Lower body positive pressure treadmill for individuals with knee osteoarthritis: Reliability, pain responses, and comparison of reweighting protocols



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Knee osteoarthritis (OA) is a common source of disability in older adults and often results in difficulty with walking as well as other activities of daily living. Often these individuals become less active which is associated with chronic diseases such as cancer, cardiovascular disease, type 2 diabetes, and osteoporosis as well as all-cause mortality in older adults and significant economic costs. Exercises-induced pain is common in this population which further limits their ability to walk. Lower body positive pressure (LBPP) treadmills are a recent technology that use air pressure to decrease body weight while walking on a treadmill. Previous research has shown that in individuals with knee OA, increases in pain can be minimized with body weight support (BWS) walking compared to full body weighting walking. The purposes of this study were to assess 1) reliability of percentage of BWS and pain response during an unweighting protocol, 2) correlation of BWS to ten study variables and investigation of the pain response of several subgroups during an unweighting protocol, and 3) the optimal way to reload the subject to maximize carryover effects. The results revealed moderate to good reliability for BWS needed for maximal pain relief as well as for lowest pain achieved. There were no significant correlations between the percentage of BWS necessary to reached lowest pain and any of the 10 study variables and no difference between groups for those that reached their lowest potential pain and those that did not. Individuals with both high and low kinesiophobia had a significant decrease in pain when walking with BWS. Additionally, the results support that an immediate reweighting protocol results in a lower pain level immediately following the walking session compared to a progressive reweighting protocol. While reweighting protocols do not appear to directly affect gait speed or SLS percentage, all individuals showed a decrease in walking speed after a 15-minute walking intervention on an LBPP treadmill.



Lower Body Positive Pressure Treadmill, Alter G, knee osteoarthritis, walking, unweighting, kinesiophobia, reweighting, exercise induced pain, correlation