Osteoarthritis, Knee Clinical Trial
Official title:
Reaching Exercise Goals: Comparison of the Underwater Treadmill, Land Based Treadmill, and Exercise Cycle in Patients With Knee Osteoarthritis
The primary objective is to evaluate water based treadmill exercise, land based treadmill
exercise, and upright cycling in meeting American College of Sports Medicine exercise goals
for moderate exercise.
The secondary objective is to compare exercise tolerance for water based treadmill, land
based treadmill, and upright cycling in meeting American College of Sports Medicine exercise
goals for moderate exercise.
The tertiary objective is to evaluate quality of life improvements for water based treadmill
exercise, land based treadmill exercise, and upright cycling.
Osteoarthritis is the most common joint disorder in the United States, affecting
approximately 26.9 million adults greater than 25 years of age. This disorder can be very
debilitating: more than 40% of adults with doctor diagnosed arthritis have reported that
joint symptoms cause them to modify their activities. Risk of disability (defined as needing
help walking or climbing stairs) associated with osteoarthritis is considered equivalent to
cardiovascular disease and is greater than any other medical condition in elderly patients
[13]. Persons with disability associated with osteoarthritis have a substantially worse
health-related quality of life, in large part due to their inability to exercise.
Exercise has been shown to help maintain function in knee osteoarthritis [5]. Aerobic
walking and quadriceps strengthening exercises ([18];[7]) and resistance training [15] have
demonstrated that exercise can potentially improve pain and function in individuals with
knee osteoarthritis. Likewise, a Cochrane review on aquatic exercise provided gold level
evidence that aquatic exercise probably reduces pain and increases function over 3 months;
but, it stated clearly that more research was needed to understand which type of aquatic
exercise, how often, and for how long might be beneficial [2]. The American College of
Sports Medicine (ACSM) recommendations for healthy adults recommend moderate-intensity
aerobic exercise (endurance) physical activity for a minimum of 30 minutes, 5 days per week
or vigorous-intensity aerobic physical activity for a minimum of 20 minutes, 3 days per week
in all healthy adults aged 18 to 65 to promote and maintain health [9]. The best method of
reaching current ACSM goals in patients with knee osteoarthritis is not known, as
impact-related exercise certainly demands healthy joints and many patients with knee
osteoarthritis do not tolerate this form of exercise.
In counseling patients with knee osteoarthritis, the question remains: how best to exercise
to reach the ACSM goals for exercise. This study will compare water-based and land-based
treadmill exercise and upright cycling in meeting ACSM exercise goals for moderate exercise.
Interested subjects will undergo knee radiographs to confirm presence and degree of knee
osteoarthritis. Eligible participants will then be randomized into one of the three exercise
cohorts. During each session, participants will complete between 10 to 45 minutes of
exercise, with a goal of achieving 30 minutes of moderate aerobic exercise. All subjects
will only participate in routine activities for the 8 week study period outside of the study
protocol (no strength training, cardio training, etc.). Health status measurement
questionnaires (WOMAC, KOOS, and SF12) will be completed at the time of randomization and at
the conclusion of each week of exercise for a total of 9 times.
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