Assessing the efficacy of the Stop OsteoARthritis (SOAR) program: A randomized delayed-controlled trial in persons at increased risk of early onset post-traumatic knee osteoarthritis

Justin M Losciale; Linda K Truong; Kexin Zhang; Trish Silvester-Lee; Maxi Miciak; Andrea Pajkic; Christina Y Le; Hui Xie; Alison M Hoens; Amber D Mosewich; Michael A Hunt; Linda C Li; Ewa M Roos; Jackie L Whittaker

doi:10.1016/j.joca.2024.04.003

Assessing the efficacy of the Stop OsteoARthritis (SOAR) program: A randomized delayed-controlled trial in persons at increased risk of early onset post-traumatic knee osteoarthritis

Osteoarthritis Cartilage. 2024 Apr 12:S1063-4584(24)01151-8. doi: 10.1016/j.joca.2024.04.003. Online ahead of print.

Authors

Affiliations

¹ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada.
² British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
³ Arthritis Research Canada, Vancouver, British Columbia, Canada.
⁴ Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
⁵ Glen Sather Sports Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada.
⁶ Arthritis Research Canada, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
⁷ Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada.
⁸ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
⁹ Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
¹⁰ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Arthritis Research Canada, Vancouver, British Columbia, Canada. Electronic address: jackie.whittaker@ubc.ca.

PMID: 38615974
DOI: 10.1016/j.joca.2024.04.003

Abstract

Objective: Assess the efficacy of an 8-week virtual, physiotherapist (PT)-guided knee health program (Stop OsteoARthritis (SOAR)) to improve knee extensor strength in individuals at risk of post-traumatic knee osteoarthritis (PTOA).

Method: In this superiority, randomized delayed-control trial, persons aged 16-35 years, 1-4 years after a self-reported knee joint injury were randomly assigned (1:1) to receive the SOAR program immediately (experimental group) or after a 9-week delay (control group). SOAR includes 1) one-time Knee Camp (virtual PT-guided group education, knee assessment, 1:1 exercise and physical activity (PA) goal-setting); 2) Weekly personalized home-based exercise and PA program with tracking; 3) Weekly 1:1 PT counseling (virtual). The primary outcome was a change in isokinetic knee extensor strength (baseline to 9-weeks). Additional outcomes included change in self-reported knee-related quality-of-life (QOL), self-efficacy, self-management and kinesiophobia, and PA (accelerometer) at 9 and 18-weeks. Linear regression models estimated the effect of the 8-week intervention at the primary endpoint (9-week).

Results: 49 of 54 randomized participants completed the study (91%). Participants were a mean ± standard deviation age of 27 ± 5.0 years, and 2.4 ± 0.9 years post-injury. No mean between group differences for the primary (0.05; 95% confidence interval (CI): -0.10, 0.19) or other outcomes were seen at 9 weeks except for greater improvements in perceived self-management (Partner in Health Scale; 11.3/96, 95%CI: 5.5, 17.1) and kinesiophobia (Tampa Scale of Kinesiophobia; -4.4/33, 95%CI: -7.0, -1.8).

Conclusion: For active persons with elevated risk of PTOA, an 8-week SOAR program did not change knee-related strength, QOL, self-efficacy, or PA, on average, but may benefit the ability to self-manage knee health and kinesiophobia.

Keywords: Anterior cruciate ligament tear; Knee extension strength; Personalized care.