8 and 12 weeks compared to the control group ( p ˂ .05). Examination of the net changes (% ∆) between RDS and RMS showed a statistically significant difference only in the right 30‐second arm curl records of individuals in the RDS group, which were significantly higher than the RMS group at the post‐test ( p ˂ .05). Conclusion Rehabilitative training providers are advised to distribute the drills of rehabilitative exercise training within and between the sessions of exercise per week only when a positive Bottom‐Up Rise Strength Transfer effect (BURST) effect of exercise training is needed. Otherwise, if the whole amount of rehabilitative exercise work is identical the benefit of going five versus three times per week to the rehabilitation centers would be similar.