Exercise and education for community-dwelling older participants with knee osteoarthritis: a video-linked programme protocol based on a randomised controlled trial

Abstract

Background Neuromuscular and quadriceps exercises have been shown to be effective approaches to relieve pain and to improve function for patients with knee osteoarthritis. In this study, we aim to provide an informative feasible model in which therapeutic exercise and education will be undertaken with physiotherapy supervision and instruction via video link. We also aim to explore the relationship between program-induced pain alleviation/functional improvements and reduction in irritability, which might be mediated through program-induced psychosocial benefits. Methods In this proposed two-parallel group (neuromuscular exercise versus quadriceps exercise), single-blinded, randomised controlled trial, participants aged ≥50 years with osteoarthritic knee pain will undergo a 12-week intervention, comprising video-linked education, supervised exercises, and a 12-week follow-up. Seven measurements will be taken to collect longitudinal data. A generalised estimating equation will be used to establish the adjusted difference in effectiveness on pain, function, irritability, and psychosocial outcomes between participants undertaking neuromuscular exercises and those undertaking quadriceps exercises. The primary outcomes are overall average pain in the knee joint during walking, as assessed through the 11-point Numerical Pain Rating Scale, and the Western Ontario and McMaster Universities osteoarthritis index physical function subscale. Furthermore, pressure pain threshold and changes in self-report pain scores pre-, during, and post-exercise were also measured as an indication of irritability. In addition, both the 6-min walk test and a timed up & go test were used to assess walking function performance. Finally, patients’ emotions (e.g., fear and catastrophising), self-trust, needs in terms of disease knowledge, mental resilience, social support and health-related quality of life were investigated. Two four-wave cross-lagged models will be used to investigate directional relationships, aiming to investigate the complex mechanisms concerning the effects of exercise programmes. Discussion Through summarising the study’s strengths and limitations, this study may provide promising insights in terms of exercise therapy optimisation for people with knee osteoarthritis and/or other chronic pain within a psychosocial framework. Trial registration ChiCTR2100041978 (chictr.org.cn), January 10, 2021.

mHealth for the Self-management of Knee Osteoarthritis: Scoping Review (Preprint)

“…Three studies focused on patients with obesity and knee OA [21,24,25]. In terms of mHealth and the apps evaluated, 7 studies included mHealth or apps on exercise therapy such as strength training [20][21][22][23][24]26,27], 6 involved patient education [20][21][22][23]25,26], and 2 were related to dietary advice [21,25]. Word clouds generated by the titles and abstracts of the 8 studies are shown in Multimedia Appendix 2, and a summary of our findings is shown in Tables 1 and 2.…”

“…The years of publication of the included studies were 2017 (n=1) [22], 2019 (n=1) [20], 2020 (n=3) [23,25,26], and 2021 (n=3) [21,24,27]. There were 3 randomized controlled trials (RCTs) [21,23,24], 4 RCT protocols [22,[25][26][27], and 1 conference abstract on an RCT [20]. The studies were conducted in the United States, the Netherlands, Germany, Australia, Turkey, China, Pakistan, and Taiwan.…”

mHealth for the Self-management of Knee Osteoarthritis: Scoping Review

“…The years of publication of the included studies were 2017 (n=1) [ 22 ], 2019 (n=1) [ 20 ], 2020 (n=3) [ 23 , 25 , 26 ], and 2021 (n=3) [ 21 , 24 , 27 ]. There were 3 randomized controlled trials (RCTs) [ 21 , 23 , 24 ], 4 RCT protocols [ 22 , 25 - 27 ], and 1 conference abstract on an RCT [ 20 ]. The studies were conducted in the United States, the Netherlands, Germany, Australia, Turkey, China, Pakistan, and Taiwan.…”

“…Three studies focused on patients with obesity and knee OA [ 21 , 24 , 25 ]. In terms of mHealth and the apps evaluated, 7 studies included mHealth or apps on exercise therapy such as strength training [ 20 - 24 , 26 , 27 ], 6 involved patient education [ 20 - 23 , 25 , 26 ], and 2 were related to dietary advice [ 21 , 25 ]. Word clouds generated by the titles and abstracts of the 8 studies are shown in Multimedia Appendix 2 , and a summary of our findings is shown in Tables 1 and 2 .…”

Effects of Internet of Things-based power cycling and neuromuscular training on pain and walking ability in elderly patients with KOA: protocol for a randomized controlled trial

“…The exercise process requires community administrators and family members to supervise and provide any support. During telerehabilitation, participants will have opportunities to communicate with their peers in a community setting, thereby promoting willingness and motivation to participate through mutual encouragement [ 50 ]. Besides, performing neuromuscular training at home saves patients’ time commuting to hospitals.…”