Comparison of a Group-/Home-Based and a Weight-Machine-Based Exercise Training for Patients with Hip or Knee Osteoarthritis-A Secondary Analysis of Two Trial Interventions in a Real-World Context

Inka Roesel; Inga Krauss; Peter Martus; Benjamin Steinhilber; Gerhard Mueller

doi:10.3390/ijerph192417088

Comparison of a Group-/Home-Based and a Weight-Machine-Based Exercise Training for Patients with Hip or Knee Osteoarthritis-A Secondary Analysis of Two Trial Interventions in a Real-World Context

Int J Environ Res Public Health. 2022 Dec 19;19(24):17088. doi: 10.3390/ijerph192417088.

Authors

Inka Roesel^{1

2}, Inga Krauss^{2

3}, Peter Martus¹, Benjamin Steinhilber⁴, Gerhard Mueller⁵

Affiliations

¹ Institute for Clinical Epidemiology and Applied Biostatistics, University Hospital of Tuebingen, 72076 Tuebingen, Germany.
² Department of Sports Medicine, University Hospital, Medical Clinic, 72076 Tuebingen, Germany.
³ Interfaculty Research Institute for Sports and Physical Activity Tuebingen, 72074 Tuebingen, Germany.
⁴ Institute for Occupational and Social Medicine and Health Services Research, University Hospital of Tuebingen, 72074 Tuebingen, Germany.
⁵ Allgemeine Ortskrankenkasse AOK Baden-Wuerttemberg, 70191 Stuttgart, Germany.

Abstract

This study aimed to compare an individual weight-machine-based strengthening program (MbT) with a group-/homebased training offering strengthening/functional exercises (GHT) in a general health care setting. A total of 657 participants (GHT = 521, MbT = 136) suffering from hip/knee OA were included and analysed with a pre-post design (baseline (T0)/3-months (T1)). Primary outcomes were pain and physical functioning (Western Ontario and McMaster Universities Osteoarthritis Index, range 0-10). Additionally, adherence and perceived patient benefit were measured (T1). Data were analysed with linear mixed models (time, treatment, baseline pain/physical impairment severity) adjusted for patient characteristics. No significant between-group differences in pain reduction/functional improvements (time*treatment*baseline pain/physical impairment severity, pain/function: n.s.; time*treatment, pain: p = 0.884, function: p = 0.067). Within-group improvements were dependent on baseline severity: Higher severity levels demonstrated larger changes from baseline. Perceived patient-benefit (very high to high, GHT: 78%, MbT: 92%) and exercise adherence (Dropouts T1: GHT: 27.8%, MbT: 16.2%; adherence to supervised sessions: GHT: 89%, MbT: 92%) was slightly better in the MbT. In summary, both MbT and GHT, showed positive results for patients with at least moderate disease symptoms. Findings for physical functioning, perceived patient-benefit, exercise adherence hint towards a superiority of MbT. Individual preferences should be considered when prescribing exercise therapy. Trial registration: (1) German Clinical Trial Register DRKS00009251. Registered 10 September 2015. (2) German Clinical Trial Register DRKS00009257. Registered 11 September 2015.

Keywords: WOMAC; group training; health care research; hip osteoarthritis; knee osteoarthritis; short-term results; weight-machine-supported training.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Exercise
Exercise Therapy / methods
Humans
Knee Joint
Osteoarthritis, Hip* / therapy
Osteoarthritis, Knee* / complications
Osteoarthritis, Knee* / therapy
Pain / complications
Treatment Outcome

Associated data

DRKS/DRKS00009251
DRKS/DRKS00009257

Grants and funding

The two original trials used in this study were conducted in cooperation with the Allgemeine Ortskrankenkasse (AOK) Baden-Wuerttemberg, Germany. The AOK provided financial support to the University Hospital Tuebingen, Germany, for designing and evaluating the trials and for training courses provided for exercise instructors.