Victims of osteoarthritis (OA) of the knee or hip should make exercise a regular feature in their lifestyle as it is known to improve their physical function and reduce pain, a new study has revealed.
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, claims the study which will be published in the August print issue of Arthritis Care and Research, a journal of the American College of Rheumatology.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion, and joint instability, the study found.
According to the World Health Organization (WHO) OA is one of the ten most disabling diseases in developed countries. Often OA patients are referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living.
To reach the conclusion, researchers conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study subjects were followed for 60 months to assess adherence to self-directed exercise (during and after prescribed physical therapy treatment period) on patient outcomes of pain, physical function, and self-perceived effect.
Three forms of adherence, which is defined as the subject's behavior that corresponds to agreed recommendations by his or her physical therapist, were measured-adherence to home exercises, home activities, and increased physical activity. Researchers used a self-report questionnaire to measure participants' adherence to home exercise (e.g. muscle strengthening exercises) and activity (e.g. walking or cycling). Assessment of adherence started at baseline, and then took place again at 3, 15, and 60 months.
Patient outcomes of pain and physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The WOMAC scale ranges from best to worst, meaning lower scores represent less pain and improved physical function. Participants' physical performance was measured by the time (in seconds) it took to walk the distance of 5 meters with improvement in performance noted by a reduction in time to complete the walk.
Results show at the 3-month follow-up 57.8 percent of study subjects adhered to the recommended exercises and 53.8 percent to recommended activities. Adherence to exercise was significantly associated with a decrease in pain, and improvements in self-reported physical function and physical performance. "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," said lead study author, Martijn Pisters, M.Sc., PT.