Effectiveness of Combined Treatment Using Physical Exercise and Ultrasound-Guided Radiofrequency Ablation of Genicular Nerves in Patients with Knee Osteoarthritis

Radiofrequency (RF) is a mini-invasive neuromodulation intervention that is commonly used in chronic pain conditions including general musculoskeletal pain related to several diseases, including knee osteoarthritis (KOA). However, to date, few studies investigated synergistic therapeutic approaches combining RF with rehabilitative physical exercise protocols in KOA patients. This prospective cohort study aimed at assessing the short-term effects on pain in KOA patients of a multimodal intervention consisting of ultrasound (US)-guided RF geniculate ablation and concomitant rehabilitative physical exercise. We included grade III KOA patients with knee pain (Numerical Pain Rating Scale, NPRS >4) not responsive to conventional treatments. They underwent a combined intervention including US-guided RF geniculate ablation and a 2-week physical exercise program. At the baseline (T0) and 1 month after (T1) we assessed: NPRS, Knee Injury and Osteoarthritis Outcome Scale (KOOS), quality of life, exercise adherence, and safety. All the 47 KOA patients enrolled (68.8 ± 13.7 years old) showed a reduction of pain (NPRS: 7.48 ± 1.74; 3.63 ± 1.68; p < 0.001). In addition, there was a significant improvement (p < 0.05) also in the other functioning and HRQoL outcomes. Adherence to the exercise program was over 80% in more than half (28) of the patients. No major adverse events were reported. These findings suggested that US-guided RF ablation of genicular nerves combined with rehabilitative exercise therapy might be considered a safe and effective approach in the complex management of KOA patients.

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Efficacy of physical exercise program in patients with work-related knee osteoarthritis

Romanian Journal of Occupational Medicine ◽

10.2478/rjom-2018-0007 ◽

2018 ◽

Vol 69 (1) ◽

pp. 37-42

Author(s):

Iulia-Rahela Marcu ◽

Ion Toma ◽

Adrian Costin Bighea

Keyword(s):

Quality Of Life ◽

Physical Exercise ◽

Knee Osteoarthritis ◽

Functional Status ◽

Muscular Strength ◽

Exercise Program ◽

Knee Oa ◽

Work Related ◽

Sf 36

Abstract Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.

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Behavior Change Text Messages for Home Exercise Adherence in Knee Osteoarthritis: Randomized Trial

Journal of Medical Internet Research ◽

10.2196/21749 ◽

2020 ◽

Vol 22 (9) ◽

pp. e21749 ◽

Cited By ~ 1

Author(s):

Kim Bennell ◽

Rachel K Nelligan ◽

Sarah Schwartz ◽

Jessica Kasza ◽

Alexander Kimp ◽

...

Keyword(s):

Behavior Change ◽

Knee Osteoarthritis ◽

Rating Scale ◽

Exercise Program ◽

Exercise Adherence ◽

Home Exercise ◽

Knee Oa ◽

The Past ◽

Sms Intervention ◽

Secondary Outcomes

Background Exercise is a core recommended treatment for knee osteoarthritis (OA), yet adherence declines, particularly following cessation of clinician supervision. Objective This study aims to evaluate whether a 24-week SMS intervention improves adherence to unsupervised home exercise in people with knee OA and obesity compared with no SMS. Methods A two-group superiority randomized controlled trial was performed in a community setting. Participants were people aged 50 years with knee OA and BMI ≥30 kg/m2 who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times per week for 24 weeks and were randomly allocated to a behavior change theory–informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by the Exercise Adherence Rating Scale (EARS) Section B (0-24, higher number indicating greater adherence) and the number of days exercised in the past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality of life, global change, physical activity, self-efficacy, pain catastrophizing, and kinesiophobia. Results A total of 110 participants (56 SMS group and 54 no SMS) were enrolled and 99 (90.0%) completed both primary outcomes (48/56, 86% SMS group and 51/54, 94% no SMS). At 24 weeks, the SMS group reported higher EARS scores (mean 16.5, SD 6.5 vs mean 13.3, SD 7.0; mean difference 3.1, 95% CI 0.8-5.5; P=.01) and more days exercised in the past week (mean 1.8, SD 1.2 vs mean 1.3, SD 1.2; mean difference 0.6, 95% CI 0.2-1.0; P=.01) than the control group. There was no evidence of between-group differences in secondary outcomes. Conclusions An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes. Trial Registration Australian New Zealand Clinical Trials Registry 12617001243303; https://tinyurl.com/y2ud7on5 International Registered Report Identifier (IRRID) RR2-10.1186/s12891-019-2801-z

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Behavior Change Text Messages for Home Exercise Adherence in Knee Osteoarthritis: Randomized Trial (Preprint)

10.2196/preprints.21749 ◽

2020 ◽

Author(s):

Kim Bennell ◽

Rachel K Nelligan ◽

Sarah Schwartz ◽

Jessica Kasza ◽

Alexander Kimp ◽

...

Keyword(s):

Behavior Change ◽

Knee Osteoarthritis ◽

Rating Scale ◽

Exercise Program ◽

Exercise Adherence ◽

Home Exercise ◽

Knee Oa ◽

The Past ◽

Sms Intervention ◽

Secondary Outcomes

BACKGROUND Exercise is a core recommended treatment for knee osteoarthritis (OA), yet adherence declines, particularly following cessation of clinician supervision. OBJECTIVE This study aims to evaluate whether a 24-week SMS intervention improves adherence to unsupervised home exercise in people with knee OA and obesity compared with no SMS. METHODS A two-group superiority randomized controlled trial was performed in a community setting. Participants were people aged 50 years with knee OA and BMI ≥30 kg/m2 who had undertaken a 12-week physiotherapist-supervised exercise program as part of a preceding clinical trial. Both groups were asked to continue their home exercise program unsupervised three times per week for 24 weeks and were randomly allocated to a behavior change theory–informed, automated, semi-interactive SMS intervention addressing exercise barriers and facilitators or to control (no SMS). Primary outcomes were self-reported home exercise adherence at 24 weeks measured by the Exercise Adherence Rating Scale (EARS) Section B (0-24, higher number indicating greater adherence) and the number of days exercised in the past week (0-3). Secondary outcomes included self-rated adherence (numeric rating scale), knee pain, physical function, quality of life, global change, physical activity, self-efficacy, pain catastrophizing, and kinesiophobia. RESULTS A total of 110 participants (56 SMS group and 54 no SMS) were enrolled and 99 (90.0%) completed both primary outcomes (48/56, 86% SMS group and 51/54, 94% no SMS). At 24 weeks, the SMS group reported higher EARS scores (mean 16.5, SD 6.5 vs mean 13.3, SD 7.0; mean difference 3.1, 95% CI 0.8-5.5; P=.01) and more days exercised in the past week (mean 1.8, SD 1.2 vs mean 1.3, SD 1.2; mean difference 0.6, 95% CI 0.2-1.0; P=.01) than the control group. There was no evidence of between-group differences in secondary outcomes. CONCLUSIONS An SMS program increased self-reported adherence to unsupervised home exercise in people with knee OA and obesity, although this did not translate into improved clinical outcomes. CLINICALTRIAL Australian New Zealand Clinical Trials Registry 12617001243303; https://tinyurl.com/y2ud7on5 INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12891-019-2801-z

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3D Kinematics and Decision Trees to Predict the Impact of a Physical Exercise Program on Knee Osteoarthritis Patients

Applied Sciences ◽

10.3390/app11020834 ◽

2021 ◽

Vol 11 (2) ◽

pp. 834

Author(s):

Marwa Mezghani ◽

Nicola Hagemeister ◽

Youssef Ouakrim ◽

Alix Cagnin ◽

Alexandre Fuentes ◽

...

Keyword(s):

