The effects of exercise therapy on knee joint biomechanics during walking in patients with knee osteoarthritis: secondary outcome analyses from a randomized controlled trial

Objective: To test the acceptability and feasibility of self-administered acupressure as an intervention for knee pain among middle-aged and older adults with knee osteoarthritis (KOA). Methods: In this pilot randomized controlled trial, 35 participants with KOA were randomized to receive self-administered acupressure (n = 17, two self-administered acupressure training sessions followed by self-practice for 6 weeks) or knee health education (n = 18, two health education sessions about KOA management followed by self-care for 6 weeks). Current pain intensity (primary outcome) was measured using a Numeric Rating Scale (NRS) at baseline and weeks 1, 2, 4 and 6 (post-intervention). Secondary outcome measures included worst and least pain intensity, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM) of the knee joints and Short-Form Six-Dimension (SF-6D) scores for health-related quality of life. Results: Participants in both groups attended all training sessions. In the self-administered acupressure group, all subjects mastered the acupressure technique and passed a consistency check. Both groups showed a decreasing trend in current knee pain intensity measured using NRS post-intervention. A medium between-group effect size (0.40) was found, but between-group differences were not statistically significant. The other secondary outcome measures were also comparable between both groups post-intervention (all p > 0.05). Conclusion: A two-session self-administered acupressure training was acceptable to and feasible in participants with KOA. The data generated allowed for calculation of a sample size for a definitive randomized controlled trial (RCT) to confirm whether self-acupressure is effective for pain management in KOA. Furthermore trials with adequate power and longer follow-up periods are warranted.

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Hip abductor strength–based exercise therapy in treating women with moderate-to-severe knee osteoarthritis: a randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215519875328 ◽

2019 ◽

Vol 34 (2) ◽

pp. 160-169 ◽

Cited By ~ 1

Author(s):

Jianxiong Wang ◽

Yujie Xie ◽

Li Wang ◽

Lei Lei ◽

Peng Liao ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Knee Osteoarthritis ◽

Exercise Therapy ◽

Controlled Trial ◽

Control Group ◽

Randomized Controlled ◽

Strength Based ◽

Hip Abductor ◽

Experimental Group ◽

Abductor Strength

Objective: To investigate whether hip abductor strength–based exercise therapy could result in further function improvement and more pain relief in women with knee osteoarthritis. Design: Randomized controlled trial. Settings: Rehabilitation department of Affiliated Hospital of Southwest Medical University from years 2016 to 2018. Subjects: In total, 82 women aged 50–70 years, with knee osteoarthritis grade II–IV on the Kellgren–Lawrence scale. Intervention: The experimental group engaged in hip abductor strength–based exercises under the supervision of physical therapists (once a day for six weeks), while the control group engaged in quadriceps femoris strength–based exercises. Main measures: Osteoarthritis severity measured by the Western Ontario and McMaster Universities Osteoarthritis Index, pain on a visual analogue scale and three objective functional tests were assessed at the sixth and 12th week. Repeated measures analysis of variance and multivariable analysis were applied. Results: Finally, 72 participants completed the study: 35 in the experimental group and 37 in the control group. The self-reported functional difficulties score in the experimental group was significantly lower than that in the control group both at the sixth week and at the 12th week ( P < 0.001). There were significant differences between groups in the stair ascent/descent task and Figure of 8 Walk test, but not in the Five Times Sit-to-Stand Test. The pain in the experimental group decreased compared with that in the control group at the sixth week ( P < 0.05), but not at the 12th week ( P > 0.05). Conclusion: Hip abductor strength–based exercises could result in better performance and higher self-reported function in women with symptomatic knee osteoarthritis.

