Effects of Two Physiotherapy Booster Sessions on Outcomes With Home Exercise in People With Knee Osteoarthritis: A Randomized Controlled Trial

Authors

  • Kim L. Bennell,

    Corresponding author
    1. University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia
    • Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, 3010, Victoria, Australia. E-mail: k.bennell@unimelb.edu.au

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  • Mary Kyriakides,

    1. University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia
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  • Paul W. Hodges,

    1. University of Queensland, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Queensland, Australia
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  • Rana S. Hinman

    1. University of Melbourne, Centre for Health, Exercise and Sports Medicine, Melbourne, Victoria, Australia
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  • ANZCTR: 12612000595819.

Abstract

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/m2, 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.

Ancillary