Effectiveness and efficiency of an 11-week exercise intervention for patients with hip or knee osteoarthritis: a protocol for a controlled study in the context of health services research

Krauß, Inga; Muêller, G.; Haupt, Georg; Steinhilber, Benjamin; Janssen, Pia; Jentner, Nicola; Martus, Peter

doi:10.1186/s12889-016-3030-0

Cited by 30 publications

(17 citation statements)

References 29 publications

(42 reference statements)

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“…Group exercise approaches have been documented for the knee, 33 thoracolumbar spine, 34,35 cervical spine, 36 and wrist. 37 The evidence for the shoulder is less clear.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial

2018

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Introduction: Shoulder pain, a leading reason to consult a physician or physiotherapist, continues to be a challenge to rehabilitate, particularly with a military population. A rotator cuff (RC) tendinopathy, the most important source of shoulder pain, is one of the leading reasons for sick leave or a discharge from active military service. Research encourages the use of exercise prescription for the management of a RC tendinopathy, however the ideal method of delivery (group setting versus one-on-one) remains uncertain. The purpose of this single-blind (evaluator) pilot randomized clinical trial was to compare two 6-week rehabilitation programs, a newly developed groupsupervised neuromuscular training program and usual one-on-one physiotherapy care, on the pain and symptoms of Canadian soldiers affected by a RC tendinopathy. Materials and Methods: Thirty-one soldiers with the Canadian Armed Forces were randomly assigned to (1) a group-supervised neuromuscular training program (UPEx-NTP) or; (2) one-on-one usual physiotherapy care (UPC). The primary outcome was the Disability of Arm, Hand and Shoulder (DASH) questionnaire. Secondary outcomes included the Western Ontario Rotator Cuff (WORC) Index, pain levels at rest, and maximum isometric voluntary contractions (MIVC) of the abductors and external (lateral) rotators of the affected shoulder. Both were assessed at baseline (T 0 ), 6 (T 6 ) and 12 (T 12 ) weeks. Analysis included two-way repeated measures of variance for intention-to-treat (ITT) and per-protocol analyses. Results: Eighty military members with a RC tendinopathy were contacted, resulting in 31 participants who were randomized for their active intervention, in the UPEx-NTP or UPC, respectively. No significant group (p ≥ 0.16) or group × time interactions (p ≥ 0.11) were found for either ITT or per-protocol analyses. A statistically significant time effect (p < 0.001) was established for the DASH and WORC, showing that both groups improved over time. Conclusions: Our preliminary data demonstrates that both rehabilitation approaches, grounded in active exercises, were not statistically different from each other, and derived similar benefits over time for a military population. This suggests that a group intervention for a RC tendinopathy has potential to be just as effective as a one-on-one approach for a military population, an interesting avenue for an active working population. Larger sample sizes and further investigation are warranted regarding the cost and clinical resource benefits of a supervised group approach.

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“…Group exercise approaches have been documented for the knee, 33 thoracolumbar spine, 34,35 cervical spine, 36 and wrist. 37 The evidence for the shoulder is less clear.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial

2018

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“…Osteoarthritis is a complex, multifactorial disease that can be successfully managed and treated through exercise, with minimal risk for negative consequences (13). The chronic character of osteoarthritis requires a longterm therapeutic treatment -in this regard lifestyle interventions such as physical exercises that can be carried out by the patient himself are recommended as the first-line treatment (14). However, to have greatest impact, appropriate exercise prescription is needed (13).…”

Section: Discussionmentioning

confidence: 99%

Effects of strength, stretching and balance home exercise program on quality of life of people with knee osteoarthritis

