Patients with osteoarthritis (OA) of the knee or hip who adhere to the recommended home physical therapy exercises and physically active lifestyle experience more improvement in pain, physical function and self-perceived effect, according to a study from researchers in the Netherlands. Research also shows that maintenance of exercise behavior and physically active lifestyle after discharge of physical therapy improves the long-term effectiveness of exercise therapy in patients with knee or hip OA, according to a press release.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion and joint instability. According to WHO, OA is one of the 10 most disabling diseases in developed countries. Further, WHO estimated that 80% of those with OA have limitations in movement and 25% can not perform major daily life activities. OA patients are often referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living. Although exercise therapy has beneficial short-term effects — earlier research has shown that after discharge of exercise therapy — the positive treatment effects decline and finally disappear in the long-term.
The Dutch research team conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study participants were followed for 60 months to assess adherence to self-directed exercise during and after prescribed physical therapy treatment periods on patient outcomes of pain, physical function and self-perceived effect.
Researchers used a self-report questionnaire to measure participants’ adherence to home exercise, such as muscle strengthening exercises and activities such as walking or cycling. Assessment of adherence started at baseline and then took place again at 3, 15, and 60 months.
“Better adherence to home exercises and being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee,” Martijn Pisters, MSc, PT, stated in the release.
Results show at the 3 month follow-up, 57.8% of study participants adhered to the recommended exercises and 53.8% to recommended activities. Adherence to exercise was significantly associated with a decrease in pain (-1 point on a scale from 0 to 20) and improvements in self-reported physical function (-2.3 points on a scale from 0 to 68) and physical performance (-0.29 seconds compared with the base-line time of 4.8 seconds to walk 5 m.
Additionally, researchers noted a decline in exercise adherence upon completion of physical therapy with only 44.1% of patients and 30.1% still exercising at the 15 and 60 month follow-up, respectively. Similarly, adherence to home activities decreased at the 15 and 60 month follow-up with only with 29.5% and 36%, respectively, of study subjects being adherent.