EFFECT OF CLINIC- AND TELEREHABILITATION-BASED EXERCISE ON CLINICAL AND PSYCHOSOCIAL OUTCOMES IN PATIENTS WITH KNEE OSTEOARTHRITIS

C.E. Mbada¹, A.H. Akintunji², A.O. Sonuga², T. Gebrye¹, R. Woolf¹, F. Fatoye¹

¹Manchester Metropolitan University, Health Professions, Manchester, United Kingdom, ²Obafemi Awolowo University, Department of Medical Rehabilitation, Ile-lfe, Nigeria

Background: Limited studies have explored the potentials of video-based telerehabilitation for patients with knee Osteoarthritis (OA).

Purpose: This study investigated the effect of a Clinic-based Strengthening Exercise (CbSE) and Video-based Telerehabilitation Strengthening Exercise (VbTSE) on clinical and psychosocial outcomes in patients with knee OA.

Methods: Patients with knee OA participated in this experimental study. Eligible patients were assigned into either CbSE or VbTSE group. CbSE is a circuit exercise module comprising knee flexion and extension warm-up in sitting (3-5 repetition), quadriceps isometric setting; quadriceps strengthening exercise; hamstrings clenches; wall squat and a cool down of knee flexion and extension. The VbTSE is a video-based version of CbSE. Both interventions were carried out for eight weeks. Outcomes were assessed in terms of Pain Intensity (PI), Range of Motion (ROM), Muscle Strength (MS), Disability (Ds) and Health related Quality of Life (HRQoL) using quadruple visual analogue scale (QVAS), goniometer, tensiometer, Ibadan knee/hip osteoarthritis outcome measure (IKHOAM)/osteoarthritis knee and hip quality of life (OAKHOoL), respectively at week four and eight of the study respectively. Data was analyzed using descriptive and inferential statistics. Alpha level was set at p < 0.05.

Results: There were fifty-two with mean age of 56.2 ± 7.5years in the study. Both groups were comparable in baseline measures except on OAKHOL domains of HRQoL (p = 0.001) and least pain on QVAS (p = 0.021). Within group comparison indicate that both CbSE and VbTSE produced significant effects in all the outcomes (p < 0.05) across baseline, 4th and 8th week of the study. There were no significant differences (p > 0.05) in the treatment outcomes across the two groups at the end of the fourth week of the study except for mental health (16.0 12.8; t =-3.000: 0.004), pain (8.3 5.4; t =-3.644: p = 0.001), social support (25.1 7.9; t =-2.739: 0.009) and social activities (22.7 5.7; t =2.196: 0.033) domains of OAKHOL where the TbSE group had significantly higher mean scores. Also, there was significant higher scores in mental Health (17.5 vs. 11.6; t = -2.139: p = 0.037) and pain (23.6 vs. 5.5; t = -2.782: p = 0.008) domains of OAKHOL in VbTSE group at week 8. However, CbSE led to significant higher mean change in score for current pain at week eight (0.5 vs. 0.1; t = 2.133: p = 0.038).

Conclusions: Clinic-based strengthening exercise circuit training and its digital variant are effectiveat reducing pain, impairments and disability, and also improve the quality of life of patients with chronic knee OA.

Implications: While, VbTSE was associated with higher improvement in HRQoL domains, CbSE led to higher improvement in current pain. Clinicians are to be aware of the findings of this study as they help provide support for the use of telerehabilitation for patients with OA to improve their health outcomes.

Funding acknowledgements: No funding

Keywords:
Telerehabilitation
Clinical
Knee osteoarthritis

Topics:
Disability & rehabilitation
Musculoskeletal
Rheumatology

Did this work require ethics approval? Yes

Institution: Federal Medical Centre Makurdi, Nigeria

Committee: The Health Research Ethical Committee

Ethics number: FMH/FMC/HRE/VL 1-24/03/21