The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis: A knowledge translation randomized controlled trial: Part II: Clinical outcomes

Abstract

BackgroundOsteoarthritis (OA) is the most common joint disorder in the world, as it is appears to be prevalent among 80% of individuals over the age of 75. Although physical activities such as walking have been scientifically proven to improve physical function and arthritic symptoms, individuals with OA tend to adopt a sedentary lifestyle. There is therefore a need to improve knowledge translation in order to influence individuals to adopt effective self-management interventions, such as an adapted walking program.MethodsA single-blind, randomized control trial was conducted. Subjects (n = 222) were randomized to one of three knowledge translation groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period.ResultsThe clinical and quality of life outcomes improved among participants in each of the three comparative groups. However, there were few statistically significant differences observed for quality of life and clinical outcomes at long-term measurements at 12-months end of intervention and at 6- months post intervention (18-month follow-up). Outcome results varied among the three groups.ConclusionThe three groups were equivalent when determining the effectiveness of knowledge uptake and improvements in quality of life and other clinical outcomes. OA can be managed through the implementation of a proven effective walking program in existing community-based walking clubs.Trial registrationCurrent Controlled Trials IRSCTNO9193542

Use of Wearable Activity Trackers to Improve Physical Activity Behavior in Patients With Rheumatic and Musculoskeletal Diseases: A Systematic Review and Meta‐Analysis

“…The electronic search yielded 2,795 potentially relevant hits ( Figure 1). One study was potentially relevant, but the full text was not available (43) (27), and 5 studies included elderly patients with osteoarthritis (the remaining 4 studies on osteoarthritis were not related specifically to elderly patients) (35,38,(40)(41)(42). One study was potentially relevant, but the full text was not available (43) (27), and 5 studies included elderly patients with osteoarthritis (the remaining 4 studies on osteoarthritis were not related specifically to elderly patients) (35,38,(40)(41)(42).…”

Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

“…A total of 1843 participants walked in outdoor walking groups with at least 1488 h of provision (3 studies did not give enough information from which to calculate dosage) and a total of 74 023 h of participant walking time. Walking groups were used with participants with a broad range of health conditions: arthritis,29 30 dementia and cognitive impairment,31–33 diabetes,34–36 fibromyalgia,37–39 obesity and overweight,40–44 mental health issues45–49 and Parkinson's disease50 with 64 different tools used to test outcomes.…”

“…This is against a back drop of over 74 000 participant hours. Attrition was less clearly described but in one study there was a participant withdrawal as overweight and self-conscious;45 one author states that travel to the walking club may have affected attrition,29 and one describes the different attrition rates between African-American and white walkers 40…”

Which is the Best Physical Treatment for Osteoarthritis?

“…Interestingly, Mangani and coauthors evaluated aerobic exercise interventions in 435 participants with knee OA (mean age of 68.7 years) in the presence of other clinical conditions, concluding that aerobic training improves physical function in individuals with comorbidity and that, however, aerobic training improves physical function and knee pain independently of the presence of comorbidity [59]. Better results from aerobic training are obtained when it is associated with behavioral intervention, as evidenced in a clinical trial by Brosseau and collaborators, in which an aerobic walking program with or without behavioral intervention was administered to 222 patients with mild to moderate knee OA, and the clinical and quality of life outcomes improved among participants, concluding that OA can be managed through the implementation of a proven effective aerobic walking program [60]. However, the clinical trials on the treatment of OA frequently include both aerobic and strengthening training, and in general, both are associated with improvements in relieving joint symptoms and improving function; even if in some studies, greater pain relief was found with aerobic training, in most cases differences were not significant [57,61].…”