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

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.

Analysis of the Application Effect of Exercise Rehabilitation Therapy Based on Data Mining in the Prevention and Treatment of Knee Osteoarthritis

“…Among all kinds of rehabilitation therapy for arthritis, the role of exercise rehabilitation therapy is the most recognized by evidence-based medicine. Its functions promote blood circulation, enhance venous return and venous congestion, increase joint range of motion, muscle strength, and joint stability, promote the diffusion of synovial fluid to the cartilage surface and the intercellular substance, and can stimulate the proliferation of chondrocytes around the lesion area, supporting the regeneration of degenerated cartilage, and the strength of the sufferer's extensor muscles may increase the stability of the knee joint [ 12 ]. Clinical studies have shown that exercise rehabilitation is the most effective way to prevent and treat joint diseases and injuries and to support articular cartilage repair.…”

Safety evaluation of antibacterial and analgesic autoinjector devices for rapid administration during emergency situations: a crossover study in rabbits

“…Pain can be studied or visualised by change in gait, licking, rubbing, abnormal posture or decreased food and water intake. 14,15…”