Reaching Exercise Goals: Comparison of Exercise Means in Patients With Knee Osteoarthritis
Condition: Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Observational

Summary: 
      The primary objective is to evaluate water based treadmill exercise, land based treadmill
      exercise, and upright cycling in meeting American College of Sports Medicine exercise goals
      for moderate exercise.

      The secondary objective is to compare exercise tolerance for water based treadmill, land
      based treadmill, and upright cycling in meeting American College of Sports Medicine exercise
      goals for moderate exercise.

      The tertiary objective is to evaluate quality of life improvements for water based treadmill
      exercise, land based treadmill exercise, and upright cycling.
    

Detailed description: 
      Osteoarthritis is the most common joint disorder in the United States, affecting
      approximately 26.9 million adults greater than 25 years of age. This disorder can be very
      debilitating: more than 40% of adults with doctor diagnosed arthritis have reported that
      joint symptoms cause them to modify their activities. Risk of disability (defined as needing
      help walking or climbing stairs) associated with osteoarthritis is considered equivalent to
      cardiovascular disease and is greater than any other medical condition in elderly patients
      [13]. Persons with disability associated with osteoarthritis have a substantially worse
      health-related quality of life, in large part due to their inability to exercise.

      Exercise has been shown to help maintain function in knee osteoarthritis [5]. Aerobic walking
      and quadriceps strengthening exercises ([18];[7]) and resistance training [15] have
      demonstrated that exercise can potentially improve pain and function in individuals with knee
      osteoarthritis. Likewise, a Cochrane review on aquatic exercise provided gold level evidence
      that aquatic exercise probably reduces pain and increases function over 3 months; but, it
      stated clearly that more research was needed to understand which type of aquatic exercise,
      how often, and for how long might be beneficial [2]. The American College of Sports Medicine
      (ACSM) recommendations for healthy adults recommend moderate-intensity aerobic exercise
      (endurance) physical activity for a minimum of 30 minutes, 5 days per week or
      vigorous-intensity aerobic physical activity for a minimum of 20 minutes, 3 days per week in
      all healthy adults aged 18 to 65 to promote and maintain health [9]. The best method of
      reaching current ACSM goals in patients with knee osteoarthritis is not known, as
      impact-related exercise certainly demands healthy joints and many patients with knee
      osteoarthritis do not tolerate this form of exercise.

      In counseling patients with knee osteoarthritis, the question remains: how best to exercise
      to reach the ACSM goals for exercise. This study will compare water-based and land-based
      treadmill exercise and upright cycling in meeting ACSM exercise goals for moderate exercise.

      Interested subjects will undergo knee radiographs to confirm presence and degree of knee
      osteoarthritis. Eligible participants will then be randomized into one of the three exercise
      cohorts. During each session, participants will complete between 10 to 45 minutes of
      exercise, with a goal of achieving 30 minutes of moderate aerobic exercise. All subjects will
      only participate in routine activities for the 8 week study period outside of the study
      protocol (no strength training, cardio training, etc.). Health status measurement
      questionnaires (WOMAC, KOOS, and SF12) will be completed at the time of randomization and at
      the conclusion of each week of exercise for a total of 9 times.
    

Intervention name(s): Exercise Cycle; Land-based Treadmill; Water-based Treadmill
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Exercise regimen: three monitored exercise sessions per week for eight weeks using the upright exercise cycle.; Exercise regimen: three monitored exercise sessions per week for eight weeks using the land-based treadmill.; Exercise regimen: three monitored exercise sessions per week for eight weeks using the water-based treadmill.
Other intervention name(s): Schwinn Windsprint Exercise Cycle; True CS 6.0 treadmill; Nautilus NTR 700 treadmill; Hydroworx 2000 Series pool treadmill
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Subjects for this study will be recruited from Penn State Milton S. Hershey Medical Center
        and surrounding communities via internal and external advertisements.
      
Keywords: Osteoarthritis, Knee; Exercise Therapies