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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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DOI: doi:10.1007/s10067-022-06477-5


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 Details

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 Division:Health
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)
ID Code:155640
Year Published:2023
Deposited By:Menzies Institute for Medical Research
Deposited On:2023-03-03
Last Modified:2023-03-06

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