Supervised Fitness Walking in Patients with Osteoarthritis of the Knee

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Abstract
▪ Objective: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patientswith osteoarthritis of the knee. ▪ Design: An 8-week randomized, controlled trial. ▪ Setting: Inpatient and outpatient services of an orthopedic hospital in an academic medical center. ▪ Patients: A total of 102 patients with a documented diagnosis of primary osteoarthritis of one or both knees participated in the study. Data were obtained on 47 of 51 intervention patients and 45 of 51 control patients. ▪ Interventions: An 8-week program of supervised fitness walking and patient education or standard routine medical care. ▪ Measurements: Patients were evaluated and outcomes assessed before and after the intervention using a 6-minute test of walking distance and scores on the physical activity, arthritis impact, pain, and medication subscales of the Arthritis Impact Measurement Scale (AIMS). ▪ Results: Patients randomly assigned to the walking program had a 70-meter increase in walking distance relative to their baseline assessment, which represents an improvement of 18.4% (95% Cl, 9.8% to 27.0%). In contrast, controls showed a 17-meter decrease in walking distance relative to their baseline assessment (P < 0.001). Improvements in functional status as measured by the AIMS physical activity subscale were also observed in the walking group but not in the control group (P < 0.001); patients assigned to the walking program improved 39% (Cl, 15.6% to 60.4%). Although changes in scores on the arthritis impact subscale were similar in the two groups (P = 0.093), the walking group experienced a decrease in arthritis pain of 27% (Cl, 9.6% to 41.4%) (P = 0.003). Medication use was less frequent in the walking group than in the control group at the post-test (P = 0.08). ▪ Conclusions: A program of supervised fitness walking and patient education can improve functional status without worsening pain or exacerbating arthritis-related symptoms in patients with osteoarthritis of the knee.