A pilot randomized controlled trial evaluating outdoor community walking for knee osteoarthritis: walk.

Autor: Drummen SJJ; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia. Stan.Drummen@utas.edu.au., Balogun S; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.; Australian National University, Canberra, Australia., Lahham A; Monash University, Melbourne, Australia., Bennell K; The University of Melbourne, Melbourne, Australia., Hinman RS; The University of Melbourne, Melbourne, Australia., Callisaya M; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.; Monash University, Melbourne, Australia., Cai G; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China., Otahal P; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Winzenberg T; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Wang Z; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Antony B; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Munugoda IP; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Martel-Pelletier J; Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada., Pelletier JP; Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada., Abram F; Medical Imaging Research & Development, ArthroLab Inc, Montreal, QC, Canada., Jones G; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia., Aitken D; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
Jazyk: angličtina
Zdroj: Clinical rheumatology [Clin Rheumatol] 2023 May; Vol. 42 (5), pp. 1409-1421. Date of Electronic Publication: 2023 Jan 24.
DOI: 10.1007/s10067-022-06477-5
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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