Effect of clinic-based and asynchronous video-based exercise on clinical and psychosocial outcomes in patients with knee osteoarthritis: a quasi-experimental study

Mbada, Chidozie E ORCID: https://orcid.org/0000-0003-3666-7432, Awosika, Henry A, Sonuga, Oluwatobi A, Akande, Micheal, Gebrye, Tadesse ORCID: https://orcid.org/0000-0001-7976-2013, Woolf, Richard and Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953 (2024) Effect of clinic-based and asynchronous video-based exercise on clinical and psychosocial outcomes in patients with knee osteoarthritis: a quasi-experimental study. Journal of Medical Internet Research. ISSN 1438-8871 (In Press)

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Abstract

Background Telerehabilitation is a promising digital health strategy for improving knee Osteoarthritis (OA), but the effect of different telerehabilitation strategies on knee OA is unclear. Objective This study examined the effect of a Clinic-based Strengthening Exercise (CbSE) and Asynchronous Video-based Strengthening Exercise (AVbSE) on pain, range of motion, muscle strength, quality of life, and physical function among patients with knee OA. Methods Fifty-two consenting patients participated in this 8-week experimental study; they were assigned to either CbSE or AVbSE group at two different health facilities that served as the study sites. CbSE is a circuit exercise module comprising knee flexion and extension warm-up in sitting (3-5 repetitions), quadriceps isometric setting, quadriceps strengthening exercise, hamstring clenches, wall squat, and a cooldown of knee flexion and extension. The AVbSE is an asynchronous video-based version of the CbSE. Results This research began on the 31st of March, 2021 and ended on the 26th of November, 2021; Sixty-four participants were recruited for the study but eight participants discontinued. Data collection and analysis have been completed. Significant differences were only observed in mental health (t= -3.0, P=.004), pain (t=-3.6, P<.001), social support (t=-2.7, P=.009), and social activities (t=2.2, P=.03) domains of Osteoarthritis Knee and Hip Quality of Life (OAKHQoL) with higher scores in the AVbSE group at the end of 4th week. At the end of the 8th week, significant differences were observed in mental health (t= -2.2, P=.04) and pain (t= -2.8, P=.008) measures with higher scores in AVbSE; however, a higher significant score was observed in the CbSE group for the Quadruple Visual Analogue Scale (QVAS). There was no significant effect of time across baseline, 4th and 8th week of the study except in muscle strength F2, 100 = 1.5, P=.24, social support F2, 100 =2.5, P=.09, social activities F2, 100 =0.7, P=.48 domains of OAKHQoL and the Activity limitation F2, 100 =0.1,P=.90 and Performance Restriction F2, 100 =1.3, P=.27 domain of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM). There was no significant difference between groups in all OAKHQoL measure domains except social activities (17.6(1.2) vs. 22.8(1.2); P=.003) and average pain (2.8(1.6) vs 2.3(1.6); P=.03) with higher AvbSE mean scores. However, a higher score was observed for the CbSE group in the (QVAS) least pain domain (1.2(0.2) vs 0.7(0.2); P=.04). Also, interaction effects showed that AvbSE scores were significantly higher for OAKHQoL physical activity and mental health domains at all time points. However, CbSE was higher for the Physical performance domain of IKHOAM in the 8th week. Conclusions CbSE circuit training and its AvbSE variant effectively improve treatment outcomes and increase patients’ quality of life. While AVbSE was associated with higher improvement in most HRQoL domains, CbSE led to higher improvement in average pain. Registration: pactr.samrc.ac.za PACTR202208515182119, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=23943