Effects of a 12-week increased hip flexion gait exercise intervention in individuals with obesity and knee osteoarthritis: a randomized crossover feasibility study

Introduction:

The novel increased hip flexion gait (HFgait) exercise modality involves specific neuromuscular and biomechanical characteristics that might be beneficial for individuals with knee osteoarthritis (OA). The current study examined the efficacy and feasibility of a 12-week HFgait exercise program in patients with obesity and symptomatic knee OA.

Methods:

Double-arm crossover design with three timepoint measurements. Twelve participants (Age: 62.9 ± 10.6 yrs, BMI: 31.7 ± 6.0 kg/m2; 72% female) with obesity, self-reported clinician diagnoses of knee OA and moderate to severe pain score (≥ 5) from the Western Ontario and McMasters Universities Index (WOMAC) enrolled in a 12-week, supervised HFgait intervention with sessions occurring 3-d/wk. Feasibility, motor function, symptomatic burden, balance, strength, cardiometabolic health, body composition, and cardiovascular fitness were assessed.

Results:

6MWT [post-pre intervention difference, mean ± SD: Δ 52.2 ± 26.5 m, 95% CI: (33.1, 71.4)], TUG [Δ 0.9 ± 1.2 s, (0.03, 1.8)], WOMAC-Pain [Δ 3.4 ± 3.7, (0.7, 6.1)], WOMAC-Function [Δ 7.6 ± 9.6, (0.6, 14.5)] and WOMAC-Total [Δ 11.4 ± 13.5, (1.6, 21.2)] significantly improved with the HFgait intervention. A significant main effect of sequence of control-intervention was observed for WOMAC-Pain [2.0 ± 3.2, (0.1, 3.9)]. Additionally, hip circumference [Δ −2.8 ± 3.8 cm, (−4.9, −0.6)], body fat percentage [Δ −1.1 ± 1.7%, (−2.2, −0.01)], and lumbar spine bone mineral density [Δ 0.04 ± 0.05 g/cm2, (0.01, 0.1)] improved with the HFgait intervention.

Discussion:

A 12-week HFgait intervention showed high retention and adherence with no adverse events. The HFgait exercise program improved motor function, OA symptoms, and body composition. Trial registration number: clinicaltrials.gov: NCT05997862.