Creatine, Exercise and Inflammatory Markers in Knee Osteoarthritis

Participants will provide informed consent, complete participant information and knee demographic forms, and undergo radiographic evaluation to confirm eligibility. Baseline evaluation of (1) systemic inflammation; and (2) knee joint pain and function will be completed. Following baseline evaluation, participants will be randomly assigned to 1 of 3 groups using online software available at http://www.randomizer.org/:

1. Exercise group: Participants will exercise for 30 minutes under low-load walking conditions 3x per week for 12 consecutive weeks on a Lower Body Positive Pressure (LBPP) treadmill (Alter-G Inc - Menlo Park, CA) at a set speed of 3.1 mph at 0⁰ incline. The initial five minutes of each exercise session will be used as a warm-up to allow the participant to reach their target heart rate, to accommodate to walking on the treadmill's belt surface, and to facilitate adjustment of the LBPP within the treadmill's air chamber to a percentage of unweighting that eliminates or substantially reduces the participant's acute knee pain for the duration of the 30 minute walking session. Subjects will be blinded to the amount of LBPP used to un-weight them during each low-load walking session.
2. Creatine group: Participants will supplement their regular diet with creatine monohydrate for 12 consecutive weeks. In week #1, participants will ingest 5 grams of creatine monohydrate 4x per day for a total ingestion of 20 grams per day. For the remaining 11 weeks, participants will consume 5 grams of creatine monohydrate per day to maintain the increased concentration of creatine.
3. Placebo group: Participants in the placebo group will supplement their regular diet with maltodextrin (an inert sugar based molecule) for 12 consecutive weeks. In week #1, participants will ingest 5 grams of maltodextrin 4x per day for a total ingestion of 20 grams per day. They will then ingest 5 grams of maltodextrin per day for the remaining 11 weeks.

All data collection will take place at the Pan Am Clinic, a multidisciplinary tertiary care hospital and research facility that serves as the Winnipeg Regional Health Authority's "Centre of Excellence for Musculoskeletal Injury Assessment and Treatment". This project will utilize the combined assets of University of Manitoba and Pan Am Clinic to access medical resources that are used on a daily basis for the diagnosis, treatment, and long term management of patients with knee OA. All participants will undergo follow-up evaluation 13 weeks after their initial baseline evaluation.

Aim #1: Determine if knee OA systemic inflammation is significantly decreased following completion of a 12 week creatine supplementation or low-load treadmill walking exercise regimen.

Hypotheses: