| Author: | Su, Shan |
| Title: | An investigation into structured exercise program for promoting aerobic capacity in community older adults with knee osteoarthritis |
| Advisors: | Fu, Amy (RS) Yu, Chung-Wah (RS) |
| Degree: | Ph.D. |
| Year: | 2025 |
| Subject: | Knee -- Diseases Osteoarthritis Fitness walking Hong Kong Polytechnic University -- Dissertations |
| Department: | Department of Rehabilitation Sciences |
| Pages: | xx, 206 pages : color illustrations |
| Language: | English |
| Abstract: | Aerobic capacity declines in patients with knee osteoarthritis (OA) due to reduced physical activity. As disease severity progresses, patients with knee OA often experience increased symptoms, functional limitations, and reduced quality of life. However, the levels of aerobic capacity, the factors influencing it at various stages of disease, and tailored exercise regimens remain unclear. Thus, this project aimed to investigate aerobic capacity levels and the factors influencing it at different stages of knee OA, and to explore tailored exercise interventions that enhance aerobic capacity. This project consisted of one cross-sectional study and two experimental studies. The cross-sectional study compared the levels of aerobic capacity across different stages of knee OA and with healthy controls. Associations between knee function, physical activity, respiratory function, and aerobic capacity were examined. Findings indicated that patients with knee OA had reduced maximal oxygen consumption (VO2 max) compared to healthy controls, and this decline became more pronounced with disease progression. In the mild-to-moderate group, increased stiffness was associated with reduced VO2 max, and higher physical activity levels appeared to mitigate this negative effect. In the severe group, lower maximal inspiratory pressure was associated with reduced VO2 max. These findings highlight that the factors influencing aerobic capacity differ by disease stage, supporting the need for tailored interventions to enhance aerobic capacity in patients with knee OA. Experimental study one recruited 37 participants with mild-to-moderate knee OA and randomly allocated them to either a 6-week Nordic walking programme plus routine management or routine management alone. Outcome measures were assessed at baseline and at the 6-week follow-up. The experimental group demonstrated an improvement in VO2 max, especially among participants with VO2 max levels below 20 ml·kg-1·min-1 at baseline, whereas the control group showed no change. The intervention demonstrated a good attendance rate, with no severe adverse events reported. Based on the observed effect on VO2 max (Cohen’s d = 0.45), a sample size of 158 is recommended for further studies. Experimental study two recruited 35 participants with severe knee OA awaiting total knee arthroplasty and randomly assigned them to either an experimental group (inspiratory muscle training in addition to pre-operation rehabilitation exercise) or control group (only pre-operation rehabilitation exercise only) for aerobic training. Outcome measures were assessed at baseline and at the 8-week follow-up. The experimental group demonstrated a significant improvement in VO2 max compared to the control group among adherent participants (attendance rate > 60%). The intervention demonstrated a good attendance rate, with no severe adverse events reported. The project concluded that patients with knee OA exhibited reduced aerobic capacity, which worsened with increasing disease severity. Tailored exercise interventions should be considered to improve aerobic capacity in individuals at different stages of knee OA. Nordic walking was found to be safe and effective, particularly for individuals with lower baseline aerobic capacity, suggesting its suitability for patients with mild-to-moderate knee OA. Inspiratory muscle training showed no adverse effects and improved aerobic capacity, making it suitable for patients with severe knee OA awaiting total knee arthroplasty. |
| Rights: | All rights reserved |
| Access: | open access |
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