Acute Physiological Effects of Continuous Versus Intermittent Walking During Golf in Individuals With Knee Osteoarthritis: A Pilot Study.
Prakash Jayabalan, Rachel Bergman, Emilio Jauregui and 2 others
PMID 34310345WHAT IT FOUND
Walking a golf course increased knee pain and cartilage stress markers in people with knee osteoarthritis, while using a motorized cart limited these effects.
However, walking provided significantly higher cardiovascular exercise intensity. Both methods met daily aerobic guidelines, so cart use is a viable option for those whose pain worsens with walking.
Key findings
01Participants with knee osteoarthritis who walked the course reported a significant increase in knee pain and serum COMP levels (a marker of cartilage stress), whereas those using a motorized cart did not have a significant increase in pain and had much smaller COMP elevations.
02Walking the course resulted in significantly higher heart rates and step counts compared to using a motorized cart, with participants spending more than twice as much of the round in moderate-to-vigorous physical activity.
03Even when using a motorized cart, participants with knee osteoarthritis still spent over 30% of the round in moderate-to-vigorous physical activity, meeting daily aerobic exercise guidelines.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was a pilot with a very small sample size (10 participants with knee osteoarthritis). Participants were regular golfers who already walked the course, meaning they were likely more functionally capable than the general knee osteoarthritis population. The study measured acute physiological responses (biomarkers and pain) and did not track long-term outcomes like joint health or function. Biomarkers were measured in serum, not synovial fluid, which may reflect systemic responses rather than joint-specific effects. The study did not account for potential differences in terrain or bag weight between the walking and cart conditions.
Declared interests
The study received research support from the National Institutes of Health (NIH) and non-U.S. government sources. No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the increased biomarkers and pain from walking as proof that walking causes long-term cartilage damage. This study only measured acute, transient changes in a small group of already active golfers, and the authors note that these markers are indicators of stress, not necessarily destruction.