Aerobic training modulates T cell activation in elderly women with knee osteoarthritis

Osteoarthritis of the knee (kOA) is a disease that mainly affects the elderly and can lead to major physical and functional limitations. However, the specific effects of walking, particularly on the immune system, are unknown. Therefore, this study aimed to analyze the effect of 12 weeks of walking (3×/week) on the leukocyte profile and quality of life (QL) of elderly women with kOA. Sixteen women (age: 67±4 years, body mass index: 28.07±4.16 kg/m2) participated in a walking program. The variables were assessed before and after 12 weeks of training with a progressively longer duration (30–55 min) and higher intensity (72–82% of HRmax determined using a graded incremental treadmill test). The QL was assessed using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), and blood samples were collected for analysis with a cell counter and the San Fac flow cytometer. Walking training resulted in a 47% enhancement of the self-reported QL (P<0.05) and a 21% increase in the VO2max (P<0.0001) in elderly women with kOA. Furthermore, there was a reduction in CD4+ cells (pre=46.59±7%, post=44.58±9%, P=0.0189) and a higher fluorescence intensity for CD18+CD4+ (pre=45.30±10, post=64.27±33, P=0.0256) and CD18+CD8+ (pre=64.2±27, post=85.02±35, P=0.0130). In conclusion, the walking program stimulated leukocyte production, which may be related to the immunomodulatory effect of exercise. Walking also led to improvements in the QL and physical performance in elderly women with kOA.

膝关节骨关节炎（knee Osteoarthritis, kOA）是一种主要累及老年人群的疾病，可引发严重的躯体活动与功能受限。然而，步行运动尤其是其对免疫系统的具体影响尚不明确。为此，本研究旨在分析为期12周的步行训练（每周3次）对膝关节骨关节炎老年女性患者的白细胞谱与生活质量（Quality of Life, QL）的影响。

本研究共纳入16名女性受试者，年龄为67±4岁，体质量指数为28.07±4.16 kg/m²。受试者参与本次步行训练项目，训练方案采用渐进式调整：训练时长从30分钟逐步延长至55分钟，训练强度设定为基于递增负荷跑步机试验测得的最大心率的72%~82%。分别于训练前后对各项观测指标进行评估。

生活质量采用《医学结局研究36条目简明健康调查问卷》（Medical Outcomes Study 36-Item Short Form Health Survey, SF-36）进行评定；采集受试者静脉血样，分别通过血细胞计数仪与San Fac流式细胞仪完成血液指标分析。

实验结果显示，步行训练可使膝关节骨关节炎老年女性患者的自我报告生活质量提升47%（P<0.05），最大摄氧量（VO₂max）增加21%（P<0.0001）。此外，受试者外周血CD4+T细胞占比出现显著下降（干预前为46.59±7%，干预后为44.58±9%，P=0.0189），而CD18+CD4+T细胞（干预前为45.30±10，干预后为64.27±33，P=0.0256）与CD18+CD8+T细胞（干预前为64.2±27，干预后为85.02±35，P=0.0130）的荧光强度显著升高。

综上，步行训练可促进白细胞生成，这可能与运动的免疫调节作用相关。同时，步行训练还可改善膝关节骨关节炎老年女性患者的生活质量与躯体运动能力。