Pre-exercise and acute movement-evoked pain trajectories during a 24-week outdoor walking program for knee osteoarthritis (WALK)

• Published in: Osteoarthritis and cartilage open 2024-09, Vol.6 (3), p.100481-100481, Article 100481
• Main Authors: Drummen, S.J.J., Aitken, D., Balogun, S., Bennell, K.L., Hinman, R.S., Callisaya, M.L., Otahal, P., Blizzard, L., Antony, B., Munugoda, I.P., Winzenberg, T., Jones, G., Scheepers, L.E.J.M.
• Format: Article
• Language: English
• Subjects: Aerobic; Exercise; Flares; ORIGINAL PAPER; Pain; Rehabilitation
• ISSN: 2665-9131; 2665-9131
• DOI: 10.1016/j.ocarto.2024.100481

Exploring (1) pre-exercise and acute movement-evoked pain (AMEP) during an outdoor walking program in individuals with knee osteoarthritis (OA); and (2) comparing baseline physical performance and AMEP flares initiated by walking between participants with either a higher or lower attendance rate. Individuals with knee OA were prescribed a 24-week walking program, including one unsupervised walk and two supervised walk classes per week. Participants self-reported knee pain on a numerical rating scale (NRS; 0–10) before and after each supervised class. Mixed-effects models were used to investigate trajectories over time for pre-exercise pain and AMEP change (post-minus pre-exercise pain; positive value indicates flare-up). Baseline physical performance (6 tests) and AMEP flares were compared between participants with higher (attending ≥70% of supervised classes) and lower attendance rates. Of 24 participants commencing the program, 7 (29%) withdrew. Over 24 weeks, pre-exercise pain improved by 1.20 NRS (95% CI -1.41 to −0.99), with estimated largest per class improvements during the first 8 weeks (−0.05 (−0.06 to −0.03) and plateauing around 20-weeks. The AMEP was estimated to improve by 0.19 NRS (95% CI -0.38 to −0.004) over 24-weeks, with improvements plateauing around 12-weeks. Participants with lower attendance (n ​= ​11) scored poorer on all physical performance tests and experienced a slight increase in AMEP during the first two weeks of the program. Participants improved in pre-exercise pain and AMEP in the first 20 and 12 weeks, respectively. Despite supervision, physical performance and AMEP flares may have contributed to lower attendance. 12618001097235.