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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">inovmed</journal-id><journal-title-group><journal-title xml:lang="ru">Инновационная медицина Кубани</journal-title><trans-title-group xml:lang="en"><trans-title>Innovative Medicine of Kuban</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2541-9897</issn><publisher><publisher-name>Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.35401/2541-9897-2026-11-1-62-70</article-id><article-id custom-type="elpub" pub-id-type="custom">inovmed-1464</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>Сравнительный эффект упражнений с осевой нагрузкой и без на психологическое благополучие, нейробиологические показатели и параметры клеточной оксигенации: путь к восстановлению</article-title><trans-title-group xml:lang="en"><trans-title>Comparative Effect of Weight-Bearing and Non-Weight-Bearing Exercises on Psychological Well-Being, Neurobiological, and Cellular Oxygenation Outcomes: A Pathway to Recovery</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9756-8812</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мунир</surname><given-names>М.</given-names></name><name name-style="western" xml:lang="en"><surname>Munir</surname><given-names>M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мунир Музна – ассистент.</p><p>Лахор</p></bio><bio xml:lang="en"><p>Muzna Munir - Assistant Professor, Riphah International University.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6682-9896</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шакил-ур-Рехман</surname><given-names>С.</given-names></name><name name-style="western" xml:lang="en"><surname>Shakil-Ur-Rehman</surname><given-names>S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шакил-ур-Рехман Саид - PhD, руководитель кафедры смежных медицинских наук.</p><p>Лахор</p></bio><bio xml:lang="en"><p>Syed Shakil-ur-Rehman - PhD, Director of Allied Health Sciences, Riphah International University.</p><p>Lahore</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5892-3674</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бейг</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Baig</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Байг Атиф Амин - доцент, прикладной колледж.</p><p>Табук</p></bio><bio xml:lang="en"><p>Atif Amin Baig - Associate Professor, Applied College, University of Tabuk.</p><p>Tabuk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-8980-1113</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Афзал</surname><given-names>А.</given-names></name><name name-style="western" xml:lang="en"><surname>Afzal</surname><given-names>A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Афзал Ахсан – физиотерапевт.</p><p>Кентербери</p></bio><bio xml:lang="en"><p>Ahsan Afzal - Physiotherapist, Canterbury Christ Church University.</p><p>Canterbury</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2871-086X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чопра</surname><given-names>Ш.</given-names></name><name name-style="western" xml:lang="en"><surname>Chopra</surname><given-names>Sh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чопра Шивани - доцент, кафедра биологических наук, Инженерная школа Saveetha.</p><p>Ченнаи</p></bio><bio xml:lang="en"><p>Shivani Chopra - Associate Professor, Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences.</p><p>Chennai</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8867-7603</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чопра</surname><given-names>Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Chopra</surname><given-names>H.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Чопра Хитеш - доцент, Центр оценки влияния и результатов исследований, Фармацевтический колледж Chitkara.