Back to community and being active again: exercise training programme for patients with knee osteoarthritis

Abstract

Introduction: Since 2016, a Comprehensive Osteoarthritis ManagEment (COME) programme for patients with knee osteoarthritis (OA) was launched in our centre. The COME programme consists of a 3-hour education session, 12 physiotherapy exercise sessions, and six occupational therapy sessions of coping skills. This study reviews the results after 1 year. Methods: Patients with radiological stages of Kellgren-Lawrence Grade I to III were recruited and assessed at baseline, 6 weeks, 3 months and 1 year with telephone follow-up evaluation. The following outcomes were assessed: physical performance with 1-minute chair-stand test and both quadriceps strength with dynamometer; pain on walking or stairs climbing; weekly time on physical activities and exercise training; functional status with Patient Specific Function Score (PSFS); self-efficacy with Self-Exercise Efficacy (SEE) score; and health with EuroQol visual analogue scale (EQ-VAS) score. Results: A total of 100 patients completed the programme and 1-year follow-up evaluation. Significant outcome improvements were observed: the 1-minute chair-stand test increased by 13.2 ± 11.7 repetitions, quadriceps strength increased by 6.4 ± 8.7 kgf and 6.9 ± 8.2 kgf in right and left side, respectively, at 3 months (p<0.001). Pain was reduced by 1.3 ± 2.6 points, time spent on physical activities and training increased from 43.2 ± 45.0 to 85.3 ± 113.5 minutes, PSFS improved by 3.8 ± 2.7 points, SEE improved the greatest by 13.5 ± 19.0 points, and EQ-VAS improved by 8.8 ± 21.1 points at 1 year (p<0.001). Also, 80% of patients reported they would continue physiotherapy exercises at public fitness facilities. Conclusion: The COME is effective to improve patients’ physical performance, quality of life, and self-efficacy to maintain exercise habit.