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

Objective: To evaluate the effect of patient education and tailored exercise in the knee osteoarthritis (OA) patients. Methods: One hundred and eighty-five patients with knee OA were enrolled in this ongoing prospective cohort study at Arthritis Clinic and Research Center, Peking University People's Hospital since May, 2016.The treatment consisted of two one-hour sessions of patient education and six weeks of supervised, in-group, tailored exercise.The contents of the patient education were evidence-based and its overall focus was to increase the knowledge of the participants regarding OA and how to treat it.The exercise program was a neuromuscular exercise based on biomechanical and neuromuscular principles that aimed at restoring a neutral functional alignment of the lower extremities by improving sensorimotor control and obtaining compensatory functional stability.The outcomes were evaluated at baseline, 3 and 6 months, which included pain on the visual analogue scale (VAS, 0-100), quality of life on the Euro-quality of life-5 Dimensional (EQ-5D) VAS form, Knee Injury and Osteoarthritis Outcome Score (KOOS), 30-second chair stand test, 40-meter walk test and use of analgesics.The participants were also asked to rate their opinion of this program on a five-point scale (very satisfactory, satisfactory, neither satisfactory nor dissatisfactory, dissatisfactory, very dissatisfactory). One way analysis of variance was applied to compare the outcomes at baseline and 3 and 6 months follow-up. Results: One hundred and forty-two participants completed the 6-month follow-up.There were significant improvements in pain VAS, EQ-5D-VAS, 30-second chair stand test and 40-meter walk test at the follow-up at 3 and 6 months when compared with those at baseline (F=22.9, 8.4, 3.4, 4.1, 3.8, all P<0.05). The rate of analgesics use in the past two week at baseline was 43.2%, and it decreased to 18.9% at 6-month follow-up (P<0.001). Most participants (71.1%, 101 out of 142) rated the program as 'Very Satisfactory' and the rest (28.9%, 41 out of 142) rated the program as 'Satisfactory'. Conclusion: This program comprising the group patient education and tailored exercise therapy is effective in relieving pain, improving the function and quality of life in patients with knee OA.