Uphill treadmill walking plus physical therapy versus physical therapy alone in the management of individuals with knee osteoarthritis: a randomized clinical trial

Abstract

Purpose This study aims to compare the effectiveness of uphill walking and physical therapy versus physical therapy alone on knee pain, excursion ranges, stride length, and walking speed in individuals with knee osteoarthritis. Methods In this randomized clinical trial, 30 patients with knee osteoarthritis participated. Both control and intervention groups received 10-session physical therapy. Moreover, the intervention group received an 8-degree treadmill walking at a speed of 1.1 m/s for 30 min in each session. Outcome measures, including pain, excursion ranges, stride length, and walking speed, were measured at baseline, post-treatment, and a 20-day follow-up. Results Significant improvements in stride length and walking speed were observed just in the intervention group from baseline to post-treatment (p ≤ 0.001) and from baseline to follow-up (p ≤ 0.001). Furthermore, significant improvement in excursion ranges was observed just in the intervention group from baseline to follow-up (p < 0.05). Conclusions This study revealed that the addition of uphill walking to physical therapy results in stride length and walking speed improvements and that it also has persistent effects on knee ranges, stride length, and walking speed as compared with physical therapy alone. This clinical trial was registered at irct.ir (study ID: IRCT20171115034920N1). Implications for Rehabilitation Stretching exercises are recommended to correct knee flexion contracture and uphill treadmill walking is a form of functional stretching. This study shows 10 sessions of combined uphill treadmill walking and physical therapy provided superior improvements in stride length and walking speed at 10-session or 20-day follow-up, and active and passive excursion ranges at 20-day follow-up compared with physical therapy alone. Physical therapist may consider uphill treadmill walking when designing a physical therapy for patients with knee osteoarthritis to promote the results of the rehabilitation programs.