{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:13:22Z","timestamp":1785392002717,"version":"3.55.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Knee osteoarthritis (KOA) is a prevalent chronic condition among the adult individuals, leading to pain, joint stiffness, and muscle weakness. Resistance training is an effective strategy for alleviating KOA-related symptoms and improving physical function. However, the efficacy of such interventions also depends on their fidelity, ensuring that the prescribed exercise protocols are followed correctly. This study aimed to assess the fidelity of a structured strength training program and its effects on pain management in adult individuals with KOA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 72 adults (mean age = 56.27 \u00b1 4.89 years), approximately 40% of whom were overweight, were randomly assigned to either a strength training group (n = 37) or a control group (n = 35). Quantitative data were collected using the Knee Injury and Osteoarthritis Outcome Score (KOOS), while qualitative data on intervention fidelity were obtained through self-reported adherence to daily home workouts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results indicated a significant improvement in KOOS scores in the strength training group compared to the control group (p &amp;lt; 0.001). Participants consistently adhere to the prescribed exercise program in their home workouts. These findings highlight the importance of intervention fidelity in strength training programs for adult individuals with KOA, emphasizing its role in optimizing health outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study contributes to the growing evidence supporting structured strength training as a viable strategy for managing KOA-related symptoms and enhancing physical function in ageing populations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1583153","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T04:15:32Z","timestamp":1750220132000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Strength training intervention for adult individuals with knee osteoarthritis: Establishing fidelity"],"prefix":"10.3389","volume":"16","author":[{"given":"Hamza","family":"K\u00fc\u00e7\u00fck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niloufar","family":"Ghadamyari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma Ne\u015fe","family":"\u015eahin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcner","family":"\u00c7i\u00e7ek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00fclay","family":"Ceylan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zkan","family":"G\u00fcler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur Mutlu","family":"Ya\u015far","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00fcneyt","family":"\u015eensoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansel","family":"Arslano\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erol","family":"Do\u011fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erkal","family":"Arslano\u011flu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"B1","first-page":"53","article-title":"Comparison of knee osteoarthritis in retired professional zurkhaneh athletes and non-athletic individuals","volume":"21","author":"Ahanjan","year":"2013","journal-title":"J. Kerman Univ. Med. Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.5606\/tftrd.2020.3089","article-title":"The effect of physical therapy and rehabilitation modalities on sleep quality in patients with primary knee osteoarthritis: a single-blind, prospective, randomized controlled study","volume":"66","author":"Alta\u015f","year":"2020","journal-title":"Turk J. Phys. Med. Rehabil."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1578","DOI":"10.1016\/j.joca.2019.06.011","article-title":"OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis","volume":"27","author":"Bannuru","year":"2019","journal-title":"Osteoarthr. Cartil."},{"key":"B4","doi-asserted-by":"publisher","first-page":"6641208","DOI":"10.1155\/2021\/6641208","article-title":"How has intervention fidelity been assessed in smoking cessation interventions? A systematic review","volume":"2021","author":"Begum","year":"2021","journal-title":"J. Smok. Cessat."},{"key":"B5","doi-asserted-by":"publisher","first-page":"101249","DOI":"10.1016\/j.ssmph.2022.101249","article-title":"Measurement and assessment of fidelity and competence in nonspecialist-delivered, evidence-based behavioral and mental health interventions: a systematic review","volume":"19","author":"Bond","year":"2022","journal-title":"SSM-Population Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1111\/j.1752-7325.2011.00233.x","article-title":"The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials","volume":"71","author":"Borrelli","year":"2011","journal-title":"J. Public Health Dent."