Aquatic circuit training including aqua-cycling in patients with knee osteoarthritis: A feasibility study

Rewald, Stefanie; Mesters, Ilse; Emans, Pieter J.; Arts, Jacobus J.; Lenssen, Antoine F.; Bie, Rob A. de

doi:10.2340/16501977-1937

Cited by 16 publications

(20 citation statements)

References 7 publications

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“…Our results are somewhat supportive of the feasibility of home-based HIIT and MICT cycling programs for middle-aged and older adults with knee OA, with the enrolment rate and adherence rate for both the HIIT and MICT groups comparable to other cycling studies involving similar populations (Alkatan et al 2016;Rewald et al 2015;Salacinski et al 2012). The number of adverse events (HIIT: 2 of 9 participants, 26 adverse events; MICT: 1 of 8 participants, 2 adverse events) appeared very high, although 24 of these adverse events were reported by one HIIT individual with a Bakers cyst on their knee, who still completed 25 of the requested 32 exercise sessions.…”

Section: Discussionsupporting

confidence: 80%

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Peer Review #1 of "Is high-intensity interval cycling feasible and more beneficial than continuous cycling for knee osteoarthritic patients? Results of a randomised control feasibility trial (v0.2)"

2018

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Background. Knee osteoarthritis (OA) patients often suffer joint pain and stiffness, which contributes to negative changes in body composition, strength, physical performance (function), physical activity and health-related quality of life. To reduce these symptoms and side effects of knee OA, moderate intensity continuous cycling (MICT) is often recommended. While resistance training is considered the optimal form of training to improve sarcopenic outcomes, it imposes higher joint loads and requires supervision, either initially or continuously by trained exercise professionals. Therefore, this pilot study sought to gain some insight into the feasibility and potential benefits of high intensity interval training (HIIT) cycling as an alternative exercise option to MICT cycling for individuals with knee OA. Methods. Twenty-seven middle-aged and older adults with knee OA were randomly allocated to either MICT or HIIT, with both programs involving 4 unsupervised home-based cycling sessions (~25 minutes per session) each week for 8 weeks. Feasibility was assessed by enrolment rate, withdrawal rate, exercise adherence and number of adverse effects. Efficacy was assessed by health-related quality of life (WOMAC and Lequesne index), physical function (Timed Up-and-go (TUG), Sit-to-stand (STS) and preferred gait speed) and body composition (body mass, BMI, body fat percentage and muscle mass). Results. Twenty-seven of the interested 50 potential participants (54%) enrolled in the study, with 17 of the 27 participants completing the trial (withdrawal rate of 37%); with the primary withdrawal reasons being unrelated injuries or illness or family related issues. Of the 17 participants who completed the trial, exercise adherence was very high (HIIT 94%; MICT 88%). While only three individuals (one in the MICT and two in the HIIT group) reported adverse events, a total of 28 adverse events were reported, with 24 of these attributed to one HIIT participant. Pre-post test analyses

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Section: Discussionsupporting

confidence: 80%

“…The sample size was also relatively small, which may affect our ability to detect within and between group significant differences and the potential generalisability of the trial findings. Nevertheless, the sample size in the study was greater (Rewald et al 2015)…”

Section: Manuscript To Be Reviewedmentioning

confidence: 97%

Peer Review #1 of "Is high-intensity interval cycling feasible and more beneficial than continuous cycling for knee osteoarthritic patients? Results of a randomised control feasibility trial (v0.2)"

2018

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“…It might also an option for patients who feel uncomfortable with traditional aquatic exercise because of poor swimming skills or hydrophobia. Previous studies have shown that aqua-cycling is well accepted by patients who have hydrophobia [ 22 , 24 ]. As aqua-cycling has become a recent fitness trend in Europe and the US, many public swimming pools offer aqua-spinning to a healthy population.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a conditioning phase of 25 min, this is an increase of 1 % per week, which is lower than the recommended weekly increase of 2.5 % as advocated by the American Geriatric Society [ 33 ]. This is deliberate, however, as the assumption is that aqua-cycling is more demanding than stationary cycling on land [ 24 , 33 ]. Increased pedalling resistance was offered with caution and only if a participant was able to cycle continuously at 60 rpm without adverse reactions such as increased knee pain after the session, because increased workload results in increased knee load.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, a small one-group pre-test and post-test study on the effects of a 10-week aqua-cycling programme involving patients with rheumatic diseases showed a positive influence on strength, well-being and joint mobility [ 23 ]. Another small study on the feasibility of aqua-cycling, as a part of an aquatic circuit training for patients with knee OA, evaluated aqua-cycling as a safe and controlled exercise regimen and reported that participants were very satisfied with the training [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of aqua-cycling on pain and physical functioning compared with usual care in patients with knee osteoarthritis: study protocol of a randomised controlled trial

