"Progressive walking" combined with glucosamine sulphate supplementation has been shown to improve the symptoms of osteoarthritis. Researchers writing in BioMed Central's open-access journal Arthritis Research and Therapy found that patients who walked at least two bouts of 1500 steps each on three days of the week reported significantly less arthritis pain, and significantly improved physical function.
Dr Kristiann Heesch worked with a team of researchers from The University of Queensland, Australia, to carry out the trial in 36 osteoarthritis patients (aged 42-73 years). All patients received the dietary supplement for six weeks, after which they continued to take the supplement during a 12-week progressive walking program. The program, called Stepping Out, includes a walking guide; a pedometer; weekly log sheets and a weekly planner, all intended to help patients adopt the exercise regime.
Seventeen patients were randomly assigned to walk five days per week, while the remaining 19 were instructed to walk three days a week.
The team found that both groups achieved significant improvement in their symptoms, however being encouraged to walk five days a week was notmore effective than being encouraged to walk three days. "These findings are not surprising given that the three-day and five-day walking groups did not differ significantly in the mean number of days actually walked per week, the mean number of daily steps walked, nor their weekly minutes of physical activity," Dr Heesch said. "They provide preliminary evidence that osteoarthritis sufferers can benefit from a combination of glucosamine sulphate and walking 3000 steps per day for exercise, in bouts of at least 1500 steps each, on at least three days per week."
This amount of walking is less than current physical activity recommendations for the general population, but follows the recommendations for people with arthritis.
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Tuesday, February 16, 2010
Most Patients Gain Weight After Knee Replacement Surgery
You'd think folks who've had knee replacement surgery -- finally able to walk and exercise without pain -- would lose weight instead of put on pounds, but surprisingly that's not the case, according to a University of Delaware study.
Researchers Joseph Zeni and Lynn Snyder-Mackler in the Department of Physical Therapy in UD's College of Health Sciences found that patients typically drop weight in the first few weeks after total knee arthroplasty (TKA), but then the number on the scale starts creeping upward, with an average weight gain of 14 pounds in two years.
The study, which was sponsored by the National Institutes of Health, is reported in the Jan. 15 online edition of Osteoarthritis and Cartilage, the official journal of the Osteoarthritis Research Society International.
The research involved 106 individuals with end-stage osteoarthritis who had knee replacement surgery, and an age-matched, healthy control group of 31 subjects who did not have surgery. Height, weight, quadriceps strength, and self-perceived functional ability were measured during an initial visit to UD's Physical Therapy Clinic, and at a follow-up visit two years later.
"We saw a significant increase in body mass index (BMI) over two years for the surgical group, but not the control group," says Zeni, a research assistant professor at UD. "Sixty-six percent of the people in the surgical group gained weight over the two years -- the average weight gain was 14 pounds."
Those who had the knee replacement surgery started out heavier and ended heavier than the control group. The weaker the surgery patients were, as measured by the strength of the quadriceps, the more weight they gained, Zeni notes.
"These findings are making us re-think the component after total knee surgery and of patients not being in a routine of moving around," says Snyder-Mackler, Alumni Distinguished Professor of Physical Therapy at UD.
She notes that it's critical that people not wait too long to have a knee replaced because their functional level going into surgery typically dictates their functional level after surgery.
Gaining weight after one knee replacement is worrisome because it could jeopardize the patient's other knee. Between 35-50 percent will have surgery on the other side within 10 years, Snyder-Mackler says.
The researchers note that weight gain after a knee replacement needs to be treated as a separate concern and integrated into post-operative care through a combination of approaches, including nutritional counseling to help patients with portion control, and more emphasis on retraining patients with new knees to walk normally.
"For physical therapists and surgeons, the common thinking is that after a patient's knee has been replaced, that patient will be more active," says Snyder-Mackler. "But the practices and habits these patients developed to get around in the years prior to surgery are hard to break, and often they don't take advantage of the functional gain once they get a new knee," she notes.
"We need to re-train patients with new knees to walk more normally and more systematically. And we need to encourage more community participation," Snyder-Mackler adds. "If you're not getting out of the house, you won't gain the benefit. We need people with new knees to get out there -- with the help of their family, their friends, and the community at large."
Researchers Joseph Zeni and Lynn Snyder-Mackler in the Department of Physical Therapy in UD's College of Health Sciences found that patients typically drop weight in the first few weeks after total knee arthroplasty (TKA), but then the number on the scale starts creeping upward, with an average weight gain of 14 pounds in two years.
The study, which was sponsored by the National Institutes of Health, is reported in the Jan. 15 online edition of Osteoarthritis and Cartilage, the official journal of the Osteoarthritis Research Society International.
The research involved 106 individuals with end-stage osteoarthritis who had knee replacement surgery, and an age-matched, healthy control group of 31 subjects who did not have surgery. Height, weight, quadriceps strength, and self-perceived functional ability were measured during an initial visit to UD's Physical Therapy Clinic, and at a follow-up visit two years later.
"We saw a significant increase in body mass index (BMI) over two years for the surgical group, but not the control group," says Zeni, a research assistant professor at UD. "Sixty-six percent of the people in the surgical group gained weight over the two years -- the average weight gain was 14 pounds."
Those who had the knee replacement surgery started out heavier and ended heavier than the control group. The weaker the surgery patients were, as measured by the strength of the quadriceps, the more weight they gained, Zeni notes.
"These findings are making us re-think the component after total knee surgery and of patients not being in a routine of moving around," says Snyder-Mackler, Alumni Distinguished Professor of Physical Therapy at UD.
She notes that it's critical that people not wait too long to have a knee replaced because their functional level going into surgery typically dictates their functional level after surgery.
Gaining weight after one knee replacement is worrisome because it could jeopardize the patient's other knee. Between 35-50 percent will have surgery on the other side within 10 years, Snyder-Mackler says.
The researchers note that weight gain after a knee replacement needs to be treated as a separate concern and integrated into post-operative care through a combination of approaches, including nutritional counseling to help patients with portion control, and more emphasis on retraining patients with new knees to walk normally.
"For physical therapists and surgeons, the common thinking is that after a patient's knee has been replaced, that patient will be more active," says Snyder-Mackler. "But the practices and habits these patients developed to get around in the years prior to surgery are hard to break, and often they don't take advantage of the functional gain once they get a new knee," she notes.
"We need to re-train patients with new knees to walk more normally and more systematically. And we need to encourage more community participation," Snyder-Mackler adds. "If you're not getting out of the house, you won't gain the benefit. We need people with new knees to get out there -- with the help of their family, their friends, and the community at large."
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