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Effects of Two Physiotherapy Booster Sessions on Outcomes With Home Exercise in People With Knee Osteoarthritis: A Randomized Controlled Trial
Author(s) -
Bennell Kim L.,
Kyriakides Mary,
Hodges Paul W.,
Hinman Rana S.
Publication year - 2014
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22350
Subject(s) - medicine , physical therapy , osteoarthritis , randomized controlled trial , confidence interval , body mass index , visual analogue scale , booster (rocketry) , surgery , alternative medicine , pathology , physics , astronomy
Objective Enhancing exercise adherence over the longer term is an important goal in self‐management of knee osteoarthritis (OA). Following an initial period of more intensive exercise supervision, this study investigated whether 2 additional physiotherapy visits improved outcomes with continued home exercise over a subsequent 24‐week period. Methods A total of 78 people with medial knee OA (mean ± SD age 62.1 ± 6.9 years, mean ± SD body mass index 29.4 ± 4.0 kg/m 2 , and radiographic disease severity 19% mild, 49% moderate, and 32% severe) who completed a 12‐week physiotherapist‐supervised exercise trial were randomly allocated to 2 30‐minute physiotherapy booster sessions (delivered by 8 physiotherapists in private clinics) or no booster sessions for the subsequent 24 weeks. All participants were asked to continue home exercises 4 times weekly. Primary outcomes were change in pain, using a 100‐mm visual analog scale, and self‐reported physical function, measured using the Western Ontario McMaster Universities Osteoarthritis Index. Participants and physiotherapists were unblinded to group allocation, although participants were blinded to the study hypothesis. Results A total of 74 participants (95%) completed the trial. There was no significant difference between groups for change in pain (mean difference [95% confidence interval (95% CI)] 0.7 mm [−9.4, 8.0]; P = 0.88) or physical function (−0.3 units [95% CI −4.0, 3.5]; P = 0.88). The mean ± SD percentage of home exercise sessions completed was 56% ± 34% in the booster group and 51% ± 37% in the control group ( P > 0.05). Conclusion Two booster sessions with a physiotherapist did not influence pain or physical function outcomes, or measures of home exercise adherence. These findings suggest other more effective strategies are needed to maximize longer‐term adherence with the aim to achieve greater improvements in clinical outcomes from exercise in this patient population.