SUPERVISED FITNESS WALKING IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE - A RANDOMIZED, CONTROLLED TRIAL

被引:381
作者
KOVAR, PA
ALLEGRANTE, JP
MACKENZIE, CR
PETERSON, MGE
GUTIN, B
CHARLSON, ME
机构
[1] HOSP SPECIAL SURG, CORNELL ARTHRIT & MUSCULOSKELETAL DIS CTR, 535 E 70TH ST, NEW YORK, NY 10021 USA
[2] COLUMBIA UNIV, NEW YORK, NY 10027 USA
[3] MED COLL GEORGIA, DEPT PEDIAT, AUGUSTA, GA 30912 USA
[4] MED COLL GEORGIA, GEORGIA PREVENT INST, AUGUSTA, GA 30912 USA
关键词
WALKING; OSTEOARTHRITIS; KNEE INJURIES; EXERCISE THERAPY; PATIENT EDUCATION;
D O I
10.7326/0003-4819-116-7-529
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patients with 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% CI, 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% (CI, 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% (CI, 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.
引用
收藏
页码:529 / 534
页数:6
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