Feasibility of Multimodal Physical Therapy in Hispanic American Older Adults With Moderate Knee Osteoarthritis

Conservative, and culturally appropriate treatment options are needed for Hispanic American (HA) older adults with knee osteoarthritis (OA). The purpose of this pilot study was to explore feasibility, including recruitment, adherence, and retention in a quasi-experimental study among older HA adults with moderate knee OA after multimodal physical therapy. The secondary aim was to explore changes in physical performance.

Hispanic American older adults with moderate knee OA were recruited from an urban health system. Participants attended 10, small group, physical therapy clinic visits over 8 weeks, followed by 4 weekly support phone calls. Participants were instructed to exercise 3 days per week. The intervention was led in Spanish and included progressive quadriceps and glutaeal strengthening, progressive cycling with short high-velocity intervals, manual therapy, and self-management training. Feasibility was explored by using descriptive statistics to document recruitment, retention, and adherence to exercise. Secondary physical function measures were compared pre/post intervention using paired sample t-tests.

Eighteen of the 20 participants who enrolled came from sending 500 targeted recruitment letters, mean age of 62.9 (SD 8.0, range: 51-75) years; mean exercise adherence was 3.7 (SD 1.5) days per week for the 12-week study duration. Preliminary estimates of changes in physical function were promising; however, the study was not powered to detect changes.

Multimodal physical therapy was feasible in terms of retention, and adherence to exercise and recruitment was low. Clinical changes in physical function are promising. A controlled trial is warranted to test the efficacy of the intervention.