The effects of a home-based exercise intervention on elderly patients with knee osteoarthritis: a quasi-experimental study

Abstract

Background Knee osteoarthritis (KOA) is common in elderly people, causes pain, loss of physical functioning, and disability. This was a two-arm, superiority, quasi-experimental trial. The aim of this study was to evaluate the effectiveness of a home-based exercise intervention (HBEI) to reduce KOA symptoms and improve the physical functioning of elderly patients. Methods A total of 171 elderly patients (60 years of age or older) with KOA were recruited from four community centers. Patients from two community centers were randomly assigned to the intervention group (IG) and the other two centers were randomly assigned to the control group (CG). Participants in the IG received a 12-week HBEI (including four 2-h sessions supervised by a physiotherapist and fortnightly telephone support) combined with health education, while patients in the CG only received health education. The participants and physiotherapists were aware of the group assignment and alternative treatment components, but the study’s hypotheses were not disclosed to the participants. Pain intensity, joint stiffness, lower-limb muscle strength, balance, mobility, and quality of life were measured before and after the intervention by the same blinded assessor. Results A total of 171 patients (IG: n = 84, CG: n = 87) were enrolled. Data were obtained from 141 patients with an average age of 68 (range, 60–86 years) who completed the 12-week study (IG: n = 71, CG: n = 70). No significant group differences were found in any outcome measures at baseline. At week 12, the pretest/posttest changes 3significant between-group differences in decreases in pain intensity (− 1.60 (CI, − 2.75 to − 0.58)) and stiffness (− 0.79 (CI, − 1.37 to − 0.21)), with the IG exhibiting significantly larger improvements on both measures than the CG. The IG also showed significantly greater improvements on all the secondary outcomes than the CG did. Conclusions HBEI may be effective for relieving KOA symptoms, increasing the physical functioning, and improving quality of life in community-dwelling KOA elderly patients. A large randomized controlled trial with long-term follow-up is needed to confirm these findings. Trial registration Chinese Clinical Trails Registry number ChiCTR1800017026 (retrospectively registered). Registered 9 July 2018. Electronic supplementary material The online version of this article (10.1186/s12891-019-2521-4) contains supplementary material, which is available to authorized users.

Evaluation of the Interaction Model of Client Health Behavior‐based multifaceted intervention on patient activation and osteoarthritis symptoms

“…Others reported that Tai Chi exercise offered to osteoarthritis patients, which has muscle strengthening effects, was effective in decreasing joint pain (Cho et al, ; Song et al, ). Consistent with former studies (Chen et al, ; Cho et al, ), the results of the present study showed that both experimental groups had decreased joint pain and joint stiffness, while their physical functioning had improved after the intervention compared to those in the control group. These three indicators (joint pain, joint stiffness, and physical functioning) are important criteria for evaluating the health status of osteoarthritis patients.…”

Effect of quadriceps strengthening exercises alone and in combination with Baduanjin qigong on older adults with knee osteoarthritis: a quasi-experimental study

“…Therefore, quadriceps strengthening is key in KOA management [22]. QSE as a widely used muscle training method [7,10,11], its effect on pain relief and functional improvement in patients with KOA was also demonstrated in our study ( Table 2). But the evaluation parameters of pain and physical function of WOMAC in intervention group improved significantly compared with that in control group during follow-up period.…”

“…Maintaining functionality is one of the main goals in OA treatment [9,33]. Good physical function benefits patients to perform daily activities and social interaction independently [7]. And then, quality of life in these patients improved correspondingly [33].…”

“…Until now, since there is no way to cure KOA [1], the treatment goal of KOA mainly focuses on pain reduction and improvement of physical function and quality of life (QoL) [6,7]. Exercise therapy is one of the most effective non-pharmacologic treatments for KOA due to its high safety, low-cost, and easy operation [7,8].…”

“…Among the recommended exercise programs, quadriceps strengthening exercises (QSE) has been widely used for KOA patients. Previous studies show that QSE have better short-term effects on relieving joints' pain or stiffness and improving the QoL [7,10,11]. However, the long-term adherence to exercise becomes a barrier to widespread use and implementation [11,12].…”