Yazigi (2013) protocol knee OA and obesity

Background: Aquatic exercise is recommended by the Osteoarthritis Research Society (OARSI), by theAmerican College of Rheumatology (ACR) and by the European League Against Rheumatism (EULAR) as anonpharmacological method of controlling the knee osteoarthritis (KOA) symptoms. Moreover, given that weightloss results in a reduction of the load that is exerted upon the knee during daily activities, obesity is also consideredto be a modifiable risk factor for the development and or exacerbation of KOA. The implementation of an exercisebased weight loss program may, however, itself be limited by the symptoms of KOA. The aquatic program againstosteoarthritis (termed “PICO” in Portuguese) prioritizes the control of symptoms and the recovery of functionality,with an attendant increase in the patient’s physical activity level and, consequently, metabolic rate. Our laboratory isassessing the effectiveness of 3 months of PICO on the symptoms of KOA, on physical function, on quality of lifeand on gait. In addition, PICO shall examine the effects of said exercise intervention on inflammatory biomarkers,psychological health, life style and body composition.

Methods/Design: The trial is a prospective, single-blinded, randomized controlled trial, and involves 50 overweightand obese adults (BMI = 28–43.5 kg/m2; age 40–65 yrs) with radiographic KOA. The participants are randomlyallocated into either an educational attention (control) group or an aquatic (exercise program) group. This paperdescribes the experimental protocol that is used in the PICO project.

Discussion: The PICO program shall provide insight into the effectiveness of an aquatic exercise program in thecontrol of KOA symptoms and in the improvement of the quality of life. As such, they are likely to prove a usefulreference to health professionals who intend to implement any kind of therapeutic intervention based aroundaquatic exercise.Trial registration: NCT01832545.

Keywords: Aquatic exercise, Knee osteoarthritis, Exercise, Pain, Obesity