WATERinMOTION Aquatic Therapy in Obese Men With Knee Osteoarthritis

Mechanistic and Functional Outcomes of WATERinMOTION Aquatic Therapy in Obese Men With Knee Osteoarthritis: A Randomized Controlled Trial With 6-Month Follow-Up

This RCT evaluates whether WATERinMOTION aquatic therapy improves pain, function, and quality of life more effectively than land-based exercise in obese men with knee osteoarthritis (OA). We will assess clinical outcomes (WOMAC), serum biomarkers (COMP, IL-6), and real-world activity (accelerometry) at baseline, 8 weeks, and 6 months.

100 participants (BMI ≥30, age 45-65, radiographic knee OA) will be randomized to:

Aquatic group: 24 sessions over 8 weeks (3x/week) in 32°C water, progressing from buoyancy-assisted to resistance exercises.

Land group: Matched duration/intensity land-based rehabilitation. Primary outcomes: WOMAC pain/function. Secondary outcomes: SF-36 quality of life, serum COMP, 6-minute walk test, and accelerometer-measured step count.

Inclusion Criteria:

• Males aged 45-65
• BMI ≥30 kg/m²
• Radiographic knee OA (Kellgren-Lawrence grade 2-3)
• WOMAC pain score ≥25/50

Exclusion Criteria:

• Inflammatory arthritis (e.g., rheumatoid)
• Intra-articular injections within 3 months
• Contraindications to aquatic exercise