Land-Based Versus Water-Based Exercise Program in Elderly with Knee Osteoarthritis

Abstract

Osteoarthritis (OA) is a chronic-degenerative disorder that frequently affects the knee joint. OA prevalence increases with aging causing pain, stiffness and it is responsible for a higher incidence of disability than any other chronic disease in elderly. Patients with knee OA frequently report pain and problems with daily living activities, and present greater difficulty in performing physical and functional activities. Aerobic exercise, such as walking, has been studied in numerous trials, and the aquatic environment, due to their physical characteristics, is widely used for this practice in individuals with knee OA compared to walking on the soil. PURPOSE: To investigate the effect of land-based (LB) and water-based (WB) exercise training on pain, functional and physical capacity, and quality of life of elderly women with knee OA. Method: 16 elderly women with knee OA confirmed by clinical and radiographic examination underwent assessments of functional performance, by six-minute walk test (6MWT) and stair test (ST), and physical capacity, determined by maximal progressive treadmill test to determine peak oxygen consumption (VO2peak) and anaerobic threshold (AT). OA symptoms were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and quality of life by Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36). All parameters were reevaluated after 12 weeks of aerobic training in LB and WB. The aerobic training consisted of walking, for 30-55 minutes, at 72-82% of estimated maximal heart rate, 3 times/week. RESULTS: Adherence to exercise in both, LB and WB training was 92%. No significant difference was found in functional and physical performance tests, WOMAC and SF-36 between LB and WB group. However, significant improvements were observed on all evaluated parameters on both groups after training: reduction on self-report pain, increased performance in 6MWT and ST, augment in VO2peak and VO2 corresponding to AT, and improvement of quality of life. CONCLUSIONS: The walking training on LB and WB group improved the functional and physical capacities, reduced self reported pain and improved life quality of elderly women with knee OA but no differences were observed between WB and LB exercise training. Support by: CNPq, CAPES, FAPEMIG, Brazil.