Rewald

Mesters

Lenssen

et al. 2016

BMC Musculoskelet Disord

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BackgroundOver the last decade aquatic exercise has become more and more popular. One of the latest trends is aqua-cycling, where participants sit on a water-resistant stationary bike and, while immersed chest deep in the water, combine continuous cycling with upper body exercises that utilise water resistance. Since stationary cycling and aquatic exercises are frequently recommended to patients with knee osteoarthritis, combining both would seem an obvious step, and an aqua-cycling exercise programme for patients with knee osteoarthritis has indeed been developed. This study protocol gives a detailed description of the exercise programme and the methodology of a study to compare this programme with treatment involving usual care only.MethodsThe study is a single-blind, parallel-group, randomised controlled trial of Maastricht University Medical Centre+, the Netherlands. Inclusion criteria: knee pain of four to seven on a 10-point pain rating scale; a Kellgren/Lawrence score between one to three; ability to cycle; good mental health; sufficient language skills; indication for physical therapy in conjunction with impairments due to OA. Exclusion criteria: any contra-indication for aquatic exercise; planned total knee replacement; corticosteroid injection <3 months and/or hyaluronic acid injection <6 months; severe joint complaints (other than knee joint); symptomatic and radiological apparent hip OA; inflammatory joint diseases; inability to safely enter and exit the pool; fear of water. Participants will receive two 45-min moderate intense aqua-cycling sessions weekly over a period of 12 weeks in addition to usual care or usual care only. Usual care consists of an individual intervention plan comprising lifestyle recommendations, medication routine and referral to a physical therapist. Participants will be assessed at baseline, and at 12 and 24 weeks after baseline. The primary outcome is self-reported knee pain and physical functioning. Secondary outcomes are lower limb muscle strength, functional capacity, self-reported disease severity, physical activity level, quality of life, self-efficacy and fear of movement. Daily diaries will collect information on knee pain, physical functioning, level of physical activity, pain medication routine and physical therapy (control group only) or exercise participation over two 30-day periods (during the intervention period).DiscussionTo our knowledge the present study is the first randomised controlled trial evaluating the effects of aqua-cycling in the pre-surgical stage of knee osteoarthritis. This trial will demonstrate if the newly designed aqua-cycling intervention, in supplement to usual care, can help to improve impairments due to knee osteoarthritis.Trial registrationNetherlands Trial Register NTR3766 (21-12-2012).Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-0939-5) contains supplementary material, which is available to authorized users.

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Aquatic exercise for the treatment of knee and hip osteoarthritis

Bartels

Juhl

Christensen

et al. 2016

Cochrane Database of Systematic Reviews

181

142

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Background Osteoarthritis is a chronic disease characterized by joint pain, tenderness, and limitation of movement. At present, no cure is available. Thus only treatment of the person's symptoms and treatment to prevent further development of the disease are possible. Clinical trials indicate that aquatic exercise may have advantages for people with osteoarthritis. This is an update of a published Cochrane review. Objectives To evaluate the effects of aquatic exercise for people with knee or hip osteoarthritis, or both, compared to no intervention.

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Aquatic circuit training including aqua-cycling in patients with knee osteoarthritis: A feasibility study

Abstract: An aquatic circuit training that includes aqua- cycling is feasible for patients with knee osteoarthritis. Participants reported pain reduction and were positive about the diverse exercise programme. Aqua-cycling in a seated position is a safe and controlled type of movement.

Cited by 16 publications

References 7 publications

Peer Review #1 of "Is high-intensity interval cycling feasible and more beneficial than continuous cycling for knee osteoarthritic patients? Results of a randomised control feasibility trial (v0.2)"

Peer Review #1 of "Is high-intensity interval cycling feasible and more beneficial than continuous cycling for knee osteoarthritic patients? Results of a randomised control feasibility trial (v0.2)"

Effect of aqua-cycling on pain and physical functioning compared with usual care in patients with knee osteoarthritis: study protocol of a randomised controlled trial

Aquatic exercise for the treatment of knee and hip osteoarthritis

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