Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis.
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.
McCarthy
C J
CJ
The Centre for Rehabilitation Science, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. christopher.j.mccarthy@man.ac.uk
Mills
P M
PM
Pullen
R
R
Roberts
C
C
Silman
A
A
Oldham
J A
JA
D000704:Analysis of Variance; D004185:Disability Evaluation; D005081:Exercise Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D020370:Osteoarthritis, Knee / Q000523:psychology / Q000628:therapy*; D059408:Pain Management; D011615:Psychotherapy, Group