• Vilai Kuptniratsaikul, Chawalit Kittichaikarn, Phitsanu Suntornpiyapan, Kriangkrai Kovintaset, and Suwicha Inthibal.
• 1 Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
• Clin Rehabil. 2019 Jan 1; 33 (1): 85-93.

Objective:To investigate the efficacy of a four-week underwater treadmill exercise regimen compared to a home exercise regimen relative to pain relief and functional improvement in obese patients with knee osteoarthritis.Design:Single-blind randomized controlled trial.Setting:Outpatient.Participants:Eighty primary knee osteoarthritis with pain ⩾5/10 and body mass index ⩾25 kg/m2.Interventions:Daily quadriceps exercise at home for 30 minutes (control group) or underwater treadmill exercise (study group) for 30 minutes/day, three times/week for four weeks.Main Outcomes:Pain score, six-minute walking distance, quadriceps strength, and body weight were evaluated at baseline and after four weeks. Adverse events, global assessment, and satisfaction index were assessed at the end of study.Results:All outcomes in both groups were significantly improved at the end of the study, except for body weight. The mean difference (95% confidence interval (CI)) in outcomes between groups were -0.53 (-1.31, 0.26) for pain; 10.81 (-11.9, 33.53) meters for 6-minute walking distance; 0.67 (-0.10, 1.44) kilograms for quadriceps strength; and 0.01 (-0.66, 0.68) kilograms for body weight. No significant differences were observed between groups, for the per protocol analysis or the intention-to-treat analysis. Participants in the study group evaluated significantly better global improvement and higher patient satisfaction than those in control group (13 (39.4%) vs. 4 (10.8%); P = 0.014 and 23 (69.7%) vs. 16 (43.2%); P = 0.021, respectively).Conclusion:Exercise using an underwater treadmill was found to be as efficacious as home exercise for relieving pain and improving function in obese people with mild to moderate knee osteoarthritis.

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