Supervised Fitness Walking in Patients with Osteoarthritis of the Knee

A Randomized, Controlled Trial

  1. Pamela A. Kovar, PT, EdD;
  2. John P. Allegrante, PhD;
  3. C. Ronald MacKenzie, MD;
  4. Margaret G. E. Peterson, PhD;
  5. Bernard Gutin, PhD; and
  6. Mary E. Charlson, MD

    Abstract

    ▪ Objective: To assess the effect of a program of supervised fitness walking and patient education on functional status, pain, and use of medication in patientswith 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% Cl, 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% (Cl, 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% (Cl, 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.

    Article and Author Information

    • From The Hospital for Special Surgery and Columbia University, New York, New York; and the Medical College of Georgia, Augusta, Georgia. For current author addresses, see end of text.

    • Grant Support: In part by a dissertation research grant to Dr. Kovar from the Arthritis Foundation and by National Institutes of Health Multipurpose Arthritis Center Program Grant No. 1 P60 AR38520-01A1 from the National Institute for Arthritis and Musculoskeletal and Skin Diseases.

    • Requests for Reprints: John P. Allegrante, PhD, Cornell Arthritis and Musculoskeletal Diseases Center, The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021.

    • Current Author Addresses: Drs. Kovar, Allegrante, MacKenzie, Peterson, and Charlson: The Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021.

      Dr. Gutin: Department of Pediatrics and Georgia Prevention Institute, Medical College of Georgia, Augusta GA 30912-3710.

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    1. Ann Intern Med April 1, 1992 vol. 116 no. 7 529-534
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