Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial

Thomas, KS; Kr, Muir; Doherty, Michael; Ac, Jones; O'Reilly, SC; Ej, Bassey

doi:10.1136/bmj.325.7367.752

Cited by 360 publications

(309 citation statements)

References 21 publications

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“…Some evidence suggests that lack of physical activity leads to muscle strength destabilization of the knee, with a greater risk of developing or worsening OA (8). Accordingly, aerobic exercise (9) and resistance exercise (10,11) have been shown to be beneficial for OA patients and have resulted in improved gait and function. Moderate levels of physical activity are recommended for persons with OA, provided the activity is not painful (12).…”

Section: Introductionmentioning

confidence: 99%

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries

Herbolsheimer

Schaap

Edwards

et al. 2016

Arthritis Care & Research

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Objective. To investigate patterns of physical activity in older adults with knee osteoarthritis (OA) compared to older adults without knee OA across 6 European countries. We expect country-specific differences in the physical activity levels between persons with knee OA compared to persons without knee OA. A varying degree of physical activity levels across countries would express a facilitating or impeding influence of the social, environmental, and other contextual factors on a physically active lifestyle. Methods. Baseline cross-sectional data from the European Project on Osteoarthritis were analyzed. In total, 2,551 participants from 6 European countries (Germany, Italy, The Netherlands, Spain, Sweden, and the UK) were included. Results. Participants with knee OA were less likely to follow physical activity recommendations and had poorer overall physical activity profiles than those without knee OA (mean 62.9 versus 81.5 minutes/day, respectively; P 5 0.015). The magnitude of this difference varied across countries. Detailed analysis showed that low physical activity levels in persons with knee OA could be attributed to less everyday walking time (odds ratio 1.31, 95% confidence interval 1.07-1.62). Conclusion. This study highlighted the fact that having knee OA is associated with a varying degree of physical activity patterns in different countries. This national variation implies that low levels of physical activity among persons with knee OA cannot be explained exclusively by individual or disease-specific factors, but that social, environmental, and other contextual factors should also be taken into account.

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Section: Introductionmentioning

confidence: 99%

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries

Herbolsheimer

Schaap

Edwards

et al. 2016

Arthritis Care & Research

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“…Compliance to treatment is important in attaining treatment goals. When a physical exercise regimen is prescribed, adherence to this regimen is crucial in preserving physical performance and function (in terms of observed walking distance and self-reported disability, respectively) and in reducing pain for patients with knee OA (5).…”

Section: Introductionmentioning

confidence: 99%

Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis

Gool¹,

Penninx²,

Kempen³

et al. 2005

Arthritis & Rheumatism

162

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Objective. To determine whether high exercise adherence improved physical function among older adults with knee osteoarthritis (OA) who were overweight or obese. Methods. Associations between exercise adherence, changes in 6-minute walking distance in meters, and self-reported disability (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) after 6 and 18 months were examined among an Arthritis, Diet, and Activity Promotion Trial subsample (n ‫؍‬ 134) using multiple linear regression models. Results. Higher exercise adherence was associated with greater improvements in 6-minute walking distance after 6 and 18 months and in disability after 6 months. Pain and body mass index (BMI) contributed, to some extent, to explaining the link between exercise adherence and changes in physical performance and self-reported disability. Conclusion. Higher exercise adherence is associated with improved physical function in overweight and obese older adults with knee OA. This indicates that promoting adherence is clinically relevant when prescribing exercise regimens that also focus on decreasing pain and BMI.

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“…85 Ettinger (1997) 86 van Baar (1998) 87 Maurer (1999) 88 O'Reilly (1999) 89 Péloquin (1999) 90 Deyle (2000) 91 Hopman-Rock (2000) 92 Baker (2001) 93 Fransen (2001) 94 Halbert (2001) 95 Patrick (2001) 96 Belza (2002) 97 Thomas (2002) 98 Topp (2002) 99 Foley (2003) 100 Quilty (2003) 101 Talbot (2003) 102 Hughes (2004) 103 Keefe (2004) 104 Lin (2004) 105 Messier (2004) 106 Ravaud (2004) 107 Bennell (2005) 108 Cochrane (2005) 109 Tak (2005) 110 Hay (2006) 34 Mikesky (2006) 111 Fransen (2007) 112 Hinman (2007) 113 Wang (2007) 114 Subtotal (I 2 = 0.0%; p = 0.990) Sensitivity analyses were performed for advice and information, and exercise intervention studies, with results showing minimal differences in the pooled effect estimates after exclusion of studies with a high risk of bias.…”

Section: Clinical Effectiveness Of Primary Care Interventions For Ostmentioning

confidence: 99%

“…The Acupuncture, Physiotherapy and Exercise (APEX) trial, 202 which incorporated a more intensive exercise intervention that was supervised and progressed over six treatment sessions, resulted in greater improvements in pain than the exercise programme in the TOPIK trial. 34,203 Similarly, other recent trials 30,98 and reviews 204 showed small to moderate, short-term reductions in knee pain and disability that are not sustained in the long term. 192 Exercise is clearly worth doing but we need to find out if, and how, the beneficial effects can be maintained over time.…”

Section: Introductionmentioning

confidence: 99%

Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials

Hay

Dziedzic

Foster

et al. 2018

Programme Grants Appl Res

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This report should be referenced as follows:Hay E, Dziedzic K, Foster N, Peat G, van der Windt D, Bartlam B, et al. Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials. Programme Grants Appl Res 2018;6(4). Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10386. The contractual start date was in July 2008. The final report began editorial review in March 2015 and was accepted for publication in May 2016. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publicatio...

show abstract

Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial

Abstract: Objectives To determine whether a home based exercise programme can improve outcomes in patients with knee pain.

Cited by 360 publications

References 21 publications

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries

Physical Activity Patterns Among Older Adults With and Without Knee Osteoarthritis in Six European Countries

Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis

Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials

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