Comparative Effect of Weight-Bearing and Non-Weight-Bearing Exercises on Psychological Well-Being, Neurobiological, and Cellular Oxygenation Outcomes: A Pathway to Recovery

Background : Knee osteoarthritis (OA) is a degenerative and complex disease influenced by mechanical, neurological, and psychological factors. Due to its increasing prevalence associated with aging and obesity, it is essential to understand how different types of exercise affect psychological well-being, neurobiological indicators, and cellular oxygenation is essential for optimizing recovery. Objective: To compare the effectiveness of weight-bearing and non-weight-bearing exercises on psychological well-being, neurobiological markers, and cellular oxygenation. Methods : Eighty volunteers with persistent knee pain (≥3 months) were enrolled in a single-blind randomized controlled trial conducted at the Riphah Rehabilitation Center in Lahore, Pakistan. Participants aged 40 years and older were randomly allocated to two intervention groups. Both groups received baseline treatment, Group A additionally performed non-weight-bearing exercises, whereas Group B performed weight-bearing exercises, including quadriceps strengthening, for a duration of six weeks. Outcomes were assessed using the Depression Anxiety and Stress Scale (DASS 2.1), ELISA, and arterial blood gas analysis to evaluate oxygenation. Data were analyzed using SPSS version 25, with a p < 0.05 considered statistically significant. Results : Following the intervention, significant improvements were observed in stress, anxiety, depression, BDNF level, and oxygenation in both the weight-bearing and non-weight-bearing exercise groups (p < 0.05). Comparative analysis revealed no significant difference in anxiety between the groups; however, the weight-bearing group demonstrated significantly greater improvements in stress, depression, BDNF levels, and oxygenation (p < 0.05). Conclusion : Both interventions resulted in improvements in psychological and physiological outcomes among patients with knee osteoarthritis. However, weight-bearing exercises demonstrated greater benefits in terms of neurobiological markers and psychological well-being.