Exercise Program for Knee Osteoarthritis

Overseen By Ernest Vina, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Arizona

Disqualifiers: Non-Hispanic, Life expectancy <12 months, Arthroplasty, Inflammatory arthritis, Prevents exercise, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

44 Participants Needed

Trial Summary

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of this treatment for knee osteoarthritis?

Research shows that a program combining education and tailored exercise significantly reduces pain and improves function and quality of life in knee osteoarthritis patients. Participants reported high satisfaction, and there was a notable decrease in the use of pain medication. ^{1 2 3 4 5}

Is exercise safe for people with knee osteoarthritis?

Exercise, including walking and strengthening exercises, is generally safe for people with knee osteoarthritis and can improve muscle strength and function without increasing pain or the need for medication. ^{1 5 6 7 8}

How is the exercise and education treatment for knee osteoarthritis different from other treatments?

This treatment is unique because it combines online education with tailored exercise therapy, focusing on improving sensorimotor control and functional stability, which helps reduce pain and improve quality of life without relying on medications. ^{2 3 9 10 11}

What is the purpose of this trial?

The objective is to conduct an early-stage clinical trial in order to provide data required to support a future clinical trial to demonstrate the effectiveness of a culturally acceptable treatment program to increase exercise and regular physical activity among Hispanics with knee osteoarthritis (OA). Hispanic patients with knee OA paired with a chosen family member/close friend will be recruited for study participation. A pilot randomized controlled trial will be conducted. Study pairs will be randomized to receive either: 1) an intervention that will be administered by live video consultations and will include educational sessions about OA, a muscle strengthening program, and a program that will aim to promote regular physical activity involving study pairs; or 2) a control treatment that only includes live video educational sessions about OA. Study participants will fill out a survey before the start of the study and 3 months after.

Research Team

Ernest Vina, MD

Principal Investigator

University of Arizona

Eligibility Criteria

This trial is for Hispanic individuals over 50 with chronic knee pain and diagnosed with knee osteoarthritis. Participants must have internet access to attend video sessions and be accompanied by a family member or friend who will also participate.

Inclusion Criteria

I am of Hispanic/Latino ethnicity.

I am 50 years old or older.

I have a device that can connect to the internet.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either an intervention with educational sessions, a muscle strengthening program, and a physical activity program, or a control treatment with only educational sessions about OA

12 weeks

Live video consultations

Follow-up

Participants are monitored for adherence, satisfaction, and perceived helpfulness of the program, as well as changes in physical activity and OA symptoms

3 months

Treatment Details

Interventions

• Education
• General Physical Activity
• Muscle Strengthening

Trial Overview The study compares two approaches: one includes educational sessions, muscle strengthening exercises, and activities to encourage regular physical activity via live video; the other offers only educational sessions about osteoarthritis.

Participant Groups

Group I: Intervention Experimental Treatment 3 Interventions

Treatments include educational sessions about OA, a muscle strengthening program, and a program that will aim to promote regular physical activity involving dyads

Group II: Control Active Control 1 Intervention

Treatment only includes live video educational sessions about OA

Who Is Running the Clinical Trial?

University of Arizona

Lead Sponsor

Trials

545

Recruited

161,000+

University of Melbourne

Collaborator

Trials

193

Recruited

1,287,000+

Temple University

Collaborator

Trials

321

Recruited

89,100+

Findings from Research

A hospital-based patient education program was developed to promote walking among patients with knee osteoarthritis, aiming to improve their functional capacity without increasing pain or medication use.

The program integrates theories from patient compliance, exercise compliance, and behavioral psychology, and has been evaluated for both safety and efficacy, highlighting its potential as a structured approach to managing osteoarthritis through physical activity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies. Allegrante, JP., Kovar, PA., MacKenzie, CR., et al.[2019]

An 8-week online exercise and education program for knee osteoarthritis patients improved their sense of ownership over their treatment, leading to better function, well-being, and hope for the future.

While the online format provided beneficial peer support, participants expressed a need for more interactive engagement and suggested combining online sessions with in-person classes for enhanced support and individualized care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An invigorating journey towards better function and well-being: A qualitative study of knee osteoarthritis patients' experiences with an online exercise and education intervention. Simonÿ, C., Clausen, B., Beck, M., et al.[2023]

A program combining patient education and tailored exercise significantly reduced pain and improved function in 142 knee osteoarthritis patients over a 6-month period, as evidenced by improvements in pain scores and physical performance tests.

