A Telephone-based Physiotherapy Intervention for Patients with Osteoarthritis of the Knee

Abstract

This study assessed the effects of a 6-week telephone based intervention on the pain intensity and physical function of patients with knee osteoarthritis (OA), and compared the results to physiotherapy conducted in the clinic. Fifty randomly selected patients with knee OA were assigned to one of two treatment groups: a clinic group (CG) and a tele-physiotherapy group (TG). The CG received thrice-weekly physiotherapist administered osteoarthritis-specific exercises in the clinic for six weeks. The TG received structured telephone calls thrice-weekly at home, to monitor self-administered osteoarthritis-specific exercises. Participants’ pain intensity and physical function were assessed at baseline, two, four, and six weeks, in the clinic environment. Within group comparison showed significant improvements across baseline, and at weeks two, four, and six for both TG and CG’s pain intensity and physical function. Between-group comparison of CG and TG’s pain intensity and physical function at baseline and weeks two, four, and six showed no significant differences. This study demonstrated that a six-week course of structured telephone calls thrice-weekly to patients at their home, to monitor self-administered osteoarthritis-specific exercises for patients with knee OA (i.e., tele-physiotherapy) achieved comparable results to physiotherapy conducted in the clinic.

Effectiveness of telephone-based interventions for managing osteoarthritis and spinal pain: a systematic review and meta-analysis

“…All interventions focused on supporting self-management and providing education in addition to a range of intervention targets, for example physical activity (see Table 1 for details). A total of 17 studies assessed pain intensity ( Weinberger et al, 1989 ; Mazzuca et al, 1997 ; Thomas et al, 2002 ; Buhrman et al, 2004 ; Hughes et al, 2010 ; Allen et al, 2010 , 2016 , 2017 ; Odole & Ojo, 2013 ; Cuperus et al, 2015 ; De Rezende et al, 2016 ; Bennell et al, 2017 ; Gialanella et al, 2017 ; Li et al, 2017 ; O’Brien et al, 2018 ; Rutledge et al, 2018 ; Williams et al, 2018 ) and 21 studies assessed a disability outcome ( Weinberger et al, 1989 ; Maisiak, Austin & Heck, 1996 ; Mazzuca et al, 1997 ; Burks, 2001 ; Damush et al, 2003 ; Blixen et al, 2004 ; Hughes et al, 2010 ; Allen et al, 2010 , 2016 , 2017 ; Iles et al, 2011 ; Odole & Ojo, 2013 ; Cuperus et al, 2015 ; De Rezende et al, 2016 ; Bennell et al, 2017 ; Gialanella et al, 2017 ; Li et al, 2017 ; O’Brien et al, 2018 ; Rutledge et al, 2018 ; Goode et al, 2018 ; Williams et al, 2018 ).…”

“…No subgroup analyses were possible for any comparative effectiveness comparisons ( Table 2 ). A further two studies ( Hughes et al, 2010 ; Odole & Ojo, 2013 ) were not included in the meta-analysis due to dissimilar intervention components or did not report sufficient data (e.g. means at follow-up not reported).…”

“…Other studies not included in the meta-analysis (reasons included insufficient data report, dissimilar intervention components, and not reporting a measure of variance) showed no difference between groups for psychological symptoms ( Hughes et al, 2010 ; Odole & Ojo, 2013 ), self-efficacy ( Cuperus et al, 2015 ), weight loss ( Hughes et al, 2010 ; De Rezende et al, 2016 ), physical activity ( Hughes et al, 2010 ; Cuperus et al, 2015 ; Bennell et al, 2017 ), healthcare utilisation ( Bennell et al, 2017 ), health-related quality of life ( Bennell et al, 2017 ), treatment adherence ( Cuperus et al, 2015 ; De Rezende et al, 2016 ; Bennell et al, 2017 ), and fear avoidance ( Cuperus et al, 2015 ) ( Table S2 ). One study reported telephone-based interventions significantly improved global rating of change overall ( Bennell et al, 2017 ) ( Table S2 ).…”

Does telephone-delivered exercise advice and support by physiotherapists improve pain and/or function in people with knee osteoarthritis? Telecare randomised controlled trial

“…Telephone interventions for knee OA have been studied previously 41. Only two studies have involved physiotherapist consultations, evaluating telephone calls to follow-up in-person physiotherapist consultation(s) 42 43. Our trial is unique because our physiotherapists prescribed strengthening and physical activity entirely over the telephone.…”

Effectiveness of combined chain exercises on pain and function in patients with knee osteoarthritis

“…Stability of the knee joint which is enhanced by increased quadriceps muscle strength following resistance exercises has been opined to improve function in patients with OA 59 . Similarly, Alnahdi et al 64 in a review of literature also identified muscle strength especially quadriceps as a major determinant of both performance -based and self-reported physical function and further submitted that exercise therapy, including global and targeted resistance training, is 40,53,65,66 . The similarity between the findings of these researchers and that of the present study may be attributed to significant pain reduction observed in present study which was also reported by these authors; a significant inverse relationship between pain and physical function has been previously reported in literature 67 .…”