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Rheumatology Advance Access originally published online on April 27, 2004
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Rheumatology 2004; 43: 880-886
Rheumatology Vol. 43 No. 7 © British Society for Rheumatology 2004; all rights reserved

Paper

Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis

C. J. McCarthy, P. M. Mills1, R. Pullen, C. Roberts, A. Silman and J. A. Oldham

University of Manchester and 1 Manchester School of Physiotherapy, UK.

Correspondence to: C. McCarthy, The Centre for Rehabilitation Science, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. E-mail: christopher.j.mccarthy{at}man.ac.uk

Objective. The study aimed to compare the relative effectiveness of providing a home-based exercise programme versus home-based exercise supplemented with an 8-week class-based exercise programme in reducing pain and improving function in patients with knee osteoarthritis.

Methods. Patients (n = 214) with radiologically confirmed knee osteoarthritis were selected. Patients were randomly allocated to either home or home supplemented with class-based exercise programmes. Both groups were given a home exercise programme whilst the supplemented group also attended for 8 weeks of twice weekly knee classes. Assessments of locomotor function, walking pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were made. Assessments were made pre- and post-treatment and also at 6- and 12-month follow-ups. Statistical analysis involved the use of a longitudinal linear model ANCOVA with baseline values entered as a covariate.

Results. Patients from the class-based group demonstrated significantly greater improvement in locomotor function (–3.7 seconds; 95% C.I. –4.9 to –2.5) and decrease in walking pain (–15 mm; 95% C.I. –20 to –11) than the home-based group, at 12-months follow-up.

Conclusions. The supplementation of a home based exercise programme with a class-based exercise programme led to clinically significant superior improvement. These improvements were still evident at 12-month review. This is the first trial to evaluate this common physiotherapeutic practice, and based on this evidence, supplementation of home exercises with a class-based exercise programme can be recommended to patients, clinicians and service providers.

KEY WORDS: Exercise, Knee osteoarthritis, Physical therapy, Randomized controlled trial


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