Physical Exercise ◽

Knee Osteoarthritis ◽

Decision Trees ◽

Exercise Program ◽

Patient Specific ◽

Pain Level ◽

Knee Kinematic ◽

Kinematic Data ◽

3D Kinematics ◽

The Impact

Measuring knee biomechanics provides valuable clinical information for defining patient-specific treatment options, including patient-oriented physical exercise programs. It can be done by a knee kinesiography test measuring the three-dimensional rotation angles (3D kinematics) during walking, thus providing objective knowledge about knee function in dynamic and weight-bearing conditions. The purpose of this study was to assess whether 3D kinematics can be efficiently used to predict the impact of a physical exercise program on the condition of knee osteoarthritis (OA) patients. The prediction was based on 3D knee kinematic data, namely flexion/extension, adduction/abduction and external/internal rotation angles collected during a treadmill walking session at baseline. These measurements are quantifiable information suitable to develop automatic and objective methods for personalized computer-aided treatment systems. The dataset included 221 patients who followed a personalized therapeutic physical exercise program for 6 months and were then assigned to one of two classes, Improved condition (I) and not-Improved condition (nI). A 10% improvement in pain was needed at the 6-month follow-up compared to baseline to be in the improved group. The developed model was able to predict I and nI with 84.4% accuracy for men and 75.5% for women using a decision tree classifier trained with 3D knee kinematic data taken at baseline and a 10-fold validation procedure. The models showed that men with an impaired control of their varus thrust and a higher pain level at baseline, and women with a greater amplitude of internal tibia rotation were more likely to report improvements in their pain level after 6 months of exercises. Results support the effectiveness of decision trees and the relevance of 3D kinematic data to objectively predict knee OA patients’ response to a treatment consisting of a physical exercise program.

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An Effect of Muscle Strengthening Exercise Program on Muscle Strength, Pain, Depression, Self-efficacy, and Quality of Life of Patients with Knee Osteoarthritis

The Journal of Nurses Academic Society ◽

10.4040/jnas.1996.26.3.556 ◽

1996 ◽

Vol 26 (3) ◽

pp. 556 ◽

Cited By ~ 3

Author(s):

Mi Ra Lee

Keyword(s):

Quality Of Life ◽

Muscle Strength ◽

Knee Osteoarthritis ◽

Self Efficacy ◽

Exercise Program ◽

Muscle Strengthening ◽

Strengthening Exercise

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The Effect of Theory-lead Intervention for Knee Osteoarthritis in Older Adults: A Cluster Randomized Trial

10.21203/rs.2.22689/v1 ◽

2020 ◽

Author(s):

Limin Wang ◽

Hongbo Chen ◽

Han Lu ◽

Yunlin Wang ◽

Congying Liu ◽

...

Keyword(s):

Older Adults ◽

Knee Osteoarthritis ◽

Transtheoretical Model ◽

Intervention Group ◽

Exercise Program ◽

Exercise Adherence ◽

Cluster Randomized Trial ◽

Knee Function ◽

Control Group ◽

Cluster Randomized

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China via print and social media advertisements from April to October 2018. The intervention was a two-stage and 24-week transtheoretical model-based exercise program, and the control group underwent a same length but non-theory-based exercise program. Exercise adherence was measured by an 11-point numerical self-rating scale at weeks 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) and knee function (lower limb muscle strength and balance) were measured at baseline, week 24, and week 48. Latent growth model (GLM), repeated measures ANOVA and independent t-test were the main statistical tests.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: The TTM-HEI could improve the participants’ exercise adherence, knee osteoarthritis symptoms and knee function over time.

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Photobiomodulation via a cluster device associated with a physical exercise program in the level of pain and muscle strength in middle-aged and older women with knee osteoarthritis: a randomized placebo-controlled trial

Lasers in Medical Science ◽

10.1007/s10103-019-02807-3 ◽

2019 ◽

Vol 35 (1) ◽

pp. 139-148 ◽

Cited By ~ 3

Author(s):

Patricia Gabrielli Vassão ◽

Mayra Cavenague de Souza ◽

Bruna Arcaim Silva ◽

Rheguel Grillo Junqueira ◽

Marcela Regina de Camargo ◽

...

Keyword(s):

Muscle Strength ◽

Physical Exercise ◽

Knee Osteoarthritis ◽

Older Women ◽

Controlled Trial ◽

Exercise Program ◽

Middle Aged

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Effect of the Combined Intervention with Passive Whole-Body Vibration and Auriculotherapy on the Quality of Life of Individuals with Knee Osteoarthritis Assessed by the WHOQOL-Bref: A Multi-Arm Clinical Trial

Applied Sciences ◽

10.3390/app10061956 ◽

2020 ◽

Vol 10 (6) ◽

pp. 1956 ◽

Cited By ~ 1

Author(s):

Marcia Cristina Moura-Fernandes ◽

Eloá Moreira-Marconi ◽

Alexandre Gonçalves de Meirelles ◽

Ana Paula Ferreira de Oliveira ◽

Aline Reis Silva ◽

...

