The relationship between knee pain and body weight in early onset knee osteoarthritis
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Osteoarthritis (OA) is a group of diseases entailing degradation of joints, and has been designated as one of the key conditions for special attention during the World Health Organization’s Bone and Joint Decade (2000-2010) (Brooks & Hart, 2000). Research has demonstrated that body weight is the number one modifiable risk factor associated with the onset and progression of knee OA (Felson, 1996). However, exercise programs that aim to initiate weight loss and improve pain and function in knee OA often increase loading on the knee joint, contributing to degeneration of the knee and progression of the disease (Miyazaki et al, 2002). The introduction of a new anti-gravity treadmill, which utilizes a technology called Lower Body Positive Pressure (LBPP), allows the examination of the relationship between weight, knee pain and knee loading via knee acceleration during exercise. The null hypothesis states that there will be no significant difference in knee pain, knee function and knee joint acceleration when comparing full weight bearing and LBPP treadmill walking exercise in a young knee OA population. Twenty-two overweight/obese patients with mild or moderate early-onset knee OA were recruited to complete two 25 minute treadmill walking sessions (one full weight-bearing and one LBPP walking session) one week apart and two walkway walking sessions. Knee pain and knee acceleration were recorded. Paired t-tests and ANOVAs were used to compare conditions. On average, an LBPP of 12.3% body weight reduction reduced knee pain in our population. Knee pain was significantly lower during LBPP walking than during full weight-bearing walking. Knee acceleration decreased with increasing LBPP. Heel strike and toe-off data from walkway walking trials illustrated significantly different knee acceleration about the knee (slow walking loads were lower / fast walking were higher), as compared to treadmill walking sessions. This study illustrates that treadmill walking at a minimal level of LBPP can decrease knee pain and attenuate knee joint loads while allowing patients to complete exercise programs aimed at initiating weight loss and improving pain and function in knee OA. LBPP appears to be a promising tool for rehabilitation for those with painful knee OA and other lower body musculoskeletal conditions.