The effect of low-load exercise on joint pain, function, and activities of daily living in patients with knee osteoarthritis

Knee. 2018 Jan;25(1):135-145. doi: 10.1016/j.knee.2017.12.003. Epub 2018 Jan 8.


Background: Knee osteoarthritis has a lifetime risk of nearly one in two, with obese individuals being most susceptible. While exercise is universally recognized as a critical component for management, unsafe or ineffective exercise frequently leads to exacerbation of joint symptoms.

Aim: Evaluate the effect of a 12week lower body positive pressure (LBPP) supported low-load treadmill walking program on knee pain, joint function, and performance of daily activities in patients with knee osteoarthritis (OA).

Design: Prospective, observational, repeated measures investigation.

Setting: Community based, multidisciplinary musculoskeletal medicine clinic.

Patients: Thirty-one patients, aged 50-75, with a BMI ≥25kg/m2 and radiographic confirmed mild to moderate knee OA.

Intervention: Twelve week LBPP treadmill walking exercise regimen.

Outcome measures: The Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Canadian Occupational Performance Measure (COPM) were used to quantify joint symptoms and patient function; isokinetic thigh muscle strength was evaluated; and a 10-point VAS was used to quantify acute knee pain while walking. Baseline and follow-up data were compared in order to examine the effect of the 12week exercise intervention.

Results: There was a significant difference between baseline and follow-up data: KOOS and COPM scores both improved; thigh muscle strength increased; and acute knee pain during full weight bearing walking diminished significantly.

Conclusions: Participation in a 12week LBPP supported treadmill walking exercise regimen significantly enhanced patient function and quality of life, as well as the ability to perform activities of daily living that patient's self-identified as being important, yet difficult to perform.

Keywords: Activities of daily living; Exercise; Knee osteoarthritis; Lower body positive pressure (LBPP); Pain.

Publication types

  • Observational Study

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / rehabilitation*
  • Patient Outcome Assessment*
  • Prospective Studies
  • Quality of Life
  • Visual Analog Scale*
  • Walking / physiology