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Rheumatology Advance Access published online on April 27, 2004
Rheumatology, doi:10.1093/rheumatology/keh188
Rheumatology © British Society for Rheumatology 2004; all rights reserved
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Received July 7, 2003
Accepted March 12, 2004

Original Papers

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 1*, P. M. Mills 2, R. Pullen 1, C. Roberts 1, A. Silman 1, J. A. Oldham 1

1 University of Manchester, UK
2 Manchester School of Physiotherapy, UK

* To whom correspondence should be addressed. E-mail: christopher.j.mccarthy{at}man.ac.uk.


  Abstract

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: Key words: Exercise, Knee osteoarthritis, Physical therapy, Randomized controlled trial.


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