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621 - Beneficial Systemic Biological Responses Occur in Response to the Longitudinal Use of Joint Off-Loading Therapies in Individuals with Knee Osteoarthritis

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

AL

Audrey L. Lazar, BA

Research Assistant
Shirley Ryan AbilityLab, Strength & Endurance Lab
Chicago, Illinois, United States

Co-Author(s)

Yelyzaveta Merenzon, BA

Medical Student
Shirley Ryan AbilityLab, Strength & Endurance Lab
Buffalo Grove, Illinois, United States
SS

Sanchita Sen, BA, MA

Medical Student
Loyola University Stritch School of Medicine
Chicago, Illinois, United States
VD

Vikram Darbhe, MS

Biomedical Engineer III
Shirley Ryan AbilityLab
Chicago, Illinois, United States
EG

Elizabeth Gray, MS

Senior Biostatistician
Northwestern University
Chicago, Illinois, United States
LW

Leah Welty, PhD

Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States

Corresponding Author(s)

Prakash Jayabalan, MD, PhD

Physician Scientist Director, Nancy W. Knowles Strength and Endurance Lab and Associate Professor
Shirley Ryan AbilityLab/Northwestern University
Chicago, Illinois, United States

Objectives: Moderate walking exercise has known benefits in individuals with KOA; however, joint loading can increase pain, limiting engagement in this treatment. Weight off-loading walking therapies reduce load placed on the joint, potentially increasing exercise engagement. However, the biological impact of these treatments are unknown. Our objective was to determine longitudinal changes in systemic biomarkers associated with KOA, using a lower-body positive pressure (LBPP) treadmill or aquatic walking program compared to a control group with no active treatment.

Design: Randomized clinical trial. Forty-nine adults, aged >50 with KOA were enrolled in three groups for eight weeks: (1) LBPP treadmill (2x/week), n=16(5) (2) Aquatic walking (2x/week), n=17(2) (3) Control (exercise recommendations), n=16(1). Blood draws were collected at baseline and 8-weeks. Serum was tested using multiplex assays for markers in three domains: (1) Inflammatory mediators, (2) Cartilage degenerative enzymes (matrix metalloproteinases (MMPs)), (3) Transforming growth factors (TGF-β).

Results: Both the control and aquatic group saw significant increases in TGF-β1 concentration (p< 0.05 for both). However, the control group had a significant increase in the pro-inflammatory mediator, IL-1β (p=0.03), and its associated protein IL-1Ra (p=0.009), not observed in either interventional group. The LBPP was associated with a decrease in IL-6 concentration (p=0.06) not observed in the other groups. Additionally, the aquatic group had an increase in MMP-7 concentration (p=0.05), which is an enzyme associated with tissue remodeling.

Conclusions: Longitudinal off-loaded walking therapies were not associated with an increase in systemic inflammation that was observed with a group receiving exercise recommendations only. This is the first study to suggest that off-loaded walking is associated with beneficial systemic biologic changes in individuals with KOA. Future studies will examine systemic changes in a larger cohort compared to standard treadmill walking.