</p><p>Раджпур, 140401, Национальное шоссе Чандигарх – Патиала, Пенджаб</p></bio><bio xml:lang="en"><p>Hitesh Chopra - Associate Professor, Centre for Research Impact and Outcome, Chitkara College of Pharmacy, Chitkara University.</p><p>Chandigarh-Patiala National Highway, Rajpura, 140401, Punjab</p></bio><email xlink:type="simple">chopraontheride@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Международный университет Riphah</institution><country>Пакистан</country></aff><aff xml:lang="en"><institution>Riphah International University</institution><country>Pakistan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Университет Табука</institution><country>Саудовская Аравия</country></aff><aff xml:lang="en"><institution>University of Tabuk</institution><country>Saudi Arabia</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Университет Canterbury Christ Church</institution><country>Великобритания</country></aff><aff xml:lang="en"><institution>Canterbury Christ Church University</institution><country>United Kingdom</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Институт медицинских и технических наук Saveetha</institution><country>Индия</country></aff><aff xml:lang="en"><institution>Saveetha Institute of Medical and Technical Sciences</institution><country>India</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Университет Chitkara</institution><country>Индия</country></aff><aff xml:lang="en"><institution>Chitkara University</institution><country>India</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>30</day><month>03</month><year>2026</year></pub-date><volume>11</volume><issue>1</issue><fpage>62</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мунир М., Шакил-ур-Рехман С., Бейг А.А., Афзал А., Чопра Ш., Чопра Х., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Мунир М., Шакил-ур-Рехман С., Бейг А.А., Афзал А., Чопра Ш., Чопра Х.</copyright-holder><copyright-holder xml:lang="en">Munir M., Shakil-Ur-Rehman S., Baig A.A., Afzal A., Chopra S., Chopra H.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.innovmedkub.ru/jour/article/view/1464">https://www.innovmedkub.ru/jour/article/view/1464</self-uri><abstract><p>Остеоартрит коленного сустава – это дегенеративное и комплексное заболевание, на которое влияют механические, неврологические и психологические факторы. В связи с увеличением его распространённости, обусловленной старением и ожирением, важно понимать, как различные типы упражнений влияют на психологическое состояние, нейробиологические показатели и клеточную оксигенацию, чтобы оптимизировать процесс восстановления.</p><sec><title>Цель</title><p>Цель: Сравнить эффективность упражнений с осевой нагрузкой и без неё с точки зрения психологического состояния, нейробиологических показателей и клеточной оксигенации.</p></sec><sec><title>Методы</title><p>Методы: В исследование включено 80 добровольцев с персистирующей болью в коленном суставе (&gt;3 мес.) в рамках одностороннего слепого рандомизированного контролируемого исследования, проведённого в Центре реабилитации Riphah в Лахоре, Пакистан. Участники в возрасте 40 лет и старше были случайным образом разделены на две группы. Обе группы получили базовое лечение; группа А дополнительно выполняла упражнения без осевой нагрузки, а группа Б – упражнения с осевой нагрузкой, включая укрепление квадрицепсов, в течение 6 недель. Оценка результатов проводилась с использование шкалы депрессии, тревожности и стресса (DASS 2.1), анализа ELISA и анализа газов артериальной крови для оценки оксигенации. Данные анализировались с помощью SPSS версия 25 (p&lt;0,05).</p></sec><sec><title>Результаты</title><p>Результаты: После вмешательства обе группы продемонстрировали значительное улучшение показателей стресса, тревожности, депрессии, уровня BDNF и оксигенации (p&lt;0.05). Сравнительный анализ показал отсутствие значимых различий в уровне тревожности; однако группа, которая выполняла упражнения с осевой нагрузкой, продемонстрировала значительно более выраженные улучшения в показателях стресса и депрессии, уровня BDNF и клеточной оксигенации.