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Whole Body Vibration ◽

Whole Body ◽

Pharmacological Interventions ◽

Control Groups ◽

Peak Displacement ◽

Body Vibration ◽

Combined Intervention

The aim of this study was to determine the effect on the quality of life of two non-pharmacological interventions isolated or in combination: (i) passive whole-body vibration exercise (WBVE), and (ii) auriculotherapy (AT). One hundred three participants with knee osteoarthritis (KOA) were allocated to: (a) a vibration group (WBVEG; n = 17) that performed WBVE (peak-to-peak displacement: 2.5 to 7.5 mm, frequency: 5 to 14 Hz, Peak acceleration: 0.12 to 2.95 g), two days/weekly for five weeks, (b) an AT group (ATG; n = 21), stimulation of three specific auriculotherapy points (Kidney, Knee and Shenmen) in each ear pavilion, (c) WBVE + AT (WBVE + AT; n = 20) and (d) respective control groups (WBVE_CG, n = 15; AT_CG, n = 12; WBVE + AT_CG, n = 18). The participants filled out the WHOQOL-bref Questionnaire before the first and after the last sessions. Statistical differences in the various domains of the WHOQOL-bref were not found. In conclusion, WBVE or AT alone or combined did not contribute in altering the quality of life of individuals exposed to these interventions.

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Effectiveness of a Program Combining Strengthening, Stretching, and Aerobic Training Exercises in a Standing versus a Sitting Position in Overweight Subjects with Knee Osteoarthritis: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm9124113 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4113

Author(s):

Betsy Denisse Perez-Huerta ◽

Belén Díaz-Pulido ◽

Daniel Pecos-Martin ◽

David Beckwee ◽

Enrique Lluch-Girbes ◽

...

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Knee Pain ◽

Controlled Trial ◽

Exercise Program ◽

Control Group ◽

Global Increase ◽

Experimental Group ◽

Overweight Subjects

There is an increasing incidence, prevalence, and burden of knee osteoarthritis due to a global increase in obesity and an aging population. The aim of the present study was to compare the effectiveness of the addition of aerobic exercises performed in an unloaded or loaded position to a conventional exercise program in overweight subjects with knee osteoarthritis. Twenty-four subjects were randomly allocated to receive 36 sessions of 30-min duration of either sitting aerobic exercises (experimental group) or standing aerobic exercises (control group). Pain intensity, knee disability, and quality-of-life data were collected at baseline and at 12, 24, and 36 sessions. Generalized linear mixed models (GLMMs) were constructed for the analysis of the differences. Significant differences were found in the experimental group for self-reported pain and knee pain and disability at 24 and 36 sessions (p < 0.05). Significant between-group differences were observed in change in self-reported knee pain and disability and quality of life from baseline to 24th- and 36th-session measurements in favor of the experimental group. Adherence to treatment was higher in the experimental group. Adding aerobic exercises in an unloaded position to a conventional exercise program produced superior effects over time for self-reported knee pain, knee pain and disability and quality of life compared to loaded aerobic exercises in overweight subjects with knee osteoarthritis.

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Telerehabilitation for Knee Osteoarthritis in Brazil: A Feasibility Study

International Journal of Telerehabilitation ◽

10.5195/ijt.2020.6323 ◽

2020 ◽

Vol 12 (2) ◽

pp. 137-148

Author(s):

Jéssica Bianca Aily ◽

Christian John Barton ◽

Stela Marcia Mattiello ◽

Danilo De Oliveira Silva ◽

Marcos De Noronha

Keyword(s):

Knee Osteoarthritis ◽

Feasibility Study ◽

Exercise Therapy ◽

Rating Scale ◽

Exercise Adherence ◽

The Elderly ◽

Middle Aged ◽

Post Intervention ◽

Phone Calls ◽

Elderly Cohort

Background: The effectiveness of telerehabilitation for a patient with knee osteoarthritis may depend upon the person’s adherence to intervention. Thus, the aim of this study was to investigate whether people with knee osteoarthritis would adhere to exercise-therapy facilitated via multiple media in Brazil, a newly industrialized country. Method: This is a feasibility study, pre-post intervention. Middle aged (40-50 years) and elderly (?70 years) people with knee osteoarthritis received in-person exercise-therapy instructions on the first day, along with a booklet and DVD (videos) to take home. Participants also received six motivational phone calls throughout the 12-week treatment. Satisfaction and adherence were assessed one week after intervention with the Exercise Adherence Rating Scale (EARS), sections B and C. Preference on the method used to adhere to exercises was recorded. Conclusion: Telerehabilitation was well accepted by middle-aged and elderly Brazilians with knee osteoarthritis. The preferred media to enhance adherence, was a booklet with descriptions of the exercises, especially for the elderly cohort.

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