Ground or Swimming Pool Exercises for Women with Knee Osteoarthritis? A Double-blind Randomized Clinical Trial

Objectives: To compare the effectiveness of closed kinetic chain (CKC) exercises performed on the ground and in the swimming pool in women with knee osteoarthritis (KOA).

Study Design: Double-Blind Randomized Clinical Trial.

Place and Duration of the Study: Clinical School of Physiotherapy of Ulbra Torres, from March 2015 to June 2017.

Methodology: Thirty-four women with grade 1 and 2 knee knee OA were allocated into two groups. One group received treatment with CKC exercises on the ground (n = 17) and the other group had the same exercises performed in the swimming pool (n = 17) for a period of two months, three times a week, totaling 24 sessions. Subjects were initially assessed prior to randomization, after 12 sessions, after 24 sessions and 3 months after the end of the protocol. The following variables were evaluated: pain, knee joint mobility, hamstring flexibility, hamstring and quadriceps muscle strength and functionality.

Results: There was an improvement in hamstring flexibility with 12 sessions in the pool group and at the end of the protocol in both groups (P<.05). The range of motion of knee flexion increased in both study groups after the intervention (P<.05). The pool group demonstrated a reduction of this gain in the follow-up. Pain decreased similarly in both groups (P<.05). The pool group showed an initial quadriceps strength and left hamstring strength lower than the ground group. However, at the end of the protocol, both groups improved muscle strength in both knees (P<.05). The Lequesne and WOMAC scores reduced significantly with 12 sessions in both groups (P<.05), remaining likewise in the follow-up.

Conclusion: CKC exercises performed both on the ground and in the swimming pool promoted a decrease in pain and joint stiffness, also improving the mobility, muscle strength and functionality of patients with knee OA.