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1 April 1992

Supervised Fitness Walking in Patients with Osteoarthritis of the Knee: A Randomized, Controlled Trial

Publication: Annals of Internal Medicine
Volume 116, Number 7


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.

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Information & Authors


Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 116Number 71 April 1992
Pages: 529 - 534


Published in issue: 1 April 1992
Published online: 1 December 2008




Pamela A. Kovar, PT, EdD
John P. Allegrante, PhD
C. Ronald MacKenzie, MD
Margaret G. E. Peterson, PhD
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.

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Pamela A. Kovar, John P. Allegrante, C. Ronald MacKenzie, et al. Supervised Fitness Walking in Patients with Osteoarthritis of the Knee: A Randomized, Controlled Trial. Ann Intern Med.1992;116:529-534. doi:10.7326/0003-4819-116-7-529

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