Knee osteoarthritis (OA) is a major cause of musculoskeletal disability in the older population, affecting both males and females as reported by the World Health Organization on the global burden of disease. Knee OA not only manifests as pain, joint stiffness, decreased quadriceps strength, physical disability, but also impacts overall disease outcome and quality of life.

Studies have documented benefits of exercise in reducing pain and improvement in functions in patients with knee OA. Furthermore, literature also suggests that physical therapy intervention, including exercise, may reduce the need for pharmacological and surgical interventions. Physical exercise, however, can be performed both in the clinic and at home.

Benefits of home-based physiotherapy as documented by several world-renowned physiotherapists:

  • Increases independence & teaches self-management
  • Promotes empowerment
  • Consistent monitoring & follow-ups ensure continuity of patient care
  • Higher customer satisfaction rates

To further establish these claims and set a higher standard in home-based physiotherapy for those suffering with osteoarthritis of the knee, HCAH performed an outcome analysis of home-based physiotherapy on pain and disability in patients with knee OA. In a first-of-a-kind research in India on the effectiveness of physiotherapy in OA, HCAH also conducted a comparison study with other available evidence to reach a satisfactory conclusion.

Here’s a brief overview on the procedure and some of the findings of the study:

Method:

  • From January 2017 to December 2017, 139 participants who were recipients of HealthCare atHome physiotherapy services across various locations were included in the main analysis
  • The study was conducted in accordance with the 1975 Helsinki Declaration principles, as revised in 1996
  • Patients chosen were 40 years and older and had non-traumatic knee OA symptoms
  • The mean treatment cycle duration was 31.5 days
  • Physiotherapy was performed for approximately 45–50 min in the form of electrotherapy, exercise therapy, and manual therapy
  • Visual analog scale (VAS) scores were documented after each visit, whereas The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC) as an outcome were recorded weekly
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Result:

  • Statistically significant improvement in all the outcome measures were observed
  • A reduction of 1.75 cm in VAS was documented as MCID in osteoarthritis trials
  • A reduction of 17–22% on WOMAC scores was reported as MCID in participants with OA of the knee & hip
  • In present study, the average scores in pain & disability were reduced by 3.1 cm & 43% respectively which is more than MCID documented in previous studies

Findings:

  • The average scores in pain and disability were observed to have been reduced after home-based physiotherapy
  • Physical therapy can be looked as an appropriate non-surgical treatment for knee OA
  • It not only help reduce pain, but also improve function, muscle strength, range of movement (ROM), joint stability, and aerobic conditioning
  • Regular exercises by patients with knee OA, in a program of intervention through appropriate guidance, can help prevent the loss of muscle strength and restriction of daily activities
  • Females were more likely to actively seek methods to remedy pain and seek first-response treatments
  • Future research should focus on measuring quality of life in terms of tracking overall impact of home-based physiotherapy services

Pre and post mean values with % improvement in males and females

Table

Conclusion:
VAS: visual analog scale; WPS: WOMAC pain score; WSS: WOMAC stiffness score; WFS: WOMAC function score; TWS: total WOMAC score.

Home-based physiotherapy services offered by HealthCare atHome as standardized care with consistent monitoring of outcomes led to significant reduction of average scores in pain and disability in patients with osteoarthritis of knee.

To read the full study, the methods and procedures followed and the final findings, read: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181665/

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