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A pilot randomized controlled trial evaluating outdoor community walking for knee osteoarthritis: walk
Drummen, SJJ and Balogun, S and Lahham, A and Bennell, K and Hinman, RS and Callisaya, M and Cai, G and Otahal, P and Winzenberg, T and Wang, Zhiqiang and Eathakkattu Antony, BS and Munugoda, IP and Martel-Pelletier, J and Pelletier, JP and Jones, Graeme and Aitken, D, A pilot randomized controlled trial evaluating outdoor community walking for knee osteoarthritis: walk, Clinical rheumatology pp. 1-13. ISSN 1434-9949 (2023) [Refereed Article]
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Objectives:To determine the feasibility of a randomized controlled trial (RCT) examining outdoor walking on knee osteoarthritis (KOA) clinical outcomes and magnetic resonance imaging (MRI) structural changes.
Method: This was a 24-week parallel two-arm pilot RCT in Tasmania, Australia. KOA participants were randomized to either a walking plus usual care group or a usual care control group. The walking group trained 3 days/week. The primary outcome was feasibility assessed by changes being required to the study design, recruitment, randomization, program adherence, safety, and retention. Exploratory outcomes were changes in symptoms, physical performance/activity, and MRI measures.
Results: Forty participants (mean age 66 years (SD 1.4) and 60% female) were randomized to walking (n = 24) or usual care (n = 16). Simple randomization resulted in a difference in numbers randomized to the two groups. During the study, class sizes were reduced from 10 to 8 participants to improve supervision, and exclusion criteria were added to facilitate program adherence. In the walking group, total program adherence was 70.0% and retention 70.8% at 24 weeks. The walking group had a higher number of mild adverse events and experienced clinically important improvements in symptoms (e.g., visual analogue scale (VAS) knee pain change in the walking group: - 38.7 mm [95% CI - 47.1 to - 30.3] versus usual care group: 4.3 mm [- 4.9 to 13.4]).
Conclusions: This study supports the feasibility of a full-scale RCT given acceptable adherence, retention, randomization, and safety, and recruitment challenges have been identified. Large symptomatic benefits support the clinical usefulness of a subsequent trial.
Trial registration number:12618001097235. Key Points • This pilot study is the first to investigate the effects of an outdoor walking program on knee osteoarthritis clinical outcomes and MRI joint structure, and it indicates that a full-scale RCT is feasible. • The outdoor walking program (plus usual care) resulted in large improvements in self-reported knee osteoarthritis symptoms compared to usual care alone. • The study identified recruitment challenges, and the manuscript explores these in more details and provides recommendations for future studies.
|Item Type:||Refereed Article|
|Keywords:||Aerobic; Exercise; Joint; MRI; Structure|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Clinical sciences|
|Research Field:||Rheumatology and arthritis|
|Objective Group:||Clinical health|
|Objective Field:||Treatment of human diseases and conditions|
|UTAS Author:||Drummen, SJJ (Mr Stan Drummen)|
|UTAS Author:||Balogun, S (Dr Saliu Balogun)|
|UTAS Author:||Callisaya, M (Dr Michele Callisaya)|
|UTAS Author:||Cai, G (Dr Guoqi Cai)|
|UTAS Author:||Otahal, P (Mr Petr Otahal)|
|UTAS Author:||Winzenberg, T (Professor Tania Winzenberg)|
|UTAS Author:||Wang, Zhiqiang (Mr Zhiqiang Wang)|
|UTAS Author:||Eathakkattu Antony, BS (Dr Benny Eathakkattu Antony)|
|UTAS Author:||Munugoda, IP (Mr Ishanka Munugoda)|
|UTAS Author:||Jones, Graeme (Professor Graeme Jones)|
|UTAS Author:||Aitken, D (Associate Professor Dawn Aitken)|
|Deposited By:||Menzies Institute for Medical Research|
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