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The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

Author/s: 
Chen, Hongbo, Zheng, Xiaoyan, Huang, Hongjie, Liu, Congying, Wan, Qiaoqin, Shang, Shaomei
Date Added: 
May 1, 2019
Journal/Publication: 
BMC Musculoskeletal Disorders
Publisher: 
BioMed Central
Publication Date: 
April 9, 2019
Issue: 
1
Volume: 
20
URL: 
The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study
Type: 
Clinical Research Results
Format: 
Article
DOI (1): 
10.1186/s12891-019-2521-4
PMID (1): 
30967131
Keywords 
osteoarthritis
physical therapy
health education
MeSH 
independent living
quality of life
arthralgia
osteoarthritis, knee
physical therapy
aged

RPR Commentary

In this admittedly imperfect study, older osteoarthritis patients receiving 8 hours of physical therapy, periodic telephone support, and health education had significantly less pain and more function at 3 months than control patients receiving standard care.  James W. Mold, MD, MPH

Abstract

BACKGROUND:

Knee osteoarthritis (KOA) is common in elderly people, causes pain, loss of physical functioning, and disability. This was a two-arm, superiority, quasi-experimental trial. The aim of this study was to evaluate the effectiveness of a home-based exercise intervention (HBEI) to reduce KOA symptoms and improve the physical functioning of elderly patients.

METHODS:

A total of 171 elderly patients (60 years of age or older) with KOA were recruited from four community centers. Patients from two community centers were randomly assigned to the intervention group (IG) and the other two centers were randomly assigned to the control group (CG). Participants in the IG received a 12-week HBEI (including four 2-h sessions supervised by a physiotherapist and fortnightly telephone support) combined with health education, while patients in the CG only received health education. The participants and physiotherapists were aware of the group assignment and alternative treatment components, but the study's hypotheses were not disclosed to the participants. Pain intensity, joint stiffness, lower-limb muscle strength, balance, mobility, and quality of life were measured before and after the intervention by the same blinded assessor.

RESULTS:

A total of 171 patients (IG: n = 84, CG: n = 87) were enrolled. Data were obtained from 141 patients with an average age of 68 (range, 60-86 years) who completed the 12-week study (IG: n = 71, CG: n = 70). No significant group differences were found in any outcome measures at baseline. At week 12, the pretest/posttest changes 3significant between-group differences in decreases in pain intensity (- 1.60 (CI, - 2.75 to - 0.58)) and stiffness (- 0.79 (CI, - 1.37 to - 0.21)), with the IG exhibiting significantly larger improvements on both measures than the CG. The IG also showed significantly greater improvements on all the secondary outcomes than the CG did.

CONCLUSIONS:

HBEI may be effective for relieving KOA symptoms, increasing the physical functioning, and improving quality of life in community-dwelling KOA elderly patients. A large randomized controlled trial with long-term follow-up is needed to confirm these findings.