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Research ArticleArticle

Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis

Mohammed Alkatan, Jeffrey R. Baker, Daniel R. Machin, Wonil Park, Amanda S. Akkari, Evan P. Pasha and Hirofumi Tanaka
The Journal of Rheumatology January 2016, jrheum.151110; DOI: https://doi.org/10.3899/jrheum.151110
Mohammed Alkatan
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Jeffrey R. Baker
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Daniel R. Machin
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Wonil Park
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Amanda S. Akkari
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Evan P. Pasha
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Hirofumi Tanaka
From the Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA. M. Alkatan, PhD; J.R. Baker, MS; D.R. Machin, PhD; W. Park, MS; A.S. Akkari, BS; E.P. Pasha, MS; H. Tanaka, PhD, Cardiovascular Aging Research Laboratory, Department of Kinesiology and Health Education, The University of Texas at Austin. Address correspondence to H. Tanaka, Department of Kinesiology and Health Education, The University of Texas at Austin, 2109 San Jacinto Blvd., D3700, Austin, Texas 78712, USA. E-mail: htanaka@austin.utexas.edu. Accepted for publication November 18, 2015.
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Abstract

Objective Arthritis and its associated joint pain act as significant barriers for adults attempting to perform land-based physical activity. Swimming can be an ideal form of exercise for patients with arthritis. Yet there is no information on the efficacy of regular swimming exercise involving patients with arthritis. The effect of a swimming exercise intervention on joint pain, stiffness, and physical function was evaluated in patients with osteoarthritis (OA).

Methods Using a randomized study design, 48 sedentary middle-aged and older adults with OA underwent 3 months of either swimming or cycling exercise training. Supervised exercise training was performed for 45 min/day, 3 days/week at 60–70% heart rate reserve for 12 weeks. The Western Ontario and McMaster Universities Arthritis Index was used to measure joint pain, stiffness, and physical limitation.

Results After the exercise interventions, there were significant reductions in joint pain, stiffness, and physical limitation accompanied by increases in quality of life in both groups (all p < 0.05). Functional capacity as assessed by maximal handgrip strength, isokinetic knee extension and flexion power (15–30% increases), and the distance covered in the 6-min walk test increased (all p < 0.05) in both exercise groups. No differences were observed in the magnitude of improvements between swimming and cycling training.

Conclusion Regular swimming exercise reduced joint pain and stiffness associated with OA and improved muscle strength and functional capacity in middle-aged and older adults with OA. Additionally, the benefits of swimming exercise were similar to the more frequently prescribed land-based cycling training. Trial registration: clinicaltrials.gov NCT01836380.

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Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis
Mohammed Alkatan, Jeffrey R. Baker, Daniel R. Machin, Wonil Park, Amanda S. Akkari, Evan P. Pasha, Hirofumi Tanaka
The Journal of Rheumatology Jan 2016, jrheum.151110; DOI: 10.3899/jrheum.151110

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Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis
Mohammed Alkatan, Jeffrey R. Baker, Daniel R. Machin, Wonil Park, Amanda S. Akkari, Evan P. Pasha, Hirofumi Tanaka
The Journal of Rheumatology Jan 2016, jrheum.151110; DOI: 10.3899/jrheum.151110
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