},{"key":"B7","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1002\/nur.20373","article-title":"Implementation fidelity in community\u2010based interventions","volume":"33","author":"Breitenstein","year":"2010","journal-title":"Res. Nurs. and health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.nurpra.2019.10.018","article-title":"Holistic\/integrative interventions relieve knee osteoarthritis pain in older adults","volume":"16","author":"Brown","year":"2020","journal-title":"J. Nurs. Pract."},{"key":"B9","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.joca.2013.12.023","article-title":"Acute resistance exercise and pressure pain sensitivity in knee osteoarthritis: a randomised crossover trial","volume":"22","author":"Burrows","year":"2014","journal-title":"Osteoarthr. Cartil."},{"key":"B10","doi-asserted-by":"publisher","first-page":"645842","DOI":"10.3389\/fphar.2021.645842","article-title":"New trends in pharmacological treatments for osteoarthritis","volume":"12","author":"Cai","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.3390\/biology11101391","article-title":"Effects of physical exercises alone on the functional capacity of individuals with obesity and knee osteoarthritis: a systematic review","volume":"11","author":"Caiado","year":"2022","journal-title":"Biol. (Basel)"},{"key":"B12","doi-asserted-by":"publisher","first-page":"102382","DOI":"10.1016\/j.arr.2024.102382","article-title":"Trends and cross-country inequalities in the global burden of osteoarthritis, 1990-2019: a population-based study","volume":"99","author":"Cao","year":"2024","journal-title":"Ageing Res. Rev."},{"key":"B13","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1186\/1472-6882-14-160","article-title":"Yoga for managing knee osteoarthritis in older women: a pilot randomized controlled trial","volume":"14","author":"Cheung","year":"2014","journal-title":"BMC Complementary Altern. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s42836-025-00301-6","article-title":"Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement","volume":"7","author":"Choi","year":"2025","journal-title":"Arthroplasty"},{"key":"B15","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3390\/jfmk4010011","article-title":"The synovium theory: can exercise prevent knee osteoarthritis? The role of \u201cmechanokines\u201d, a possible biological key","volume":"4","author":"Di","year":"2019","journal-title":"J. Funct. Morphol. Kinesiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/j.1744-6155.2011.00305.x","article-title":"Intervention fidelity: ensuring application to practice for youth and families","volume":"17","author":"Faulkner","year":"2012","journal-title":"J. Specialists Pediatr. Nurs."},{"key":"B17","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1186\/s12877-024-05556-3","article-title":"Association of sarcopenia and its prognostic value in symptomatic knee osteoarthritis among older people in China: the first longitudinal evidence from CHARLS","volume":"24","author":"Gao","year":"2024","journal-title":"BMC Geriatr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.cpr.2010.09.007","article-title":"Major ingredients of fidelity: a review and scientific guide to improving quality of intervention research implementation","volume":"31","author":"Gearing","year":"2011","journal-title":"Clin. Psychol. Rev."},{"key":"B19","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD011279.pub2","article-title":"Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews","volume-title":"Cochrane database systematic reviews","author":"Geneen","year":"2017"},{"key":"B20","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1007\/s40279-019-01082-0","article-title":"Relative efficacy of different exercises for pain, function, performance and quality of life in knee and hip osteoarthritis: systematic review and network meta-analysis","volume":"49","author":"Goh","year":"2019","journal-title":"Sports Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1493900","DOI":"10.3389\/fpubh.2024.1493900","article-title":"Investigation of the playing digital games on shoulder flexibility, muscle strength and reaction speed in volleyball players","volume":"12","author":"G\u00fcney","year":"2024","journal-title":"Front. Public Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0309950","DOI":"10.1371\/journal.pone.0309950","article-title":"Effects of three types of resistance training on knee osteoarthritis: a systematic review and network meta-analysis","volume":"19","author":"Jiang","year":"2024","journal-title":"PLoS