Article Text

AB1176-HPR Feasibility of Aqua Cycling in Patients with Knee Osteoarthritis - A Pilot Study
  1. S. Rewald1,
  2. I. Mesters1,
  3. P.J. Emans2,
  4. T. Lenssen3,
  5. R. de Bie1
  1. 1Epidemiology, School for Public Health and Primary Care (Caphri)
  2. 2Orthopaedic Surgery
  3. 3Physiotherapy, Maastricht University Medical Centre, Maastricht, Netherlands


Background Physical exercise is a cornerstone in the treatment of osteoarthritis (OA) (1-3). However, exercising under normal conditions of gravity can be difficult and painful for patients with OA. In this case aquatic therapy offers several benefits over land-based therapy. Aqua cycling combines stationary cycling with aquatic therapy and seems obvious for patients with knee OA. Aqua cycling has not yet been considered as an exercise treatment in knee OA.

Objectives To investigate the views, experiences and ideas of patients with knee OA on aqua cycling.

Methods A volunteer sample of 10 women and men between 46 to 77 years, differing in knee OA history and exercise experience, trained once a week for 45 minutes over an 8-weeks period. The training took place in a heated therapy pool and focused on knee joint mobility and lower limb muscle strength. The training included aqua cycling, gait training, functional exercises and one leg stance exercises in a heated therapy pool. The primary outcome was feasibility of the eight week exercise program, especially the aqua cycling part, from a patient perspective. Group interviews investigated the factors that determine the patients' acceptability and satisfaction of aqua cycling with reference to their knee osteoarthritis. The analysis of interviews was guided by the steps of “Framework analysis” (4). For triangulation, pre- and post-exercise knee pain was measured on a 0 to 10 numeric pain rating scale.

Results The interviews revealed satisfaction with the training, in terms of pain relief and enjoyment. The characteristics of the participants, participants' expectations, perceived effects and motivation were identified as key terms in the explanation about the unanimous positive evaluation about the exercise programme. Pre- and post-exercise pain measured on a numeric pain rating scale showed a one-point reduction of knee pain.

Conclusions Despite variety of past exercise experience, disease duration and severity of OA, all participants were satisfied with the training, especially the aqua cycling part. Limitations of this pilot study are the lack of objective measurements of important physiological impairments caused by OA, the small sample size and the lack of a randomized control group. Other factors that restrict generalization are the predominance of women and the voluntary participation. Future research should investigate the effectiveness of aqua cycling as an exercise treatment in knee OA. To conclude, aqua cycling is feasible for patients with knee OA. Patients evaluated aqua cycling as a beneficial option for staying physically active.


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  2. Jordan et al. Ann Rheum Dis. [Review]. 2003 Dec;62(12):1145-55.

  3. Zhang et al. Osteoarthritis Cartilage. 2010;18(4):476-99.

  4. Ritchie J., Lewis J., editors. Qualitative Research Practice: A Guide for Social Science Students and Researchers. London: SAGE Publications Ltd; 2003.

Acknowledgements The AquaCruiser was provided by AquaKinetiqs. We thank Wiel Wijnen at the Department of Orthopaedics for patient recruitment. George Roox kindly allowed the use of the facilities at Maastricht University Medical Centre.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5027

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