Stepped Exercise Program for Patients With Knee Osteoarthritis : A Randomized Controlled Trial.
Journal
Annals of internal medicine
ISSN: 1539-3704
Titre abrégé: Ann Intern Med
Pays: United States
ID NLM: 0372351
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
pubmed:
29
12
2020
medline:
23
3
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
Evidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs To examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA). Randomized controlled trial. (ClinicalTrials.gov: NCT02653768). 2 U.S. Department of Veterans Affairs sites. 345 patients (mean age, 60 years; 15% female; 67% people of color) with symptomatic knee osteoarthritis. Participants were randomly assigned in a 2:1 ratio to STEP-KOA or an arthritis education (AE) control group, respectively. The STEP-KOA intervention began with 3 months of an internet-based exercise program (step 1). Participants who did not meet response criteria for improvement in pain and function after step 1 progressed to step 2, which involved 3 months of biweekly physical activity coaching calls. Participants who did not meet response criteria after step 2 went on to in-person physical therapy visits (step 3). The AE group received educational materials via mail every 2 weeks. Primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Scores for the STEP-KOA and AE groups at 9 months were compared by using linear mixed models. In the STEP-KOA group, 65% of participants (150 of 230) progressed to step 2 and 35% (81 of 230) to step 3. The estimated baseline WOMAC score for the full sample was 47.5 (95% CI, 45.7 to 49.2). At 9-month follow-up, the estimated mean WOMAC score was 6.8 points (CI, -10.5 to -3.2 points) lower in the STEP-KOA than the AE group, indicating greater improvement. Participants were mostly male veterans, and follow-up was limited. Veterans in STEP-KOA reported modest improvements in knee osteoarthritis symptoms compared with the control group. The STEP-KOA strategy may be efficient for delivering exercise therapies for knee osteoarthritis. Department of Veterans Affairs, Health Services Research and Development Service.
Sections du résumé
BACKGROUND
Evidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs
OBJECTIVE
To examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA).
DESIGN
Randomized controlled trial. (ClinicalTrials.gov: NCT02653768).
SETTING
2 U.S. Department of Veterans Affairs sites.
PARTICIPANTS
345 patients (mean age, 60 years; 15% female; 67% people of color) with symptomatic knee osteoarthritis.
INTERVENTION
Participants were randomly assigned in a 2:1 ratio to STEP-KOA or an arthritis education (AE) control group, respectively. The STEP-KOA intervention began with 3 months of an internet-based exercise program (step 1). Participants who did not meet response criteria for improvement in pain and function after step 1 progressed to step 2, which involved 3 months of biweekly physical activity coaching calls. Participants who did not meet response criteria after step 2 went on to in-person physical therapy visits (step 3). The AE group received educational materials via mail every 2 weeks.
MEASUREMENTS
Primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Scores for the STEP-KOA and AE groups at 9 months were compared by using linear mixed models.
RESULTS
In the STEP-KOA group, 65% of participants (150 of 230) progressed to step 2 and 35% (81 of 230) to step 3. The estimated baseline WOMAC score for the full sample was 47.5 (95% CI, 45.7 to 49.2). At 9-month follow-up, the estimated mean WOMAC score was 6.8 points (CI, -10.5 to -3.2 points) lower in the STEP-KOA than the AE group, indicating greater improvement.
LIMITATION
Participants were mostly male veterans, and follow-up was limited.
CONCLUSION
Veterans in STEP-KOA reported modest improvements in knee osteoarthritis symptoms compared with the control group. The STEP-KOA strategy may be efficient for delivering exercise therapies for knee osteoarthritis.
PRIMARY FUNDING SOURCE
Department of Veterans Affairs, Health Services Research and Development Service.
Identifiants
pubmed: 33370174
doi: 10.7326/M20-4447
pmc: PMC10405203
mid: NIHMS1895796
doi:
Banques de données
ClinicalTrials.gov
['NCT02653768']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
298-307Subventions
Organisme : HSRD VA
ID : I01 HX001546
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG028716
Pays : United States
Organisme : NIAMS NIH HHS
ID : P30 AR072580
Pays : United States
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