Comprehensive Osteoarthritis ManagemEnt (COME) programme - Multi-disciplinary exercise training programme for patient with osteoarthritic knee in MMRC

Abstract

Introduction: Patient education and exercise therapy are the pillars in managing osteoarthritis (OA). In 2016, a Comprehensive Osteoarthritis ManagEment (COME) programme for patients with osteoarthritic knee was launched in the MMRC after a team visit to European OA centres. The COME consists of 3-hour education, 12 physiotherapy exercise sessions and 6 occupational therapy training sessions of coping skills. This presentation is to review the one-year results. Methodology: Patients with radiological stages of Kellegren-Lawrence Grade I to III were recruited and assessed at baseline, 6-week, 3 months and lastly 1 year with telephone follow-up. These outcomes were assessed: quality of life with EQ-5D-3L and EQ-VAS (0-100); weekly time on physical activities and exercise training; physical performance with one-minute chair-stand test and both quadriceps strength with dynamometer; functional status with Patient Specific Function Score (PSFS), and self-efficacy with Self-Exercise Efficacy Scale (SEE). Results and Analysis: 75 patients completed COME with 1-year follow-up. Significant outcome improvements were observed: EQ-5D-3L showed 19-28% improvement in mobility, pain reduction and anxiety. EQ-VAS at 3 months improved by 7.5±19.5 points (p=0.001). Time spent on physical activities and training increased from 58.0±42.5 to 109.2±24.0 minutes at 1 year (p<0.001). One-minute chair-stand test increased by 11.9±8.6 repetitions. Quadriceps strength increased by 5.6±7.9 and 5.8±7.0 kgf in right and left side respectively. PSFS improved almost by 3.5±2.3 points. SEE improved the greatest at 3 months by 13.7±17.3 points. Discussion and Conclusion: The COME is effective to improve patients’ quality of life, physical performance and self-efficacy to maintain exercise habit.