Patient case (clinical description): A 66-year-old woman comes to the office due to joint pain in the hands and periodic morning stiffness that lasts less than 15 minutes.  The pain is moderately severe and worsens with daily activity. The patient used Tylenol with minimal relief.  Past medical history is notable for hypertension and hypercholesteremia.  Physical examination shows firm nodules over the distal interphalangeal joints, bilaterally. The patient has pain in her knees as well. The knees are stiff in the morning for less than 30 minutes and become worse with climbing stairs. She has some sensation of bone friction during activity. X-ray shows narrowing of the joint space, subchondral bone sclerosis and osteophyte formation along the joints.

Patient's own account: I'm a 66-year-old woman and I went to my doctor's office because of a bloody joint pain in my hands that has been lasting for a while. The pain comes and go in the morning usually. I feel like a stiffness that last less than 15 minutes. The pain is moderately severe but it gets worse when I'm using my hands. I used Tylenol which helped a little. Apart from that, I suffer from hypertension and high cholesterol. The doctor made me notice that I have bumps around both of my hand joints. I also suffer from my knees and they are also stiff in the morning for around 30 min. It's even worse when I climb up the stairs! I also feel like my bones are rubbing against each other when I'm moving. The X-ray showed that I have narrow joint space, I have sclerosis, and abnormal growths of bone along my joints.

Clinical trial: An Investigation Into the Role of Walking in Treating the Symptoms of Knee Osteoarthritis: The WalkOut Study

Eligibility criteria:
Inclusion Criteria:

        Following current NICE (The National Institute for Health Care Excellence) guidelines
        (United Kingdom) for diagnosing knee osteoarthritis:

          -  Anyone over the age of 45 with painful knee/s

          -  No morning stiffness or stiffness that lasts less than 30 minutes

        Exclusion Criteria:

          -  Exercise/activity > than current Department of Health physical activity guidelines

          -  Stiffness > 30mins in the morning

          -  Self-reported knee pathology (cruciate, meniscal, soft tissue, joint replacement)

          -  Cardiac disease - any:

               -  Acute coronary syndrome < 12 months

               -  Unexplained arrhythmia

               -  Angioplasty/cardiac surgery

               -  Congestive Cardiac Failure

               -  Valvular disease

               -  Cardiomyopathy

               -  Myocarditis

               -  Uncontrolled Hypertension

          -  Thrombolic events - any:

               -  Cerebrovascular accident/transient ischaemic attack last 12 months

               -  Deep vein thrombosis/pulmonary embolus last 6 months

          -  Asthma/Chronic Obstructive Pulmonary Disease Peak Expiratory Flow Rate <
             300L/min/frequent exacerbations

          -  Anaemia Haemoglobin <90d/L

          -  Mental illness/learning disabilities/terminal illness

          -  Does not understand English
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 45 Years old.


Eligibility (NLI label): Entailment