Does telephone-delivered exercise advice and support by physiotherapists improve pain and/or function in people with knee osteoarthritis? Telecare randomised controlled trial
| Autor: | Andrew Forbes, Kim L Bennell, Jessica Kasza, Anthony Harris, Rana S Hinman, Janette Gale, Andrew M. Briggs, Belinda J Lawford, Penny K Campbell, Caroline Bills, Simon D. French, Stephen Bunker |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Activities of daily living Cost-Benefit Analysis Physical Therapy Sports Therapy and Rehabilitation Osteoarthritis Distance Counseling law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial Behavior Therapy Rating scale law Intervention (counseling) medicine Humans Orthopedics and Sports Medicine Prospective Studies 030212 general & internal medicine Aged Telerehabilitation 030203 arthritis & rheumatology business.industry Self-Management Telecare General Medicine Middle Aged Osteoarthritis Knee medicine.disease Telephone Physical Therapists Clinical trial Knee pain Physical therapy Female medicine.symptom business |
| Zdroj: | British Journal of Sports Medicine. 54:790-797 |
| ISSN: | 1473-0480 0306-3674 |
| DOI: | 10.1136/bjsports-2019-101183 |
| Popis: | ObjectiveEvaluate a physiotherapist-led telephone-delivered exercise advice and support intervention for people with knee osteoarthritis.MethodsParticipant-blinded, assessor-blinded randomised controlled trial. 175 people were randomly allocated to (1) existing telephone service (≥1 nurse consultation for self-management advice) or (2) exercise advice and support (5–10 consultations with a physiotherapist trained in behaviour change for a personalised strengthening and physical activity programme) plus the existing service. Primary outcomes were overall knee pain (Numerical Rating Scale, range 0–10) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, range 0–68) at 6 months. Secondary outcomes, cost-effectiveness and 12-month follow-up were included.Results165 (94%) and 158 (90%) participants were retained at 6 and 12 months, respectively. At 6 months, exercise advice and support resulted in greater improvement in function (mean difference 4.7 (95% CI 1.0 to 8.4)), but not overall pain (0.7, 0.0 to 1.4). Eight of 14 secondary outcomes favoured exercise advice and support at 6 months, including pain on daily activities, walking pain, pain self-efficacy, global improvements across multiple domains (overall improvement, improved pain, improved function and improved physical activity) and satisfaction. By 12 months, most outcomes were similar between groups. Exercise advice and support cost $A514/participant and did not save other health service resources.ConclusionTelephone-delivered physiotherapist-led exercise advice and support modestly improved physical function but not the co-primary outcome of knee pain at 6 months. Functional benefits were not sustained at 12 months. The clinical significance of this effect is uncertain.Trial registration numberAustralian New Zealand Clinical Trials Registry (#12616000054415). |
| Databáze: | OpenAIRE |
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