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Golfers with knee OA should walk the course, not ride

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A new study is the first to compare the health benefits of walking the golf course versus using a motorised cart.

Based on ten individuals who play golf regularly and who have knee osteoarthritis (OA), and five who were of a similar age but did not have the disease, the research found that walking the course provides significantly higher health benefits and is not associated with increased pain, cartilage breakdown or inflammation.

Golf is often recommended for individuals with knee OA because it helps them fulfil physical activity guidelines for the disease. However, using a motorised cart for transportation between holes rather than walking potentially decreases the health benefits of the sport.

The researchers also noted that there is a high level of non-compliance with walking exercise programmes for knee OA because of perceived concerns regarding exacerbation of knee pain and further cartilage degradation and inflammation leading to joint damage.

In the study, participants completed two 18-hole rounds of golf on different days, one time walking the course and the other using a golf cart between holes. For both rounds of golf, participants wore activity monitors measuring their heart rate and step counts. They were also asked about their knee pain and provided blood samples in order to measure markers of cartilage stress and inflammation.

The results showed no significant difference in the degree of pain subjects with knee OA had walking the course compared to using a golf cart. Similarly, although there was an increase in blood-based biomarkers of cartilage stress and inflammation (as would be expected with regular walking), there was no difference between the rounds.

When walking the course, golfers with knee osteoarthritis spent more than 60% of the round with heart rates in the moderate intensity heart rate zone. When driving on a cart, golfers spent 30% of the round in this range.

“Individuals with knee osteoarthritis are often concerned about pain and may be more likely to use a golf cart,” said lead study author Dr Prakash Jayabalan, a physician scientist at the Shirley Ryan AbilityLab and an assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine.

“However, through sophisticated blood-based biomarker analysis, this study has shown that golfers with knee osteoarthritis do not need to be concerned about worsening their disease through walking the course. In fact, walking provides the best health benefit.”