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The effects of group cycling on gait and pain-related disability in individuals with mild-to-moderate knee osteoarthritis: a randomized controlled trial
Salacinski AJ, Krohn K, Lewis SF, Holland ML, Ireland K, Marchetti G
The Journal of Orthopaedic and Sports Physical Therapy 2012 Dec;42(12):985-995
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To determine the effectiveness of a community-based program of stationary group cycling on gait, pain, and physical function in individuals with mild-to-moderate knee osteoarthritis (OA). BACKGROUND: Knee pain and disability are common symptoms in individuals with knee OA. Though exercise for knee OA has acknowledged benefits, it has the potential to aggravate symptoms in some instances. METHODS: Thirty-seven subjects (27 women, 10 men) with a mean +/- SD age of 57.7 +/- 9.8 years were randomly assigned to a cycling (n = 19) or control (n = 18) group for a 12-week intervention study. Outcome variables, measured at baseline and 12 weeks, included preferred and maximal gait velocity, a visual analog pain scale at rest and following a 6-minute walk test, muscle strength, and functional-outcome questionnaires. Data were analyzed using mixed-model analyses of variance for group and time differences. RESULTS: After 12 weeks, the individuals receiving the cycling intervention showed significantly greater improvements (p < 0.05) for preferred gait velocity (mean difference between groups 8.7 cm/s; 95% confidence interval (CI) 2.2 to 15.1), visual analog pain scale on the 6-minute walk test (mean difference 16.5 mm; 95% CI 2.1 to 31.0), the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale (mean difference 14.9 points; 95% CI 2.6 to 27.0) and stiffness subscale (mean difference 10.8 points; 95% CI 0.7 to 21.3), the Knee injury and Osteoarthritis Outcome Score pain subscale (mean difference 13.3 points; 95% CI 3.4 to 23.3), and the Knee Outcome Survey activities of daily living subscale (mean difference 13.9 points; 95% CI 2.0 to 25.9) compared to controls. CONCLUSION: Stationary group cycling may be an effective exercise option for individuals with mild-to-moderate knee OA and may reduce pain with walking. US TRIAL REGISTRATION: NCT00917618. LEVEL OF EVIDENCE: Therapy, level 1b-.

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