Stratified exercise therapy does not improve outcomes compared with usual exercise therapy in people with knee osteoarthritis (OCTOPuS study): a cluster randomised trial

No evidence for stratified exercise therapy being cost-effective compared to usual exercise therapy in patients with knee osteoarthritis: Economic evaluation alongside cluster randomized controlled trial

“…As reported elsewhere, 21 we found no added value in terms of clinical outcomes of this stratified approach compared to usual exercise therapy. 25 This result aligns with that of multiple other trials in musculoskeletal patient groups, where stratified physical therapy appeared to have no added value, 26 , 27 , 28 , 29 , 30 , 31 with only one trial demonstrating a (minimal) effect of stratified physical therapy over usual care in low back pain. 32 It could be argued, however, that despite having no added value in terms of clinical outcomes, stratified exercise therapy approaches such as ours are potentially more efficient (i.e., similar effect in less consultations).…”

“…1 and previous studies 25 , 33 ). subgroup-specific, protocolized exercise therapy interventions (see Supplementary material - Table 1 and previous studies 25 , 33 ). Table 1 Baseline characteristics in OCTOPUS-trial.…”

“…This economic evaluation was conducted alongside a 12-month pragmatic, parallel, 2-group cluster-randomized controlled trial (cRCT) in primary care: the OCTOPuS trial (Optimization of exerCise Therapy in patients with knee Osteoarthritis in a Primary care Setting). 25 , 33 This trial was reported according to the CONSORT 2010 checklist for RCTs and the Consolidated Health Economic Evaluation Reporting Standards.…”

“…Physical therapists were trained to provide the model of stratified exercise therapy and make: subgroup allocation into the HMS, LMS, or OS groups through a simple stratification algorithm with only two variables (body mass index [BMI] and upper leg muscle strength [30-seconds chair stand test]) (see Supplementary material – Fig. 1 and previous studies 25 , 33 ). subgroup-specific, protocolized exercise therapy interventions (see Supplementary material - Table 1 and previous studies 25 , 33 ).…”

“…subgroup allocation into the HMS, LMS, or OS groups through a simple stratification algorithm with only two variables (body mass index [BMI] and upper leg muscle strength [30-seconds chair stand test]) (see Supplementary material – Fig. 1 and previous studies 25 , 33 ).…”