The use of analgesics decreased from 43.2% at baseline to 18.9% at the 6-month follow-up, indicating that the intervention not only helped with pain relief but also reduced reliance on medication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effect of education and tailored exercise therapy on knee osteoarthritis patients]. Wang, K., Liu, Q., Lin, JH., et al.[2018]

In a randomized controlled trial involving 90 patients with knee osteoarthritis, adding lower limb strength training to neuromuscular exercise and education did not significantly improve self-reported physical function compared to exercise and education alone after 12 weeks.

While the strength training group showed a slight advantage in stair climbing performance, most other outcomes, including pain and quality of life, showed no significant differences between the two groups, indicating that the low-dose strength training approach did not provide additional clinical benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care - a randomized controlled trial. Holm, PM., Schrøder, HM., Wernbom, M., et al.[2021]

Patient education about physical activity and exercise is crucial in managing hip and knee osteoarthritis, as it enhances compliance with exercise and weight loss programs, leading to improved function and reduced pain.

A systematic review of 13 randomized controlled trials confirmed that non-pharmacological treatments, including education, exercise, and weight loss, are effective and can lower healthcare costs through self-management strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Gay, C., Chabaud, A., Guilley, E., et al.[2022]

A survey of 161 accredited exercise physiologists in Australia revealed that their exercise prescriptions for knee osteoarthritis largely align with clinical guidelines, with 99% prescribing strength exercises and 90% weight-bearing exercises.

However, the education provided by these physiologists was limited, with only 21% offering pain neuroscience education, indicating a gap in comprehensive patient education about knee osteoarthritis management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and education for knee osteoarthritis-What are accredited exercise physiologists providing? Ram, A., Booth, J., Thom, J., et al.[2021]

Regular light to moderate exercise is beneficial for individuals with knee osteoarthritis (OA), providing both preventive and therapeutic effects.

Exercise regimens that focus on aerobic conditioning and lower extremity strength training have strong evidence supporting their effectiveness, and healthcare providers should confidently recommend tailored exercise plans to help manage OA symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of exercise and physical activity on knee osteoarthritis. Esser, S., Bailey, A.[2021]

Exercise is a safe and effective non-drug treatment for osteoarthritis (OA) of the hip and knee, showing small to moderate improvements in pain and function similar to those achieved with NSAIDs.

Both aerobic and strengthening exercises are equally effective for managing pain and improving function in OA patients, and combining diet with exercise may provide additional benefits, especially for obese individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of strengthening, aerobic, and coordination exercises for patients with osteoarthritis. Bischoff, HA., Roos, EM.[2022]

A systematic review of 26 high-quality studies found that various strengthening exercise programs significantly improve pain relief, physical function, and quality of life for patients with knee osteoarthritis within a six-month period.

Combining strengthening exercises with other therapeutic activities, like coordination and balance training, further enhances these benefits, indicating a comprehensive approach may be more effective for managing knee osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Brosseau, L., Taki, J., Desjardins, B., et al.[2022]

Mind-body exercise programs, such as Hatha Yoga and Tai Chi, have been shown to effectively improve pain relief and physical function in patients with knee osteoarthritis, based on a systematic review of high-quality studies.

Hatha Yoga and Tai Chi Qigong received high grades for their effectiveness, with significant improvements noted in pain relief and quality of life, making them valuable non-traditional exercise options for managing knee osteoarthritis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. Brosseau, L., Taki, J., Desjardins, B., et al.[2022]

In a study involving 102 elderly subjects with knee osteoarthritis, both high-resistance and low-resistance strength training significantly improved pain, function, walking time, and muscle torque over 8 weeks.

While both types of training were effective, high-resistance training showed a greater improvement compared to low-resistance training, suggesting it may be more beneficial for elderly individuals with mild to moderate knee OA, even though the differences were not statistically significant.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Jan, MH., Lin, JJ., Liau, JJ., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies. [2019]

2. England pubmed.ncbi.nlm.nih.gov

An invigorating journey towards better function and well-being: A qualitative study of knee osteoarthritis patients' experiences with an online exercise and education intervention. [2023]

3. China pubmed.ncbi.nlm.nih.gov

[Effect of education and tailored exercise therapy on knee osteoarthritis patients]. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care - a randomized controlled trial. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Exercise and education for knee osteoarthritis-What are accredited exercise physiologists providing? [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Effects of exercise and physical activity on knee osteoarthritis. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of strengthening, aerobic, and coordination exercises for patients with osteoarthritis. [2022]

9. England pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. [2022]

10. England pubmed.ncbi.nlm.nih.gov

The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Investigation of clinical effects of high- and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. [2022]