</p></sec><sec><title>Заключение</title><p>Заключение: Оба подхода привели к улучшению психологических и физиологических показателей у пациентов с остеоартрозом коленного сустава. При этом упражнения с осевой нагрузкой характеризовались более выраженным положительным влиянием на нейробиологические маркеры и психологическое благополучие.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background: Knee osteoarthritis (OA) is a degenerative and complex disease influenced by mechanical, neurological, and psychological factors. Due to its increasing prevalence associated with aging and obesity, it is essential to understand how different types of exercise affect psychological well-being, neurobiological indicators, and cellular oxygenation is essential for optimizing recovery. Objective: To compare the effectiveness of weight-bearing and non-weight-bearing exercises on psychological well-being, neurobiological markers, and cellular oxygenation.</p></sec><sec><title>Methods</title><p>Methods: Eighty volunteers with persistent knee pain (≥3 months) were enrolled in a single-blind randomized controlled trial conducted at the Riphah Rehabilitation Center in Lahore, Pakistan. Participants aged 40 years and older were randomly allocated to two intervention groups. Both groups received baseline treatment, Group A additionally performed non-weight-bearing exercises, whereas Group B performed weight-bearing exercises, including quadriceps strengthening, for a duration of six weeks. Outcomes were assessed using the Depression Anxiety and Stress Scale (DASS 2.1), ELISA, and arterial blood gas analysis to evaluate oxygenation. Data were analyzed using SPSS version 25, with a p &lt; 0.05 considered statistically significant.</p></sec><sec><title>Results</title><p>Results: Following the intervention, significant improvements were observed in stress, anxiety, depression, BDNF level, and oxygenation in both the weight-bearing and non-weight-bearing exercise groups (p &lt; 0.05). Comparative analysis revealed no significant difference in anxiety between the groups; however, the weight-bearing group demonstrated significantly greater improvements in stress, depression, BDNF levels, and oxygenation (p &lt; 0.05).</p></sec><sec><title>Conclusion</title><p>Conclusion: Both interventions resulted in improvements in psychological and physiological outcomes among patients with knee osteoarthritis. However, weight-bearing exercises demonstrated greater benefits in terms of neurobiological markers and psychological well-being.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>остеоартроз коленного сустава</kwd><kwd>нейротрофический фактор мозга (BDNF)</kwd><kwd>синдром передней боли в колене</kwd><kwd>упражнения с осевой нагрузкой</kwd><kwd>тревожность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>knee osteoarthritis</kwd><kwd>brain-derived neurotrophic factor</kwd><kwd>anterior knee pain syndrome</kwd><kwd>weight-bearing exercise</kwd><kwd>anxiety</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. PMID: 29035179. PMCID: PMC5638628. https://doi.org/10.7812/tpp/16-183</mixed-citation><mixed-citation xml:lang="en">Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. PMID: 29035179. PMCID: PMC5638628. https://doi.org/10.7812/tpp/16-183</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage. 2022;30(2):184-195. PMID: 34534661. PMCID: PMC10735233. https://doi.org/10.1016/j.joca.2021.04.020</mixed-citation><mixed-citation xml:lang="en">Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage. 2022;30(2):184-195. PMID: 34534661. PMCID: PMC10735233. https://doi.org/10.1016/j.joca.2021.04.020</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Swain S, Sarmanova A, Mallen C, et al. Trends in incidence and prevalence of osteoarthritis in the United Kingdom: findings from the Clinical Practice Research Datalink (CPRD). Osteoarthritis Cartilage. 2020;28(6):792-801. PMID: 32184134. https://doi.org/10.1016/j.joca.2020.03.004</mixed-citation><mixed-citation xml:lang="en">Swain S, Sarmanova A, Mallen C, et al. Trends in incidence and prevalence of osteoarthritis in the United Kingdom: findings from the Clinical Practice Research Datalink (CPRD). Osteoarthritis Cartilage. 2020;28(6):792-801. PMID: 32184134. https://doi.org/10.1016/j.joca.2020.03.004</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Giorgino R, Albano D, Fusco S, Peretti GM, Mangiavini L, Messina C. Knee Osteoarthritis: Epidemiology, Pathogenesis, and Mesenchymal Stem Cells: What Else Is New? An Update. Int J Mol Sci. 2023;24(7):6405. PMID: 37047377. PMCID: PMC10094836. https://doi.org/10.3390/ijms24076405</mixed-citation><mixed-citation xml:lang="en">Giorgino R, Albano D, Fusco S, Peretti GM, Mangiavini L, Messina C. Knee Osteoarthritis: Epidemiology, Pathogenesis, and Mesenchymal Stem Cells: What Else Is New? An Update. Int J Mol Sci. 2023;24(7):6405. PMID: 37047377. PMCID: PMC10094836. https://doi.org/10.3390/ijms24076405</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Binvignat M, Sokol H, Mariotti-Ferrandiz E, Berenbaum F, Sellam J. Osteoarthritis and gut microbiome. Joint Bone Spine. 2021;88(5):105203. PMID: 33962035. https://doi.org/10.1016/j.jbspin.2021.105203</mixed-citation><mixed-citation xml:lang="en">Binvignat M, Sokol H, Mariotti-Ferrandiz E, Berenbaum F, Sellam J. Osteoarthritis and gut microbiome. Joint Bone Spine. 2021;88(5):105203. PMID: 33962035. https://doi.org/10.1016/j.jbspin.2021.105203</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Dainese P, Wyngaert KV, De Mits S, Wittoek R, Van Ginckel A, Calders P. Association between knee inflammation and knee pain in patients with knee osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2022;30(4):516-534. PMID: 34968719. https://doi.org/10.1016/j.joca.2021.12.003</mixed-citation><mixed-citation xml:lang="en">Dainese P, Wyngaert KV, De Mits S, Wittoek R, Van Ginckel A, Calders P. Association between knee inflammation and knee pain in patients with knee osteoarthritis: a systematic review. Osteoarthritis Cartilage. 2022;30(4):516-534. PMID: 34968719. https://doi.org/10.1016/j.joca.2021.12.003</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001;286(2):188-195. PMID: 11448282. https://doi.org/10.1001/jama.286.2.188</mixed-citation><mixed-citation xml:lang="en">Sharma L, Song J, Felson DT, Cahue S, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001;286(2):188-195. PMID: 11448282. https://doi.org/10.1001/jama.286.2.188</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Driban JB, Harkey MS, Barbe MF, et al. Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord. 2020;21(1):332. PMID: 32471412. PMCID: PMC7260785. https://doi.org/10.1186/s12891-020-03367-2</mixed-citation><mixed-citation xml:lang="en">Driban JB, Harkey MS, Barbe MF, et al. Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review. BMC Musculoskelet Disord. 2020;21(1):332. PMID: 32471412. PMCID: PMC7260785. https://doi.org/10.1186/s12891-020-03367-2</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Oo W.M., Hunter J., Intra-articular therapies for knee osteoarthritis: current update. Curr Treat Options in Rheum. 2023;9(3):99-119. https://doi.org/10.1007/s40674-023-00207-x</mixed-citation><mixed-citation xml:lang="en">Oo W.M., Hunter J., Intra-articular therapies for knee osteoarthritis: current update. Curr Treat Options in Rheum. 2023;9(3):99-119. https://doi.org/10.1007/s40674-023-00207-x</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">López-Bravo MD, Zamarrón-Cassinello MD, Touche R, Muñoz-Plata R, Cuenca-Martínez F, Ramos-Toro M. Psychological Factors Associated with Functional Disability in Patients with Hip and Knee Osteoarthritis. Behav Med. 2021;47(4):285-295. PMID: 32910744. https://doi.org/10.1080/08964289.2020.1813682</mixed-citation><mixed-citation xml:lang="en">López-Bravo MD, Zamarrón-Cassinello MD, Touche R, Muñoz-Plata R, Cuenca-Martínez F, Ramos-Toro M. Psychological Factors Associated with Functional Disability in Patients with Hip and Knee Osteoarthritis. Behav Med. 2021;47(4):285-295. PMID: 32910744. https://doi.org/10.1080/08964289.2020.1813682</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Nah S, Park SS, Choi S, Jang HD, Moon JE, Han S. Association between Chronic Knee Pain and Psychological Stress in Those over 50 Years of Age: A Nationwide Cross-Sectional Study Based on the Sixth Korea National Health and Nutrition Examination Survey (KNHANES 2013-2015). Int J Environ Res Public Health. 2021;18(18):9771. PMID: 34574694. PMCID: PMC8467605. https://doi.org/10.3390/ijerph18189771</mixed-citation><mixed-citation xml:lang="en">Nah S, Park SS, Choi S, Jang HD, Moon JE, Han S. Association between Chronic Knee Pain and Psychological Stress in Those over 50 Years of Age: A Nationwide Cross-Sectional Study Based on the Sixth Korea National Health and Nutrition Examination Survey (KNHANES 2013-2015). Int J Environ Res Public Health. 2021;18(18):9771. PMID: 34574694. PMCID: PMC8467605. https://doi.org/10.3390/ijerph18189771</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Silva MJ. Treating Anxiety-Based Cognitive Distortions Pertaining to Somatic Perception for Better Chronic Pain Outcomes: A Recommendation for Better Practice in the Present Day and the Cyber Age of Medicine. J Clin Med. 2024;13(19):5923. PMID: 39407983. PMCID: PMC11478175. https://doi.org/10.3390/jcm13195923</mixed-citation><mixed-citation xml:lang="en">Silva MJ. Treating Anxiety-Based Cognitive Distortions Pertaining to Somatic Perception for Better Chronic Pain Outcomes: A Recommendation for Better Practice in the Present Day and the Cyber Age of Medicine. J Clin Med. 2024;13(19):5923. PMID: 39407983. PMCID: PMC11478175. https://doi.org/10.3390/jcm13195923</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Li B, Yang Z, Li Y, Zhang J, Li C, Lv N. Exploration beyond osteoarthritis: the association and mechanism of its related comorbidities. Front Endocrinol (Lausanne). 2024;15:1352671. PMID: 38779455. PMCID: PMC11110169. https://doi.org/10.3389/fendo.2024.1352671</mixed-citation><mixed-citation xml:lang="en">Li B, Yang Z, Li Y, Zhang J, Li C, Lv N. Exploration beyond osteoarthritis: the association and mechanism of its related comorbidities. Front Endocrinol (Lausanne). 2024;15:1352671. PMID: 38779455. PMCID: PMC11110169. https://doi.org/10.3389/fendo.2024.1352671</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Wojcieszek A, Kurowska A, Majda A, Liszka H, Gądek A. The Impact of Chronic Pain, Stiffness and Difficulties in Performing Daily Activities on the Quality of Life of Older Patients with Knee Osteoarthritis. Int J Environ Res Public Health. 2022;19(24):16815. PMID: 36554695. PMCID: PMC9779661. https://doi.org/10.3390/ijerph192416815</mixed-citation><mixed-citation xml:lang="en">Wojcieszek A, Kurowska A, Majda A, Liszka H, Gądek A. The Impact of Chronic Pain, Stiffness and Difficulties in Performing Daily Activities on the Quality of Life of Older Patients with Knee Osteoarthritis. Int J Environ Res Public Health. 2022;19(24):16815. PMID: 36554695. PMCID: PMC9779661. https://doi.org/10.3390/ijerph192416815</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Merry Del Val B, Shukla SR, Oduoye MO, Nsengiyumva M, Tesfaye T, Glinkowski WM. Prevalence of mental health disorders in knee osteoarthritis patients: a systematic review and meta-analysis. Ann Med Surg (Lond). 2024;86(8):4705-4713. PMID: 39118762. PMCID: PMC11305717. https://doi.org/10.1097/ms9.0000000000002258</mixed-citation><mixed-citation xml:lang="en">Merry Del Val B, Shukla SR, Oduoye MO, Nsengiyumva M, Tesfaye T, Glinkowski WM. Prevalence of mental health disorders in knee osteoarthritis patients: a systematic review and meta-analysis. Ann Med Surg (Lond). 