Thomas, KS, Muir, KR, Doherty, Michael, Jones, AC, O'Reilly, SC and Bassey, EJ
(2002)
Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial.
Britich Medical Journal (BMJ), 325
(7367).
pp. 752-757.
Full text not available from this repository.
Abstract
Objectives To determine whether a home based
exercise programme can improve outcomes in
patients with knee pain.
Design Pragmatic, factorial randomised controlled
trial of two years' duration.
Setting Two general practices in Nottingham.
Participants 786 men and women aged >45 years
with self reported knee pain.
Interventions Participants were randomised to four
groups to receive exercise therapy, monthly telephone
contact, exercise therapy plus telephone contact, or no
intervention. Patients in the no intervention and
combined exercise and telephone groups were
randomised to receive or not receive a placebo health
food tablet.
Main outcome measures Primary outcome was self
reported score for knee pain on the Western Ontario
and McMaster universities (WOMAC) osteoarthritis
index at two years. Secondary outcomes included
knee specific physical function and stiffness (scored on
WOMAC index), general physical function (scored on
SF36 questionnaire), psychological outlook (scored
on hospital anxiety and depression scale), and
isometric muscle strength.
Results 600 (76.3%) participants completed the study.
At 24 months, highly significant reductions in knee
pain were apparent for the pooled exercise groups
compared with the nonexercise groups (mean
difference –0.82, 95% confidence interval –1.3 to
–0.3). Similar improvements were observed at 6, 12,
and 18 months. Regular telephone contact alone did
not reduce pain. The reduction in pain was greater
the closer patients adhered to the exercise plan.
Conclusions A simple home based exercise
programme can significantly reduce knee pain. The
lack of improvement in patients who received only
telephone contact suggests that improvements are not
just due to psychosocial effects because of contact
with the therapist.
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