Lower Positive Body Pressure Walking Significantly Improves Pain and Function In Individuals With Knee Osteoarthritis: A Pilot Randomized Clinical Trial.
Prakash Jayabalan, Yelyzaveta Merenzon, Audrey Lazar et al.
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In 30 seconds
This parallel-group pilot randomized clinical trial evaluated body weight-supported walking in 49 adults aged over 50 with knee osteoarthritis, assigned to control, aquatic walking, or lower-body positive pressure (LBPP) treadmill walking. After 8 weeks, the LBPP group had a statistically significant and clinically relevant improvement in KOOS-Pain of 15.3 (95% CI: 5.0, 25.6); changes in the aquatic and control groups were not significant. LBPP participants also improved on the 6-minute walk test and most other KOOS subscales. Forty-one participants completed the trial.
Key findings
- KOOS-Pain improved by 15.3 (95% CI: 5.0, 25.6) in the LBPP group; aquatic and control changes were not statistically significant.
- The LBPP group improved on the 6-minute walk test by 58.9 m (95% CI: 26.1, 91.7) and on most KOOS subscales.
- LBPP-group pain improvement was associated with increased knee flexion (P =0.02); only controls had significant increases in IL-1β and IL-1RA.
Why it matters
Walking-based rehabilitation may be difficult when knee pain limits weight-bearing. These pilot findings suggest that LBPP treadmill walking can improve pain and walking capacity over an 8-week intervention in people with knee osteoarthritis, while aquatic walking did not show significant pain improvement in this trial. The results provide a basis for further evaluation of this approach.
What to keep in mind
This was a pilot trial with 49 participants, 41 of whom completed it, and follow-up was limited to 8 weeks. The authors call for larger studies to assess effect size, durability, and cost-effectiveness.