Authors (including presenting author) :
Yeung MH(1), Cheung CT(1), Lau WK(1), Choi TL(2), YEE KH(2)
Affiliation :
(1)Physiotherapy Department, (2)Department of Orthopedic and Traumatology, Alice Ho Miu Ling Nethersole Hospital
Introduction :
Knee osteoarthritis (OA) is one of the most common degenerative diseases in older adults. It limits patients’ activities, function and quality of life. While waiting for total joint replacement (TJR) surgeries, most patients only receive analgesics and general advice resulting suboptimal effect. Therefore, it is necessary to develop a sustainable non-surgical management program for these patients in order to delay their disease progression.
Knee Exercise and Self-management Physiotherapy (KEEP) Program was started in August 2019, aim at promoting patients’ self-management techniques and exercise habit development. Yet in many occasions, patients will find it difficult to develop exercise habit on their own. KEEP program featured collaboration with an NGO. Patients take part in weekly exercise program on voluntary basis, provided by the NGO for 6 months, upon completion of KEEP. Due to Covid 19, the program was redesigned to be a TELE-model in 2Q2020.
Objectives :
1. To enhance patients’ understanding on OA knee condition and self-management techniques.
2. To promote optimal fitness and function.
3. To assist patient in exercise habit development.
Methodology :
This is a prospective study. In KEEP program, information and advice on OA knee condition, coping strategies and activities planning were delivered. Patients followed a progressive training regime including mobilization, strength, aerobic and functional training. In TELE model, patients attended 2 on-site sessions and 4 TELE sessions. Online videos of knee care information and exercises were provided prior to every TELE session.
Primary outcomes included Physical function Short form (PS), pain (P) and quality of life (QoL) domains of the Knee injury and Osteoarthritis Outcome Score (KOOS) – Hong Kong Chinese Version. Secondary outcomes included Numeric Pain Rating Scale (NPRS) and 30-Second Chair Stand Test.
Result & Outcome :
A total of 55 patients completed KEEP program from 2019 to 2021. 10 of them completed weekly exercise program organized by NGO, and 35 of them joined TELE-KEEP. After KEEP program, all domains of KOOS were significantly improved. KOOS-P increased from 54.0 to 64.1 (p< 0.01), KOOS–PS increased from 62.8 to 67.5 (p< 0.01) and KOOS-QoL increased from 35.8 to 49.1 (p< 0.01). 30-Second Chair Stand Test were also significantly improved (from 7.6 to 10.2, p< 0.01). These results sustained till 6-month after the program.
Conclusion
KEEP program was effective in enhancing pain control, physical function, QoL as well as lower limb strength. This clinical trial also suggested that TELE-model could provide similar training effect when comparing to on-site program.
