A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program

Clin Rehabil. 2018 Feb;32(2):223-232. doi: 10.1177/0269215517718892. Epub 2017 Jul 17.

Abstract

Objective: To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE2NO program) in elderly individuals with knee osteoarthritis.

Design: Randomized controlled trial.

Setting: Four different community settings.

Subjects: Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study.

Intervention: A combined self-management and exercise intervention (treatment group) and an educational intervention (control group).

Main measures: The primary outcomes were pain and other knee osteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were knee osteoarthritis-specific health-related quality of life, self-perceived health, aerobic capacity, lower and upper limb flexibility, and handgrip strength.

Results: In all, 67 participants, mean age 69.1 ± 5.8 years, completed the study: 32 in the Educational Group and 35 in the Self-Management and Exercise Group. A significant group effect favorable to the Self-Management and Exercise Group was observed in the following variables: communication with the physicians ( P = .048), aerobic capacity ( P = .035), and functional lower limb strength ( P = .015). Although no significant group effect was detected, clinical improvements in pain (31%) and knee osteoarthritis symptoms (29%) were observed in the experimental group. No improvements regarding cognitive symptom management, self-perceived health, lower limb flexibility, and handgrip strength were found.

Conclusion: This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.

Keywords: Self-management; elderly; exercise; knee osteoarthritis.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Analysis of Variance
  • Combined Modality Therapy
  • Exercise Therapy / methods*
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / rehabilitation*
  • Pain Measurement
  • Prognosis
  • Radiography / methods
  • Range of Motion, Articular / physiology*
  • Recovery of Function / physiology*
  • Self-Management / methods*
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome