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This supports more efficient fat oxidation during sustained aerobic efforts, helps spare glycogen at submaximal intensities, and supports the cellular energy production that drives both training output and recovery
While age and sex cannot be modified, knee OA is strongly associated with lifestyle factors that can be controlled
Dosing typically begins at a lower dose, suggested initiation of 20 units (0.2 mL) weekly for the first 4 weeks, then escalates according to a titration schedule: Weeks 14: Inject 20 units (0.2 mL) one time per week Weeks 58: Inject 40 units (0.4 mL) one time per week Weeks 912: Inject 70 units (0.7 mL) one time per week Weeks 1316: Inject 90 units (0.9 mL) one time per week Weeks 1720: Inject 120 units (1.2 mL) one time per week Week 21+: Inject 140 units (1.4 mL) one time per week Dosing may deviate from this pattern to accommodate patient-specific needs
The principal findings of this paper are illustrated in Figure 5
