Probiotics' supplementation alleviates disease severity and improves postural balance by repairing intestinal leak in patients suffering from osteoarthritis: a double-blinded clinical trial.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(5):20 Br J Nutr. 2024 Dec 28;132(12):1602-1610.What this means for my practice?
Probiotic supplementation may help reduce OA severity and improve postural balance by repairing intestinal permeability and lowering systemic inflammation. Clinically, probiotics could serve as an adjunctive therapy for improving functional capacity and reducing pain in OA patients. However, limitations include the lack of microbiome composition analysis and potential confounding factors related to lifestyle and diet.
Study Summary
One hundred forty-seven patients with knee osteoarthritis (OA) were randomized to receive either a daily multistrain probiotic (Vivomix 112 billion) (n=72) or a placebo (n=75) for 12 weeks. The primary outcome was postural balance. Secondary outcomes included pain intensity (VAS), disease severity (WOMAC index), handgrip strength (HGS), gait speed, and plasma biomarkers of intestinal permeability (zonulin) and inflammation (CRP, 8-isoprostanes). A total of 136 patients completed the study (placebo: n=71, probiotics: n=65). Overall, probiotic supplementation significantly reduced pain intensity, disease severity, and inflammatory markers while improving balance, HGS, and walking speed (P<0.05 for all). However, no significant changes were observed in resting pain, knee flexion range of motion, or oxidative stress markers. These findings suggest that probiotic supplementation alleviates OA symptoms and enhances postural stability, possibly by reducing intestinal permeability and inflammation.
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