Probiotics improve functional performance in patients with osteoarthritis: a randomized placebo-controlled clinical trial.

Abstract

Purpose: Osteoarthritis (OA), a progressive joint degeneration, significantly impairs people's ability to perform everyday tasks. Currently, there are no treatment options to cure OA.

Objective: To explore the potential of probiotics to improve functional performance in OA patients.

Trial design: This study follows a single-center, double-blinded, randomized, placebo-controlled clinical trial design.

Method: Computer-based randomization assigned 60-75 years old 115 OA patients randomly into placebo (n = 55) and probiotics (n = 60) groups. The probiotic treatment was Vivomix 112 billion, one capsule daily to assess probiotic efficacy within a 16-week timeframe. The analysis included measurements of pain intensity with a visual analog scale, oxford knee score (OKS), knee flexion range of movement (ROM), short physical performance battery (SPPB), gait speed, handgrip strength (HGS), zonulin as a marker of intestinal permeability, c-reactive protein (CRP) as markers of inflammation and 8-isoprostanes for oxidative stress. Two measurements at baseline and after 16 weeks were recorded.

Results: 14 patients discontinued probiotic treatment, and six patients discontinued placebo intake, therefore, 95 patients, including placebo (n = 49) and probiotics (n = 46) groups, were analyzed. Probiotics significantly reduced plasma zonulin and pain intensity during walking, alongside notable improvements in OKS scores, ROM, gait speed, HGS, and SPPB scores compared to baseline in the probiotics group (all p < 0.05). The probiotic supplement significantly lowered CRP levels. Correlation analysis showed a robust association of % changes in plasma zonulin with OKS scores (r² = 0.294, p < 0.0001), SPPB total (r² = 0.233, p = 0.0007), and HGS (r² = 0.322, p < 0.0001).

Conclusion: Multistrain probiotics enhances functional ability in OA patients; changes in zonulin suggest a possible link to intestinal permeability, though causality remains to be established.