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An evidence-based walking program among older people with knee osteoarthritis: the PEP (participant exercise preference) pilot randomized controlled trial

  • Loew, Laurianne1
  • Brosseau, Lucie1
  • Kenny, Glen P.2, 3
  • Durand-Bush, Natalie2
  • Poitras, Stéphane1
  • De Angelis, Gino1
  • Wells, George A.4
  • 1 University of Ottawa, School of Rehabilitation Sciences, Faculty of Health Sciences, Ottawa, ON, Canada , Ottawa (Canada)
  • 2 University of Ottawa, School of Human Kinetics, Human and Environmental Physiology Research Unit, Faculty of Health Sciences, Ottawa, ON, Canada , Ottawa (Canada)
  • 3 Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada , Ottawa (Canada)
  • 4 University of Ottawa, Department of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, Ottawa, ON, Canada , Ottawa (Canada)
Published Article
Clinical Rheumatology
Publication Date
Mar 22, 2017
DOI: 10.1007/s10067-017-3606-9
Springer Nature


Knee osteoarthritis is a common joint problem leading to an increase of pain and a loss of function in older individuals. The main objective of this study was to evaluate if a participant who was randomly assigned to his preferred group improved his adherence to an effective walking program compared to a participant who did not receive his preferred group. This was a 9-month pilot randomized clinical trial, based on a patient treatment preferences design. The 69 eligible participants had a diagnosis of knee osteoarthritis. Participants were randomized to one of two groups: a supervised community-based or unsupervised walking program, based on the Ottawa Panel guidelines. At 6 months, participants who expressed a preference, either for the supervised or unsupervised program, and who were assigned to their preferred choice of program showed significantly higher adherence to walking sessions (supervised 60.7 ± 12.3%, P < 0.0001; unsupervised 43.1 ± 12.1%, P = 0.03), compared to the participants who did not obtain their preferred choice of program. After 9 months, significant improvements were shown according to the level of stiffness evaluated with the WOMAC (P = 0.01) and the functional status assessed with the Timed Up and GO Test (P = 0.04), among the adherent participants who obtained their preference, as compared to those who did not receive their preference. We show this approach promotes long-term adherence to a community-based walking program, while ensuring the maintenance of clinical benefits of walking, among older adults susceptible to avoid or not properly engage in physical activity.

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