1. Rezasoltani, Zahra MD
  2. Sanati, Ehsan MD
  3. Kazempour Mofrad, Reza MD
  4. Azizi, Sirous MD
  5. Dadarkhah, Afsaneh MSc
  6. Najafi, Sharif MD


Objective: To assess the effects of aqua-cycling on pain, physical function, and muscle strength among elderly people with knee osteoarthritis.


Methods: We performed a randomized controlled trial from November 2016 through July 2017 in an outpatient clinic of the Department of Physical Medicine and Rehabilitation at the University Hospital. Patients were 60 years and older and had knee osteoarthritis. Among 32 patients who were randomly allocated to the groups aqua-cycling and control, 30 completed the study. We used the Knee injury and Osteoarthritis Outcome Score to assess the patients' opinion about their knees and associated problems. The measurements were performed at the baseline, and after 4, 8, and 12 sessions of aqua-cycling. Participants in the intervention group performed aqua-cycling, 3 sessions per week for 4 weeks. Each session lasted 50 minutes including 10 minutes of warm-up, 30 minutes of cycling, and 10 minutes of cool-down exercises. Both groups used acetaminophen, if needed, and followed lifestyle recommendations for 4 weeks.


Results: There were significant improvements in pain reduction, physical function, and muscle strength in favor of aqua-cycling (all P < .001). Within-group analyses showed that participants in the aqua-cycling group experienced significant pain reduction (P < .001), and improved in physical function (P < .001), quadriceps (P < .001), and hamstring muscle strength (P < .001). Within-group comparisons for the group control were not significant (all P > .05).


Conclusion: Aqua-cycling is effective, and can be used alone or combined with other treatments in the management of osteoarthritis.