Telerehabilitation for Knee Osteoarthritis in Brazil: A Feasibility Study

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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Intra-Articular Hyaluronic Acid as Treatment in Elderly and Middle-Aged Patients with Knee Osteoarthritis

The Open Rheumatology Journal ◽

10.2174/1874312901307010038 ◽

2013 ◽

Vol 7 (1) ◽

pp. 38-41 ◽

Cited By ~ 9

Author(s):

Demet Uçar ◽

Demirhan Dıraçoğlu ◽

Türker Süleyman ◽

Nalan Çapan

Keyword(s):

Hyaluronic Acid ◽

Knee Osteoarthritis ◽

The Elderly ◽

Elderly Group ◽

Middle Aged ◽

Old Patients ◽

Aged Group ◽

The Third ◽

Age Related ◽

One Year

Introduction: Osteoarthritis is the most common age-related degenerative joint disease. It affects all the joints containing hyaline cartilage. Knee osteoarthritis is the most cumbersome in terms of prevalence and disability. The aim of this study to evaluate the efficacy of intra-articular hyaluronic acid in patients with knee osteoarthritis with regard to joint pain and function, as well as patient satisfaction, assessed at one month and at one year, and by age group. Methods: In this prospective randomised study, 172 patients who were diagnosed knee OA and who received three consecutive intra-articular injections of HA weekly were included. Patients 65 years of age or older were accepted as the “elderly group”, and those under 65 were accepted as the “middle-aged group”. Clinical evaluations of efficacy and safety were conducted at the beginning of the study, one month after the third injection, and one year after the third injection. Results: In the two groups, the intragroup analysis revealed significant improvements following injection when compared with preinjection values. According to the last followup controls (after 12 months) in the middle-aged group, VAS activity pain, VAS rest pain, WOMAC physical function, and WOMAC pain values were found to be statistically lower when compared with pre-injection values. In the elderly group, no statistically significant differences were found between pre-injection and after 12 months. Conclusion: We can conclude that intra-articular joint HA injections are effective in both young and old patients with OA with regard to pain and functional status over a short-term period. Further, HA injections in patients younger than 65 years can be planned for a one-year period.

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THU0627-HPR Exercise Therapy in Patients with Knee Osteoarthritis and Severe Pain is Enabled by Optimization of Analgesics – a Feasibility Study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.1725 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 1318.2-1318

Author(s):

J.A.C. van Tunen ◽

M. van der Leeden ◽

W. Bos ◽

J. Cheung ◽

M. van der Esch ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Feasibility Study ◽

Exercise Therapy ◽

Severe Pain

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Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain: A Feasibility Study

Arthritis Care & Research ◽

10.1002/acr.22682 ◽

2016 ◽

Vol 68 (3) ◽

pp. 332-340 ◽

Cited By ~ 8

Author(s):

Joyce A. C. van Tunen ◽

Marike van der Leeden ◽

Wouter H. Bos ◽

John Cheung ◽

Martin van der Esch ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Feasibility Study ◽

Exercise Therapy ◽

Severe Pain

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Effect of multimodal interventions on pain and activities of daily living among the elderly with osteoarthritis

Journal of Applied and Advanced Research ◽

10.21839/jaar.2016.v1i3.34 ◽

2016 ◽

Vol 1 (3) ◽

pp. 53

Author(s):

Shyam Das ◽

Kavitha Chandran C

Keyword(s):

Knee Osteoarthritis ◽

Activities Of Daily Living ◽

Daily Living ◽

Rating Scale ◽

Sampling Technique ◽

The Elderly ◽

Structured Interview ◽

Routine Care ◽

Control Group ◽

Control Group Design

The aim of the present study was to assess the effect of multimodal interventions on pain and activities of daily living among the elderly with knee osteoarthritis attending Physical Medicine and Rehabilitation OPD at General Hospital Alappuzha,Kerala. Objectives were to assess the level of joint pain in elderly with knee osteoarthritis, to assess the ability of elderly to perform activities of daily living, to evaluate the effect of multimodal interventions on pain and activities of daily living of elderly with knee osteoarthritis and to find out association between multimodal interventions and analgesic usage. The investigator adopted quantitative experimental approach for the study and research design was quasi experimental non equivalent control group design. The sample size was 74 elderly patients diagnosed as knee osteoarthritis selected using purposive sampling technique. A structured interview schedule was used to assess the socio personal and clinical data; pain and activities of daily living were assessed by numerical pain rating scale and Katz index respectively. Routine care was given to control group, while the experimental group underwent multimodal interventions which included educational session, isometric exercises and moist heat application for three weeks along with routine care. After three weeks, post-test was done in both groups. The findings revealed that there was a significant reduction in pain (P<0.001), improvement in activities of daily living (P<0.001) and also reduction in frequency of analgesic intake (p< 0.001) among elderly with knee osteoarthritis.

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Construction of an adherence rating scale for exercise therapy for patients with knee osteoarthritis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-018-2200-x ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Jianji Wang ◽

Long Yang ◽

Qingjun Li ◽

Zhanyu Wu ◽

Yu Sun ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Exercise Therapy ◽

Rating Scale

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FRI0733-HPR An interactive course on exercise therapy for knee osteoarthritis and comorbidity: a feasibility study

10.1136/annrheumdis-2018-eular.5144 ◽

2018 ◽

Author(s):

M. De Rooij ◽

M. van der Leeden ◽

M. van der Esch ◽

W.F. Lems ◽

J. Meesters ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Feasibility Study ◽

Exercise Therapy

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

Applied Sciences ◽

10.3390/app11104338 ◽

2021 ◽

Vol 11 (10) ◽

pp. 4338

Author(s):

Alessandro de Sire ◽

Lorenzo Lippi ◽

Claudio Curci ◽

Dario Calafiore ◽

Carlo Cisari ◽

...

Keyword(s):

Physical Exercise ◽

Knee Osteoarthritis ◽

Rating Scale ◽

Combined Treatment ◽

Exercise Program ◽

Exercise Adherence ◽

Reduction Of Pain ◽

Chronic Pain Conditions ◽

Combined Intervention

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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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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