2024;86(8):4705-4713. PMID: 39118762. PMCID: PMC11305717. https://doi.org/10.1097/ms9.0000000000002258</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Sorkpor SK, Galle K, Teixeira AL, et al. The Relationship Between Plasma BDNF and Pain in Older Adults With Knee Osteoarthritis. Biol Res Nurs. 2021;23(4):629-636. PMID: 33910384. PMCID: PMC8726424. https://doi.org/10.1177/10998004211012479</mixed-citation><mixed-citation xml:lang="en">Sorkpor SK, Galle K, Teixeira AL, et al. The Relationship Between Plasma BDNF and Pain in Older Adults With Knee Osteoarthritis. Biol Res Nurs. 2021;23(4):629-636. PMID: 33910384. PMCID: PMC8726424. https://doi.org/10.1177/10998004211012479</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Xiong HY, Hendrix J, Schabrun S, et al. The Role of the Brain-Derived Neurotrophic Factor in Chronic Pain: Links to Central Sensitization and Neuroinflammation. Biomolecules. 2024;14(1):71. PMID: 38254671. PMCID: PMC10813479. https://doi.org/10.3390/biom14010071</mixed-citation><mixed-citation xml:lang="en">Xiong HY, Hendrix J, Schabrun S, et al. The Role of the Brain-Derived Neurotrophic Factor in Chronic Pain: Links to Central Sensitization and Neuroinflammation. Biomolecules. 2024;14(1):71. PMID: 38254671. PMCID: PMC10813479. https://doi.org/10.3390/biom14010071</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Gowler PRW, Li L, Woodhams SG, et al. Peripheral brain-derived neurotrophic factor contributes to chronic osteoarthritis joint pain. Pain. 2020;161(1):61-73. PMID: 31479064. https://doi.org/10.1097/j.pain.0000000000001694</mixed-citation><mixed-citation xml:lang="en">Gowler PRW, Li L, Woodhams SG, et al. Peripheral brain-derived neurotrophic factor contributes to chronic osteoarthritis joint pain. Pain. 2020;161(1):61-73. PMID: 31479064. https://doi.org/10.1097/j.pain.0000000000001694</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Cappoli N, Tabolacci E, Aceto P, Dello Russo C. The emerging role of the BDNF-TrkB signaling pathway in the modulation of pain perception. J Neuroimmunol. 2020;349:577406. PMID: 33002723. https://doi.org/10.1016/j.jneuroim.2020.577406</mixed-citation><mixed-citation xml:lang="en">Cappoli N, Tabolacci E, Aceto P, Dello Russo C. The emerging role of the BDNF-TrkB signaling pathway in the modulation of pain perception. J Neuroimmunol. 2020;349:577406. PMID: 33002723. https://doi.org/10.1016/j.jneuroim.2020.577406</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Manukyan G, Gallo J, Mikulkova Z, et al. Phenotypic and functional characterisation of synovial fluid-derived neutrophils in knee osteoarthritis and knee infection. Osteoarthritis Cartilage. 2023;31(1):72-82. PMID: 36216277. https://doi.org/10.1016/j.joca.2022.09.011</mixed-citation><mixed-citation xml:lang="en">Manukyan G, Gallo J, Mikulkova Z, et al. Phenotypic and functional characterisation of synovial fluid-derived neutrophils in knee osteoarthritis and knee infection. Osteoarthritis Cartilage. 2023;31(1):72-82. PMID: 36216277. https://doi.org/10.1016/j.joca.2022.09.011</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Puts S, Njemini R, Bilterys T, et al. Linking Intra-Articular Inflammatory Biomarkers with Peripheral and Central Sensitization in Late-Stage Knee Osteoarthritis Pain: A Pilot Study. J Clin Med. 2024;13(17):5212. PMID: 39274424. PMCID: PMC11395782. https://doi.org/10.3390/jcm13175212</mixed-citation><mixed-citation xml:lang="en">Puts S, Njemini R, Bilterys T, et al. Linking Intra-Articular Inflammatory Biomarkers with Peripheral and Central Sensitization in Late-Stage Knee Osteoarthritis Pain: A Pilot Study. J Clin Med. 2024;13(17):5212. PMID: 39274424. PMCID: PMC11395782. https://doi.org/10.3390/jcm13175212</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Semenistaja S, Skuja S, Kadisa A, Groma V. Healthy and Osteoarthritis-Affected Joints