Authors (including presenting author) :
Su S(2), Man CHJ(1), Yu CW(2), Tang WS(1), Wong HL(1), Yan FP(1), Kam WL(1), Fu SN(2)
Affiliation :
(1)Physiotherapy Department, Yan Chai Hospital
(2)Department of Rehabilitation Sciences, The Hong Kong Polytechnic University
Introduction :
Knee osteoarthritis (OA) impairs physical activity and cardiopulmonary function in older adults, creating a cycle of inactivity that worsens health. While pain management and surgery are common treatments, effective exercise interventions that improve cardiopulmonary health without aggravating joint pain remain scarce.
Objectives :
This study compared the effects of Nordic walking for mild-to-moderate knee OA patients and inspiratory muscle training (IMT) with pre-operative rehabilitative exercise for end-stage knee OA patients. The aim was to evaluate their potential in promoting cardiopulmonary function across different OA stages.
Methodology :
80 patients were recruited and randomly allocated into the experimental group or control group: 40 with Kellgren and Lawrence Grade 2-3 knee OA and 40 with Grade 4 or awaiting total knee arthroplasty. The Nordic walking group performed nordic walk 3 times weekly for 6 weeks, while the IMT group trained 5 times weekly for 8 weeks. Primary outcome included distance of 6-minute walk test (6MWD). Secondary outcomes included knee pain intensity by numeric rating scale, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), attendance rate and adverse events.
Result & Outcome :
In the Nordic walking group, knee pain intensity showed a significant reduction by 1.87 points (p=0.013) compared with control subjects. The attendance rate was 90% with no major adverse events. In the IMT group, 6MWD increased by 78.58 meters (p=0.040) compared with control, with significant improvements in WOMAC scores for stiffness, pain, disability, and sum score. The attendance rate was 68%, and no major adverse events were reported. Nordic walking reduced knee pain in mild-to-moderate knee OA patients and was well tolerated, suggesting its potential for improving physical activity engagement without worsening symptoms. IMT improved aerobic capacity in end-stage knee OA patients, highlighting its role as a safe pre-operative intervention for improving cardiopulmonary health.
