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Thomas, KS and Muir, KR and Doherty, Michael and Jones, AC and 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.

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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