The quality of physiotherapy and rehabilitation program and the effect of telerehabilitation on patients with knee osteoarthritis

Abstract

Objective To compare the effects of telerehabilitation vs home-based exercise programs for knee osteoarthritis (KOA). Method Patients diagnosed with moderate/mild KOA were enrolled in the study and randomized into two groups. The patients in the telerehabilitation group did their exercises via video conference simultaneously, accompanied by a physiotherapist, while the patients in the control group were given a brochure showing how to do the exercises and explaining how to do each exercise. Patients completed 30-s chair stand test (30 CST), Knee Injury and Osteoarthritis Outcome Score (KOOS), Numeric Rating Scale (NRS), International Physical Activity Questionnaire Short Form (IPAQ-SF), Hospital Anxiety and Depression Scale (HADS), TAMPA Kinesiophobia Scale (TKS), Fatigue Severity Scale (FSS) twice before and after 8-week treatment, and Quality Indicators Questionnaire for Physiotherapy Management of Hip and Knee Osteoarthritis (QUIPA) and Exercise Adherence Rating Scale (EARS) after treatment only. Moreover, the number of painkillers that patients used in the last 15 days was recorded before and after treatment, and patient satisfaction with treatment was questioned after treatment. Results Forty-eight patients were included in the study. The mean age of patients was 55.83 ± 6.93 years, and 43 (89.6%) patients were women. No significant differences were determined between groups in terms of baseline characteristics. After the 8-week follow-up, telerehabilitation group demonstrated better 30 CST, IPAQ-SF, KOOS, QUIPA, treatment satisfaction, and total and C subscale of EARS scores increment and greater NRS, HADS, TKS, and FSS score reduction than the control group. It was determined that there was a statistically significant difference between the telerehabilitation and control groups for all of the specified parameters; however, no statistically significant difference was found for the B subscale of EARS. Conclusion This study indicated that telerehabilitation is superior to self-management. Moreover, through this innovative and population specific web-based approach for KOA, a vast number of patients who have internet access could be reached. Thus, patients with KOA received effective treatment. Key Points • Telerehabilitation is superior to self-management. • Telerehabilitation is a quality practice with the potential to reduce symptoms in patients with knee OA.

A systematic review on the effects of non-pharmacological interventions for fatigue among people with upper and/or lower limb osteoarthritis

“…The Short-form 36 vitality subscale (SF-36 scale) was used in thirteen of the studies [ 25 , 26 , 33 , 34 , 35 , 37 , 42 , 43 , 44 , 48 , 51 , 52 , 54 ], Visual Analogue Scale was used in three studies [ 27 , 28 , 49 ], Brief Fatigue Inventory was used in three studies [ 29 , 30 , 31 ] Numerical Rating Scale was used in four studies [ 23 , 24 , 45 , 46 , 47 ], Facit Fatigue Scale [ 38 , 53 ], and the Multidimensional Fatigue Inventory [ 40 , 50 ] were each used in two studies. Other fatigue tools include the PROMIS Fatigue-V 1.0 SF-8a [ 32 ], Short-form 12 [ 41 ], WHO quality of life questionnaire (WHOQoL) [ 36 ] and Fatigue severity scale (FSS) [ 39 ] ( Table 1 ).…”

“…We identified various forms of interventions ranging from exercise to behavioural interventions. The interventions utilized include: exercise [ 23 , 24 , 25 , 26 , 32–36 , 45 , 49 , 52 , 53 , 54 ], yoga [ 48 ], footwear modification [ 28 ], activity pacing [ 29 ], mobile app-based instructions [ 42 ], thermotherapy [ 41 ], moxibustion therapy [ 43 , 51 ], pain-coping skills [ 31 ], multidisciplinary intervention [ 46 ], cognitive behavioural therapy [ 30 ], planned behaviour-based intervention [ 41 ], balneotherapy and physiotherapy [ 38 ], Bio-electromagnetic energy regulation (BEMER) therapy, a subtype of pulsed electromagnetic field therapy which uses micro-circulation in the muscles to facilitate blood circulation [ 53 ], mud-pack [ 37 ], active video games [ 50 ], acupuncture and usual care [ 44 ], tele-rehabilitation [ 39 , 47 ], massage plus aromatherapy and electrotherapy [ 40 ]. The exercises included strengthening, balance, kinaesthesia, and mobilization, hand-based, stretching, aquatic dance-based and web-based exercises.…”

Physical activity and kinesiophobia: A systematic review and meta-analysis

“…Using reference screening and forward citation tracking, the authors identified 27 studies that assessed both physical activity and kinesiophobia, of which 8 reported an estimate of their relationship [84][85][86][87][88][89][90][91] and 19 did not [92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110] . The corresponding authors of these 19 studies were asked by email to provide this estimate or their data.…”

“…Two authors sent the estimate 104,107 . Seventeen emails remained unanswered [92][93][94][95][96][97][98][99][100][101][102][103]105,106,[108][109][110] .…”

Osteoarthritis 2050 projections and its multiple mitigation challenges

“…Those who are treating this group are thus encouraged to do so mindful of the health literacy levels, to ensure self-care is optimal and to be additionally mindful of the various skills needed to participate in telerehabilitation approaches, which may prove challenging and anxiety provoking, despite their value for some. [37][38][39] In addition to accessibility and technical skills, while digital interventions have been employed recently to advance osteoarthritis care, 40 it is impossible to gauge if they would be helpful for an older adult with deficient health literacy 41 as well as for those with poor digital skills. Even if used and somewhat successful, the problem of poor health literacy in other spheres cannot be readily overlooked, 42,43 including its possible adverse impact on frailty, 44 obesity 45 and selfefficacy 46 as well as non-tailored health plans.…”