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Are Manual Therapy or Booster Sessions Worthwhile in Addition to Exercise Therapy for Knee Osteoarthritis: Economic Evaluation and 2-Year Follow-up of a Randomized Controlled Trial

Musculoskeletal Science and Practice ◽

10.1016/j.msksp.2021.102439 ◽

2021 ◽

pp. 102439

Author(s):

Yana Pryymachenko ◽

Ross Wilson ◽

Saurab Sharma ◽

Anupa Pathak ◽

J.Haxby Abbott

Keyword(s):

Randomized Controlled Trial ◽

Economic Evaluation ◽

Knee Osteoarthritis ◽

Manual Therapy ◽

Exercise Therapy ◽

Controlled Trial ◽

Randomized Controlled ◽

Booster Sessions

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POS1470-HPR BARRIERS AND FACILITATORS OF A NEW MODEL OF STRATIFIED EXERCISE THERAPY IN KNEE OSTEOARTHRITIS: A QUALITATIVE STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1508 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1020.1-1020

Author(s):

J. Knoop ◽

W. Van Berkel-de Joode ◽

H. Brandt ◽

J. Dekker ◽

R. Ostelo

Keyword(s):

Primary Care ◽

Randomized Controlled Trial ◽

Muscle Strength ◽

Qualitative Study ◽

Knee Osteoarthritis ◽

Exercise Therapy ◽

Controlled Trial ◽

Barriers And Facilitators ◽

Added Value ◽

Randomized Controlled

Background:We have developed a model of stratified exercise therapy, in which three knee osteoarthritis (OA) subgroups (i.e., ‘high muscle strength subgroup’, ‘low muscle strength subgroup’ and ‘obesity subgroup’) can be distinguished and provided a subgroup-specific intervention. Currently, the (cost-)effectiveness of this model compared to usual exercise therapy is tested in a large-scaled randomized controlled trial (OCTOPuS-study [1]). Alongside this trial, we performed a qualitative study to explore perceived barriers and facilitators of the application of this model in primary care.Objectives:To explore barriers and facilitators of the application of this model in primary care, as perceived by patients, physiotherapists and dieticians.Methods:Qualitative data were collected through semi-structured interviews in a random sample of 15 patients (5 from each subgroup), 11 physiotherapists and 5 dieticians, from the experimental arm of the OCTUPuS trial. A thematic analysis of the data was performed.Results:We identified 14 themes in 5 categories. In general, patients and therapists were positive about the added value and applicability of the model, although some physiotherapists would prefer more flexibility. Regarding the ‘high muscle strength subgroup’, both patients and physiotherapists reported mixed feelings on the low number of supervised sessions, with some perceiving this low number as advantageous for stimulating the patient’s own responsibility, whereas others as hindering an optimally guided treatment. Regarding the ‘obesity subgroup’, dieticians and physiotherapists acknowledged the added value of the combined intervention, but both were disappointed by the lack of interdisciplinary collaboration. Moreover, those patients in this subgroup already following a diet restriction, therefore not perceiving any added value of the diet intervention.Conclusion:This qualitative study revealed relevant barriers and facilitators of our new model of stratified exercise therapy, which will help us interpreting the upcoming results on its (cost-) effectiveness [1]. If proven to be (cost-)effective, implementation strategies should specifically focus on guidance of patients from the ‘high muscle strength subgroup’ within only a few sessions, collaboration between physiotherapist and dietician in the ‘obesity subgroup’, and adequate use of booster sessions after the supervised period to optimize treatment adherence.References:[1]Knoop J, Dekker J, van der Leeden M, de Rooij M, Peter WFH, van Bodegom-Vos L, van Dongen JM, Lopuhäa N, Bennell KL, Lems WF, van der Esch M, Vliet Vlieland TPM, Ostelo RWJG. Stratified exercise therapy compared with usual care by physical therapists in patients with knee osteoarthritis: A randomized controlled trial protocol (OCTOPuS study). Physiother Res Int. 2020 Apr;25(2):e1819. doi: 10.1002/pri.1819. Epub 2019 Nov 28.Disclosure of Interests:None declared

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