Exercise for Osteoarthritis

Overseen By Gillian Hatfield, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of the Fraser Valley

Disqualifiers: Severe knee trauma, Neurological, Endocrine, Chronic disease, others

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

Compensation: Varies

Number of Visits: 2

Duration: 12 weeks

32 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on exercise for knee osteoarthritis and does not mention medication changes.

What data supports the effectiveness of the treatment Group Exercise Intervention for osteoarthritis?

Research shows that group exercise programs can improve physical performance, function, and reduce anxiety and fear of movement in older adults with osteoarthritis, making it an effective treatment option. ^{1 2 3 4 5}

Is exercise generally safe for people with osteoarthritis?

Exercise is generally safe for people with osteoarthritis, with studies showing it improves muscle strength and function without the risks associated with medications like NSAIDs. While minor injuries can occur, serious problems are rare, especially when starting with low-intensity exercises and gradually increasing. ^{6 7 8 9 10}

How is the Group Exercise Intervention treatment for osteoarthritis different from other treatments?

The Group Exercise Intervention for osteoarthritis is unique because it focuses on a group-mediated cognitive behavioral approach, which combines physical activity with behavioral strategies to improve motivation and adherence. This differs from traditional exercise therapies that may not emphasize the psychological and social aspects of exercise, making it potentially more effective in promoting long-term physical activity and self-management. ^{2 11 12 13 14}

What is the purpose of this trial?

In this study, the investigators want to find out if a 12-week exercise program improves balance in people with knee osteoarthritis. This study will involve two visits to the School of Kinesiology at the University of the Fraser Valley (Chilliwack campus). Each visit will last approximately one hour. Participants will be asked to fill out questionnaires and complete a balance test. In between visits, participants will complete 12 weeks of an exercise program specifically designed for adults with osteoarthritis. Participants will do the exercise classes twice per week. Classes can be done in person or at home Each exercise class is 45-minutes long and consists of flexibility, strength, and coordination exercises. In each class there are options to either increase or decrease the intensity of each exercise to cater to varying fitness levels and fluctuating symptoms. Each exercise has an assisted (using a chair for balance), body weight, and resisted (weight or exercise tubing) option. Participants will fill out an exercise diary each week to let the investigators know what days they did the exercise classes, and whether they experienced any changes in their knee osteoarthritis symptoms.

Research Team

Gillian Hatfield, PhD

Principal Investigator

University of the Fraser Valley

Eligibility Criteria

This trial is for adults with knee osteoarthritis who can attend two sessions at the University of the Fraser Valley and commit to a 12-week exercise program. The program includes classes twice per week, adaptable to various fitness levels.

Inclusion Criteria

Pass the Get Active Questionnaire to ensure that they are safe to begin an exercise program

I have been diagnosed with knee osteoarthritis by a doctor.

Exclusion Criteria

I have active joint inflammation.

I have a condition like Parkinson's, Alzheimer's, diabetes, or balance issues.

I have vision problems that affect my balance.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete a 12-week exercise program designed for adults with osteoarthritis, attending classes twice per week

12 weeks

2 visits (in-person) at the start and end of the program

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Group Exercise Intervention

Trial Overview The study tests whether a 12-week group exercise program, consisting of flexibility, strength, and coordination exercises, can improve balance in people with knee osteoarthritis. Participants will track their progress through questionnaires and balance tests.

Participant Groups

Group I: Exercise program Experimental Treatment 1 Intervention

Twice weekly exercise classes, for 12 weeks

Who Is Running the Clinical Trial?

University of the Fraser Valley

Lead Sponsor

Trials

4

Recruited

290+

Findings from Research

In a review of 113 randomized controlled trials involving 5909 participants with knee osteoarthritis, only 44.2% reported adverse events (AEs), indicating potential underreporting of exercise-related harm, which was found in 6.0% of participants with clear AE statements.

The study highlighted improvements in reporting AEs and dropouts (DOs) after the implementation of the CONSORT-2010 guidelines, but emphasized the need for clearer definitions and reporting standards to ensure the safety and efficacy of therapeutic exercise interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting of Harm in Randomized Controlled Trials of Therapeutic Exercise for Knee Osteoarthritis: A Systematic Review. von Heideken, J., Chowdhry, S., Borg, J., et al.[2023]

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]

In a randomized controlled trial involving 209 elderly participants (average age 80), a home-based exercise program was found to be generally safe, with 151 adverse events reported, affecting 47% of participants.

Despite the program's safety, 14% of the adverse events were serious, highlighting that high levels of pre-existing morbidity in this population can pose challenges to maintaining consistent exercise participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. Hinrichs, T., Bücker, B., Wilm, S., et al.[2015]

In a review of over 5,500 participants from 11 physical activity interventions, no serious study-related adverse events were reported, indicating a high level of safety in these exercise programs.

While minor musculoskeletal injuries were noted, the studies emphasized a 'start low and go slow' approach, suggesting that moderate-intensity physical activity is safe and effective for sedentary, chronically ill, or older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. Ory, M., Resnick, B., Jordan, PJ., et al.[2022]

References

1. Australia pubmed.ncbi.nlm.nih.gov

Group exercise for subjects with osteoarthritis of the knee. [2014]

2. Canada pubmed.ncbi.nlm.nih.gov

Group-mediated physical activity promotion and mobility in sedentary patients with knee osteoarthritis: results from the IMPACT-pilot trial. [2014]

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

Efficacy of exercise intervention as determined by the McKenzie System of Mechanical Diagnosis and Therapy for knee osteoarthritis: a randomized controlled trial. [2022]

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

Feasibility and impact of Fit & Strong! Program in Portuguese older adults with osteoarthritis: A pilot randomized controlled trial. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis. [2023]

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

Reporting of Harm in Randomized Controlled Trials of Therapeutic Exercise for Knee Osteoarthritis: A Systematic Review. [2023]

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

Reporting of Adverse Events in Randomized Controlled Trials of Therapeutic Exercise for Hip Osteoarthritis: A Systematic Review. [2023]

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

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

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

Adverse events in mobility-limited and chronically ill elderly adults participating in an exercise intervention study supported by general practitioner practices. [2015]

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

Screening, safety, and adverse events in physical activity interventions: collaborative experiences from the behavior change consortium. [2022]

11. Italy pubmed.ncbi.nlm.nih.gov

Motives for physical exercise participation as a basis for the development of patient-oriented exercise interventions in osteoarthritis: a cross-sectional study. [2018]

12. Netherlands pubmed.ncbi.nlm.nih.gov

The value of individual or collective group exercise programs for knee or hip osteoarthritis. Clinical practice recommendations. [2018]

13. England pubmed.ncbi.nlm.nih.gov

Managing osteoarthritis in primary care: exploring healthcare professionals' views on a multiple-joint intervention designed to facilitate self-management. [2022]

14. Australia pubmed.ncbi.nlm.nih.gov

Exercise & Sports Science Australia (ESSA) updated Position Statement on exercise and physical activity for people with hip/knee osteoarthritis. [2023]