Kapetanović

Horić

Avdić³

et al. 2018

JHSCI

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Introduction: The aim of this study was to assess effects of strength, stretching and balance home exercise program (moderate intensity, performed once a day, five times a week) on quality of life of people with knee osteoarthritis. Methods: Participants with knee osteoarthritis performed physical therapy for a period of two weeks at the Department for Physical Medicine and Rehabilitation. The study group (n=30) continued to perform exercise program at home while the control group (n=30) did not continue the exercise program. The participants in the study group performed strength, stretching and balance exercises of moderate intensity, once a day, five times a week, for a total of eight weeks. The Short Form-36 Health Questionnaire (SF-36) was used to examine the effects of exercise program. Results: There was no the difference between the average value of quality of life in all examined areas (physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality/energy, mental health, social functioning, physical pain, perception of general health) at the beginning of the study between the study group and control group (p>0.05 in all eight areas). The difference between the average value of quality of life at the beginning and end of the study was statistically significantly higher in the study group compared to the control group (physical functioning p=0.0001; role limitations due to physical problems p=0.0001; role limitations due to emotional problems p=0.0001; vitality/energy p=0.0001; mental health p=0.0001; social functioning p=0.0001; bodily pain p=0.0001; perception of general health p=0.0001). Conclusion: Home exercise program consisting of strength, stretching and balance exercises, of moderate intensity, performed once a day, five times a week is effective in improving quality of life of people with knee osteoarthritis.

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“…In earlier stages, conservative therapeutic interventions are important to reduce pain and increase function and health-related quality of life. 6 8 The use of pharmacological therapies in chronic diseases is limited because of known and significant side effects. 5 Non-pharmaceutical interventions such as physical exercise programme are therefore of particular importance.…”

Section: Introductionmentioning

confidence: 99%

“…However, reports on known side effects such as pain increase or falls are rare; thus, exercise appears to be a safe intervention. 6 9–11 …”

Section: Introductionmentioning

confidence: 99%

Effectiveness and efficiency of different weight machine-based strength training programmes for patients with hip or knee osteoarthritis: a protocol for a quasi-experimental controlled study in the context of health services research

Krauß¹,

Müller

Steinhilber³

et al. 2017

BMJ Open Sport Exerc Med

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IntroductionOsteoarthritis is a chronic musculoskeletal disease with a major impact on the individual and the healthcare system. As there is no cure, therapy aims for symptom release and reduction of disease progression. Physical exercises have been defined as a core treatment for osteoarthritis. However, research questions related to dose response, sustainability of effects, economic efficiency and safety are still open and will be evaluated in this trial, investigating a progressive weight machine-based strength training.Methods and analysisThis is a quasi-experimental controlled trial in the context of health services research. The intervention group (n=300) is recruited from participants of an offer for insurants of a health insurance company suffering from hip or knee osteoarthritis. Potential participants of the control group are selected and written to from the insurance database according to predefined matching criteria. The final statistical twins from the control responders will be determined via propensity score matching (n=300). The training intervention comprises 24 supervised mandatory sessions (2/week) and another 12 facultative sessions (1/week). Exercises include resistance training for the lower extremity and core muscles by use of weight machines and small training devices. The training offer is available at two sites. They differ with respect to the weight machines in use resulting in different dosage parameters. Primary outcomes are self-reported pain and function immediately after the 12-week intervention period. Health-related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Secondary analysis will be undertaken with two strata related to study site. Participants will be followed up 6, 12 and 24 months after baseline.Trial registration numberGerman Clinical Trial Register DRKS00009257. Pre-results.

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Effectiveness and efficiency of an 11-week exercise intervention for patients with hip or knee osteoarthritis: a protocol for a controlled study in the context of health services research

Cited by 30 publications

References 29 publications

The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial

The Effectiveness of an Upper Extremity Neuromuscular Training Program on the Shoulder Function of Military Members With a Rotator Cuff Tendinopathy: A Pilot Randomized Controlled Trial

Effects of strength, stretching and balance home exercise program on quality of life of people with knee osteoarthritis

Effectiveness and efficiency of different weight machine-based strength training programmes for patients with hip or knee osteoarthritis: a protocol for a quasi-experimental controlled study in the context of health services research

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