No abstract

The purpose of this study was to determine the effectiveness of a group exercise program for subjects with osteoarthritis of the knee referred for physiotherapy in terms of pain, physical function and gait. This study was initiated after an initial group exercise program at this centre failed to demonstrate significant changes in pain, physical function or gait. The study was based on repeated measures with a two month follow up, carried out in the outpatients department of a large public hospital. Pain levels in various functional situations were assessed on visual analogue scales, physical function with the Stanford Health Assessment Questionnaire, and quantitative gait variables at a normal and a fast self-selected speed with an electric foot switch walkway. On completion of the program (n = 40) more than 90% of the pain and physical function scores demonstrated significant improvements without increases in medication, use of walking aids or fatigue. The gait variables of velocity, cadence and stride length at both self-selected speeds demonstrated significant increases at this assessment without deterioration of gait symmetry. All improvements were maintained at the two month follow up assessments. This study suggests that a clinically realistic group exercise program supplemented with a home program can reduce pain, increase physical function and objective gait measures in subjects with osteoarthritis of the knee.

This study quantified differences in the gait parameters of velocity and stride length at three different self selected speeds between 113 subjects with rheumatoid arthritis and 104 normal controls stratified for age and gender. Significant differences were found between the well-matched groups of females 50-64 and over 65 years of age at all three speeds for both gait parameters. Females younger than 50 years of age, however, differed from their controls only at normal and fast velocities. The gait of males appeared to be less affected by the disease as only males over 65 years of age differed significantly from their controls and then only at the fast self selected speed. These data provide a base from which to judge the efficacy of therapeutic intervention in the arthritic population.

This study was designed to evaluate an established group exercise program at a large public hospital for subjects with osteoarthritis of the knee(s). Although quantitative gait analysis shows a clear difference between subjects with osteoarthritis of the knee(s) and asymptomatic controls, a significant effect of the group exercise program undertaken was not demonstrated, on either objectively measured gait parameters or subjectively reported pain and function. Possible reasons for this, together with an outline for a revised program and assessment procedure, are discussed.