Facing the Cellular Cross-talk. Int J Mol Sci. 2023;24(4):4120. PMID: 36835530. PMCID: PMC9964755. https://doi.org/10.3390/ijms24044120</mixed-citation><mixed-citation xml:lang="en">Semenistaja S, Skuja S, Kadisa A, Groma V. Healthy and Osteoarthritis-Affected Joints Facing the Cellular Cross-talk. Int J Mol Sci. 2023;24(4):4120. PMID: 36835530. PMCID: PMC9964755. https://doi.org/10.3390/ijms24044120</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Fu L, Zhang L, Zhang X, Chen L, Cai Q, Yang X. Roles of oxygen level and hypoxia-inducible factor signaling pathway in cartilage, bone and osteochondral tissue engineering. Biomed Mater. 2021;16(2):022006. PMID: 33440367. https://doi.org/10.1088/1748-605x/abdb73</mixed-citation><mixed-citation xml:lang="en">Fu L, Zhang L, Zhang X, Chen L, Cai Q, Yang X. Roles of oxygen level and hypoxia-inducible factor signaling pathway in cartilage, bone and osteochondral tissue engineering. Biomed Mater. 2021;16(2):022006. PMID: 33440367. https://doi.org/10.1088/1748-605x/abdb73</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Zhang, Z., Cheng D., Pan J., et al. Lubricating MXenzyme-based hybrid hydrogel reverses oxidative damage to alleviate osteoarthritis. Chem Eng J. 2024;482:148815. https://doi.org/10.1016/j.cej.2024.148815</mixed-citation><mixed-citation xml:lang="en">Zhang, Z., Cheng D., Pan J., et al. Lubricating MXenzyme-based hybrid hydrogel reverses oxidative damage to alleviate osteoarthritis. Chem Eng J. 2024;482:148815. https://doi.org/10.1016/j.cej.2024.148815</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Munteanu C., et al., Cellular and Molecular Homeostatic Micro-environmental im-balances in Osteo-arthritis and Rheumatoid Arthritis. Balneo and PRM Res J. 2023;14(2):564.</mixed-citation><mixed-citation xml:lang="en">Munteanu C., et al., Cellular and Molecular Homeostatic Micro-environmental im-balances in Osteo-arthritis and Rheumatoid Arthritis. Balneo and PRM Res J. 2023;14(2):564.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Khan S., Islam S., Khan R et al. Evaluating the Impact of Weight Bearing and Non-Weight Bearing Exercises on Pain and Physical Function in Obese Knee Osteoarthritic Patients: A Randomized Controlled Trial. Allied Medical Research Journal. 2023;1(2):27-37.</mixed-citation><mixed-citation xml:lang="en">Khan S., Islam S., Khan R et al. Evaluating the Impact of Weight Bearing and Non-Weight Bearing Exercises on Pain and Physical Function in Obese Knee Osteoarthritic Patients: A Randomized Controlled Trial. Allied Medical Research Journal. 2023;1(2):27-37.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Jeevitha D., Kotteeswaran K. Compare the Effectiveness of Weight Bearing Exercises and Plyometric Training Improve Joint Position Sense in Osteoarthritis Knee Subjects. Indian Journal of Physiotherapy &amp; Occupational Therapy. 2024:18.</mixed-citation><mixed-citation xml:lang="en">Jeevitha D., Kotteeswaran K. Compare the Effectiveness of Weight Bearing Exercises and Plyometric Training Improve Joint Position Sense in Osteoarthritis Knee Subjects. Indian Journal of Physiotherapy &amp; Occupational Therapy. 2024:18.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Bennell KL, Nelligan RK, Kimp AJ, et al. Comparison of weight bearing functional exercise and non-weight bearing quadriceps strengthening exercise on pain and function for people with knee osteoarthritis and obesity: protocol for the TARGET randomised controlled trial. BMC Musculoskelet Disord. 2019;20(1):291. PMID: 31208435. PMCID: PMC6580522. https://doi.org/10.1186/s12891-019-2662-5</mixed-citation><mixed-citation xml:lang="en">Bennell KL, Nelligan RK, Kimp AJ, et al. Comparison of weight bearing functional exercise and non-weight bearing quadriceps strengthening exercise on pain and function for people with knee osteoarthritis and obesity: protocol for the TARGET randomised controlled trial. BMC Musculoskelet Disord. 