This RCT compared the effectiveness of 10 sessions of uphill treadmill walking & PT versus PT alone on knee pain, ROM, stride length, and walking speed in individuals with knee OA.

The treadmill group completed 30 minutes of walking at a speed of 4km/h (2.5mph) at an 8-degree (15%) incline, three times a week for three weeks.

Results: After just 3 weeks, when compared to just the PT group, those who did the additional uphill treadmill walking, had significant improvements in their knee mobility, stride length and walking speed.

Clinical relevance: If your patients with symptomatic knee OA have access to a treadmill, recommend them to seriously consider uphill treadmill walking, at a comfortable pace, 3x/week, for 4 weeks.

If they don’t have a treadmill, then just walk outside, ideally in a park, on grass and on uneven terrains.

If they can’t tolerate 30 minutes of walking, then suggest 15-minute walks, but twice a day.

If they can’t walk for 15 minutes, then suggest 5-minute walks, but repeat 6 times a day.

Important note: Uphill walking is not a cure as it was in addition to their regular PT which included various manual therapies and specific exercise prescription.

Reference: Sedaghatnezhad P et al . Uphill treadmill walking plus physical therapy versus physical therapy alone in the management of individuals with knee osteoarthritis: a randomized clinical trial. Disabil Rehabil. 2019 Dec 22:1-9.
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