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A walking program for people with severe knee osteoarthritis did not reduce pain but may have benefits for cardiovascular health: a phase II randomised controlled trial.

Osteoarthritis and cartilage
December 1, 2017
J A Wallis et al. (6 authors)
Clinical Trial, Phase IIJournal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to evaluate the effect of a 12-week walking program on knee pain in patients with severe knee osteoarthritis, as well as its secondary effects on cardiovascular health, function, and quality of life.

Results Summary

The walking program did not reduce knee pain but showed cardiovascular benefits, including improved systolic blood pressure and walking speed. Adherent participants also had more daily steps, increased walking time, reduced waist circumference, but reported increased knee stiffness.

Population

Patients with severe knee osteoarthritis and increased cardiovascular risk.

Effective Dosage

70 minutes per week of at least moderate intensity.

Duration

12 weeks.

Interactions

None mentioned.

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
12-week walking program of 70 min/week of at least moderate intensity
no change
knee pain
participants with severe knee OA and increased cardiovascular risk
no significant change
showed no between-group difference
#1
12-week walking program of 70 min/week of at least moderate intensity
increase
healthy systolic blood pressure
participants with severe knee OA and increased cardiovascular risk
OR = 5.7, 95% CI 1.2-26.9
had increased odds of achieving
#2
12-week walking program of 70 min/week of at least moderate intensity
increase
walking speed
participants with severe knee OA and increased cardiovascular risk
Mean Difference (MD) = 0.12 m/s, 95% CI 0.02-0.23
had a faster
#3
12-week walking program of 70 min/week of at least moderate intensity
increase
daily steps
participants with severe knee OA and increased cardiovascular risk
MD = 1345 steps, 95% CI 365-2325
had more
#4
12-week walking program of 70 min/week of at least moderate intensity
increase
time walking
participants with severe knee OA and increased cardiovascular risk
MD = 18 min/day, 95% CI 5-31
had more
#5
12-week walking program of 70 min/week of at least moderate intensity
decrease
waist circumference
participants with severe knee OA and increased cardiovascular risk
MD = -5.3 cm, 95% CI -10.5 to -0.03
had reduced
#6
12-week walking program of 70 min/week of at least moderate intensity
increase
knee stiffness
participants with severe knee OA and increased cardiovascular risk
MD = 0.9 units, 95% CI 0.07-1.8
had increased
#7
Abstract

OBJECTIVE: The primary aim was to evaluate the effect of a dosed walking program on knee pain for patients with severe knee osteoarthritis (OA). Secondary aims evaluated the effects on cardiovascular health, function and quality of life. DESIGN: Participants with severe knee OA and increased cardiovascular risk were randomly assigned to a 12-week walking program of 70 min/week of at least moderate intensity, or to usual care. The primary outcome was knee pain (0-10). Secondary outcomes were of cardiovascular risk including physical activity, blood pressure, blood lipid and glucose levels, body mass index and waist circumference; WOMAC Index scores; physical function; and quality of life. RESULTS: Forty-six participants (23 each group) were recruited. Sixteen participants (70%) adhered to the walking program. Intention to treat analysis showed no between-group difference in knee pain. The walking group had increased odds of achieving a healthy systolic blood pressure (OR = 5.7, 95% CI 1.2-26.9), and a faster walking speed (Mean Difference (MD) = 0.12 m/s, 95% CI 0.02-0.23). Per protocol analysis based on participant adherence showed the walking group had more daily steps (MD = 1345 steps, 95% CI 365-2325); more time walking (MD = 18 min/day, 95% CI 5-31); reduced waist circumference (MD = -5.3 cm, 95% CI -10.5 to -0.03); and increased knee stiffness (MD = 0.9 units, 95% CI 0.07-1.8). CONCLUSIONS: Patients with severe knee OA prescribed a 12-week walking program of 70 min/week may have had cardiovascular benefits without decreasing knee pain. Australian New Zealand Clinical Trials Registry ACTRN12615000015549.

Medical Subject Headings (MeSH)
AgedAged, 80 and overArthralgiaAustraliaBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesCholesterol, HDLCholesterol, LDLComorbidityDyslipidemiasExerciseExercise TherapyFemaleGlucose IntoleranceHumansHypertensionMaleMiddle AgedObesityOsteoarthritis, KneePain MeasurementQuality of LifeSeverity of Illness IndexSingle-Blind MethodTreatment OutcomeTriglyceridesWaist CircumferenceWalking
Study Links
Quality Scores
Safety85
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations35
Citations/Year4.4
Relative Citation Ratio2.35
NIH Percentile79.1%
Research Impact Scores
APT Score0.75
Weight Score1.99
Normalized Score0.75
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