2019;20(1):291. PMID: 31208435. PMCID: PMC6580522. https://doi.org/10.1186/s12891-019-2662-5</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Norato O, Velez S, Lleshi A, et al. Elderly Hip Osteoarthritis: A Review of Short-Term Pain Relief Through Non-Weight-Bearing Therapies. J Funct Morphol Kinesiol. 2025;10(2):124. PMID: 40566421. PMCID: PMC12015921. https://doi.org/10.3390/jfmk10020124</mixed-citation><mixed-citation xml:lang="en">Norato O, Velez S, Lleshi A, et al. Elderly Hip Osteoarthritis: A Review of Short-Term Pain Relief Through Non-Weight-Bearing Therapies. J Funct Morphol Kinesiol. 2025;10(2):124. PMID: 40566421. PMCID: PMC12015921. https://doi.org/10.3390/jfmk10020124</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Lawford BJ, Bennell KL, Allison K, Schwartz S, Hinman RS. Challenges With Strengthening Exercises for Individuals With Knee Osteoarthritis and Comorbid Obesity: A Qualitative Study With Patients and Physical Therapists. Arthritis Care Res (Hoboken). 2022;74(1):113-125. PMID: 32886868. https://doi.org/10.1002/acr.24439</mixed-citation><mixed-citation xml:lang="en">Lawford BJ, Bennell KL, Allison K, Schwartz S, Hinman RS. Challenges With Strengthening Exercises for Individuals With Knee Osteoarthritis and Comorbid Obesity: A Qualitative Study With Patients and Physical Therapists. Arthritis Care Res (Hoboken). 2022;74(1):113-125. PMID: 32886868. https://doi.org/10.1002/acr.24439</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Hall M, Dobson F, Van Ginckel A, et al. Comparative effectiveness of exercise programs for psychological well-being in knee osteoarthritis: A systematic review and network meta-analysis. Semin Arthritis Rheum. 2021;51(5):1023-1032. PMID: 34416624. https://doi.org/10.1016/j.semarthrit.2021.07.007</mixed-citation><mixed-citation xml:lang="en">Hall M, Dobson F, Van Ginckel A, et al. Comparative effectiveness of exercise programs for psychological well-being in knee osteoarthritis: A systematic review and network meta-analysis. Semin Arthritis Rheum. 2021;51(5):1023-1032. PMID: 34416624. https://doi.org/10.1016/j.semarthrit.2021.07.007</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Ma X, Zhang H, Li G, et al. A clinical study based on bidirectional Mendelian randomization: Correlation between generalized anxiety disorder and weight-bearing joints osteoarthritis. Heliyon. 2024;10(12):e32988. PMID: 39021945. PMCID: PMC11252706. https://doi.org/10.1016/j.heliyon.2024.e32988</mixed-citation><mixed-citation xml:lang="en">Ma X, Zhang H, Li G, et al. A clinical study based on bidirectional Mendelian randomization: Correlation between generalized anxiety disorder and weight-bearing joints osteoarthritis. Heliyon. 2024;10(12):e32988. PMID: 39021945. PMCID: PMC11252706. https://doi.org/10.1016/j.heliyon.2024.e32988</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Puts S, Liberman K, Leysen L, et al. Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis. Exerc Immunol Rev. 2023;29:22-53. PMID: 37358362</mixed-citation><mixed-citation xml:lang="en">Puts S, Liberman K, Leysen L, et al. Exercise-induced effects on inflammatory markers and brain-derived neurotrophic factor in patients with knee osteoarthritis. A systematic review with meta-analysis. Exerc Immunol Rev. 2023;29:22-53. PMID: 37358362</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Tudorachi NB, Totu EE, Fifere A, et al. The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis. Antioxidants (Basel). 2021;10(6):985. PMID: 34205576. PMCID: PMC8233827. https://doi.org/10.3390/antiox10060985</mixed-citation><mixed-citation xml:lang="en">Tudorachi NB, Totu EE, Fifere A, et al. The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis. Antioxidants (Basel). 2021;10(6):985. PMID: 34205576. PMCID: PMC8233827. https://doi.org/10.3390/antiox10060985</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
