The PICO project: aquatic exercise for knee osteoarthritis in overweight and obese individuals

Abstract

BackgroundAquatic exercise is recommended by the Osteoarthritis Research Society (OARSI), by the American College of Rheumatology (ACR) and by the European League Against Rheumatism (EULAR) as a nonpharmacological method of controlling the knee osteoarthritis (KOA) symptoms. Moreover, given that weight loss results in a reduction of the load that is exerted upon the knee during daily activities, obesity is also considered to be a modifiable risk factor for the development and or exacerbation of KOA. The implementation of an exercise based weight loss program may, however, itself be limited by the symptoms of KOA. The aquatic program against osteoarthritis (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 is assessing the effectiveness of 3 months of PICO on the symptoms of KOA, on physical function, on quality of life and on gait. In addition, PICO shall examine the effects of said exercise intervention on inflammatory biomarkers, psychological health, life style and body composition.Methods/DesignThe trial is a prospective, single-blinded, randomized controlled trial, and involves 50 overweight and obese adults (BMI = 28–43.5 kg/m2; age 40–65 yrs) with radiographic KOA. The participants are randomly allocated into either an educational attention (control) group or an aquatic (exercise program) group. This paper describes the experimental protocol that is used in the PICO project.DiscussionThe PICO program shall provide insight into the effectiveness of an aquatic exercise program in the control of KOA symptoms and in the improvement of the quality of life. As such, they are likely to prove a useful reference to health professionals who intend to implement any kind of therapeutic intervention based around aquatic exercise.Trial registrationNCT01832545.

Development of the Knee OA Pre‐Screening Questionnaire

“…For this study, 222 individuals (69 with clinical and radiological diagnosis of KOA) were recruited across the PICO project. 26 The KOPS scores were compared with the ACR clinical and radiological diagnosis. 6 In addition, the ROC curve was used to find the cut-off KOPS score with the best sensitivity and specificity for diagnosing KOA.…”

Effect of the Combined Intervention with Passive Whole-Body Vibration and Auriculotherapy on the Quality of Life of Individuals with Knee Osteoarthritis Assessed by the WHOQOL-Bref: A Multi-Arm Clinical Trial

“…The current work evaluated the combined effect of various non-pharmacological interventions (AT, WBVE and combined AT and WBVE) on the quality of life in individuals with KOA. Due to the fact KOA is a degenerative disease, it leads to a progressive functional limitation that used to compromise quality of life [44]. The hypothesis of this study was that the combination of both interventions (WBVE and AT) would have additional benefits on the physical health domain of the quality of life as assessed by the WHOQOL-bref in KOA individuals.…”

The PLE2NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial

“…Studies have demonstrated that exercise benefits patients with KOA [ 35 – 46 ]. The two most recognized approaches for KOA treatment with exercise are land-based [ 47 – 49 ] and aquatic programs [ 44 , 50 – 53 ].…”