A randomised controlled trial of a self-management education program for osteoarthritis of the knee delivered by health professionals.
IntroductionOur aim was to determine whether a disease specific self-management program for primary care people with osteoarthritis (OA) of the knee (the OAK program), implemented by health professionals, would achieve and maintain clinically meaningful improvements in health related outcomes compared with a control group.
Methods:
Medical practitioners referred 146 primary care participants with OA of the knee. Volunteers with coexistent inflammatory joint disease or serious co-morbidities were excluded.
Randomisation was to either control or OAK groups. The OAK group completed a 6 week self-management program.
The control group had a 6 month waiting period before receiving the OAK program. Assessments occurred at baseline, 8 weeks and 6 months.
Primary outcomes were Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and function, SF-36. Secondary outcomes were visual analog scale (VAS) pain, timed up and go (TUG), knee range of motion, quadriceps and hamstring strength- isometric contraction.
Response to treatment (responders) and minimal clinically important improvements (MCII) were determined.
Results:
In the OAK group VAS pain improved from baseline to week 8, mean (SE) 5.21 (0.30) to 3.65 (0.29) P=<0.001. During this time period improvements in the OAK group compared with the control group and responses to treatment were demonstrated in the following outcomes: WOMAC pain, physical function and total dimensions; SF-36, physical function, role physical, body pain, vitality and social functioning domains.
Additionally from baseline to week 8, the proportion of MCII was greater among the OAK than the control group for all outcomes. For the period between baseline and month 6, WOMAC pain, physical function and total dimensions significantly improved in the OAK group compared to the control group, as did SF-36, physical function, role physical, body pain, vitality and social functioning domains, and hamstring strength in both legs.
During this same period, TUG test, range of motion extension and left knee flexion improved when compared with the control group, although these improvements had little clinical relevance.
Conclusions:
Participants in the OAK program recorded statistically significant improvements in pain, quality of life and function as demonstrated by WOMAC and SF-36 at 8 weeks and 6 months compared with a control group.
Author: Sophie ColemanN Kathryn BriffaGraeme CarrollCharles InderjeethNicola CookJean McQuade
Credits/Source: Arthritis Research &Therapy 2012, 14:R21
Published on: 2012-01-27
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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