ONE"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2209","DOI":"10.1007\/s40279-020-01344-2","article-title":"Acute effects of cluster and rest redistribution set structures on mechanical, metabolic, and perceptual fatigue during and after resistance training: a systematic review and meta-analysis","volume":"50","author":"Jukic","year":"2020","journal-title":"Sports Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1007\/s40279-020-01423-4","article-title":"The effects of set structure manipulation on chronic adaptations to resistance training: a systematic review and Meta Analysis","volume":"51","author":"Jukic","year":"2021","journal-title":"Sports Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2377960821993515","DOI":"10.1177\/2377960821993515","article-title":"Effectiveness of isometric exercise and counseling on level of pain among patients with knee osteoarthritis","volume":"7","author":"Kangeswari","year":"2021","journal-title":"SAGE Open Nurs."},{"key":"B26","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1097\/rnj.0000000000000142","article-title":"Aquatic exercise program for individuals with osteoarthritis: pain, stiffness, physical function, self-efficacy","volume":"44","author":"Kars Fertelli","year":"2019","journal-title":"Rehabil. Nurs."},{"key":"B27","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1007\/s12671-018-0974-4","article-title":"Reporting of treatment fidelity in mindfulness-based intervention trials: a review and new tool using NIH behavior change consortium guidelines","volume":"10","author":"Kechter","year":"2019","journal-title":"Mindfulness"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1207\/s15324796abm2601_01","article-title":"Self-management education: history, definition, outcomes, and mechanisms","volume":"26","author":"Lorig","year":"2003","journal-title":"Ann. Behav. Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1007\/s00393-014-1559-9","article-title":"Effectiveness of aquatic exercise for treatment of knee osteoarthritis: systematic review and meta-analysis","volume":"74","author":"Lu","year":"2015","journal-title":"Z Rheumatol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1097\/JSM.0000000000000170","article-title":"Efficacy of hip strengthening exercises compared with leg strengthening exercises on knee pain, function, and quality of life in patients with knee osteoarthritis","volume":"25","author":"Lun","year":"2015","journal-title":"Clin. J. Sport Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1123\/ijspp.2024-0274","article-title":"Comparative effects of the free weights and smith machine squat and bench press: the important role of specificity for strength adaptations","volume":"20","author":"Marcos-Frutos","year":"2025","journal-title":"Int. J. Sports Physiology Perform."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e41214","DOI":"10.2196\/41214","article-title":"How the behavior change content of a nationally implemented digital diabetes prevention program is understood and used by participants: qualitative study of fidelity of receipt and enactment","volume":"25","author":"Miles","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"B33","doi-asserted-by":"publisher","first-page":"4302","DOI":"10.3390\/app10124302","article-title":"Effect of whole-body vibration on the functional responses of the patients with knee osteoarthritis by the electromyographic profile of the vastus lateralis muscles during the five-repetition chair stand test: a randomized crossover trial","volume":"10","author":"Moreira-Marconi","year":"2020","journal-title":"Appl. Sci."},{"key":"B34","doi-asserted-by":"publisher","first-page":"5870","DOI":"10.3390\/app10175870","article-title":"Acute effects of whole-body vibration exercise on pain level, functionality, and rating of exertion of elderly obese knee osteoarthritis individuals: a randomized study","volume":"10","author":"Moura-Fernandes","year":"2020","journal-title":"Appl. Sci."},{"key":"B35","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.rehab.2016.02.010","article-title":"Rehabilitation (exercise and strength training) and osteoarthritis: a critical narrative review","volume":"59","author":"Nguyen","year":"2016","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.2147\/CIA.S174741","article-title":"Prevalence and treatment of hip and knee osteoarthritis in people aged 60 years or older in Germany: an analysis based on health insurance claims data","volume":"13","author":"Postler","year":"2018","journal-title":"Clin. Interv. Aging"},{"key":"B37","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/msc.1538","article-title":"Effects of exercise on knee osteoarthritis: a systematic review","volume":"19","author":"Raposo","year":"2021","journal-title":"Musculoskelet. Care"},{"key":"B38","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1186\/s12913-016-1904-6","article-title":"Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review","volume":"16","author":"Rixon","year":"2016","journal-title":"BMC health Serv. Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"88","DOI":"10.2519\/jospt.1998.28.2.88","article-title":"Knee injury and osteoarthritis outcome score (KOOS)\u2014development of a self-administered outcome measure","volume":"28","author":"Roos","year":"1998","journal-title":"J. Orthop. and Sports Phys. Ther."},{"key":"B40","doi-asserted-by":"publisher","first-page":"330","DOI":"10.32598\/ijn.35.137.3127","article-title":"The effect of regular exercise program on the pain of the elderly in knee osteoarthritis","volume":"35","author":"Safarnia","year":"2022","journal-title":"Iran J. Nurs."},{"key":"B41","doi-asserted-by":"publisher","first-page":"255","DOI":"10.18502\/ijph.v53i2.14911","article-title":"The influence of physical exercises on the flexibility of older individuals with knee osteoarthritis: a systematic review","volume":"53","author":"Santos","year":"2024","journal-title":"Iran. J. Public Health"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1016\/j.jbmt.2024.09.003","article-title":"Home care program and exercise prescription for improving quality of life in geriatric population with knee osteoarthritis: a systematic review and meta-analysis","volume":"40","author":"Sharma","year":"2024","journal-title":"J. Bodyw. Mov. Ther."},{"key":"B43","doi-asserted-by":"publisher","first-page":"512","DOI":"10.11622\/smedj.2020147","article-title":"Management of knee osteoarthritis in primary care","volume":"61","author":"Sim","year":"2020","journal-title":"Singap. Med. J."},{"key":"B44","doi-asserted-by":"publisher","first-page":"756","DOI":"10.3389\/fphys.2019.00756","article-title":"Whole body vibration training on muscle strength and brain-derived neurotrophic factor levels in elderly woman with knee osteoarthritis: a randomized clinical trial study","volume":"10","author":"Sim\u00e3o","year":"2019","journal-title":"Front. Physiol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"439","DOI":"10.2519\/jospt.2018.7877","article-title":"Physical activity and exercise therapy benefit more than just symptoms and impairments in people with hip and knee osteoarthritis","volume":"48","author":"Skou","year":"2018","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B46","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1002\/art.39465","article-title":"The prevalence of symptomatic knee osteoarthritis in China: results from the China health and retirement longitudinal study","volume":"68","author":"Tang","year":"2016","journal-title":"Arthritis and rheumatology"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1016\/j.joca.2019.04.020","article-title":"Do we need another trial on exercise in patients with knee osteoarthritis? No new trials on exercise in knee OA","volume":"27","author":"Verhagen","year":"2019","journal-title":"Osteoarthr. Cartil."},{"key":"B48","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.knee.2024.10.019","article-title":"The impact of different types of physical activity on the risk of knee osteoarthritis: a Mendelian randomization study","volume":"52","author":"Wang","year":"2024","journal-title":"Knee"},{"key":"B49","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1007\/s00296-008-0809-z","article-title":"Prevalence of rheumatic diseases and disability in China","volume":"29","author":"Xiang","year":"2009","journal-title":"Rheumatol. Int."},{"key":"B50","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1891\/1541-6577.27.2.131","article-title":"Intervention fidelity in a translational study: lessons learned","volume":"27","author":"Yates","year":"2013","journal-title":"Res. theory Nurs. Pract."},{"key":"B51","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1007\/s40279-025-02176-8","article-title":"Superset versus traditional resistance training prescriptions: a systematic review and meta-analysis exploring acute and chronic effects on mechanical, metabolic, and perceptual variables","volume":"55","author":"Zhang","year":"2025","journal-title":"Sports Med."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1583153\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T04:15:33Z","timestamp":1750220133000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2025.1583153\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,18]]},"references-count":51,"alternative-id":["10.3389\/fphys.2025.1583153"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2025.1583153","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,18]]},"article-number":"1583153"}}