The following four articles published by the National Library of Medicine (NLM) review the benefits and value of a home-based exercise program.
“Home based exercise therapy for older patients with knee osteoarthritis: a randomized clinical trial”
Abstract
Objective: This 8 week randomized, double blind clinical trial compared the effect of a combined home based progressive exercise program and treatment with the nonsteroidal medication oxaprozin to treatment with oxaprozin alone on pain and physical functioning in older community dwelling patients with unilateral knee osteoarthritis (OA).
Methods: Efficacy variables measured before and after 8 weeks included (1) pain using the Western Ontario McMaster (WOMAC) pain, physical disability, and stiffness subscales and a 10 point visual analog scale (VAS) before and after self-paced walking (SPW) and stepping (SPS) functional tasks; (2) physical function using the time to complete a self-paced 40 m walk (SPW) and 20 cycles of 2 steps (SPS): (3) physical activity level using the Physical Activity Scale for Elderly (PASE); (4) clinical measures of knee functioning (range of motion). One hundred seventy-nine men and women (mean age 74 +/- 6 yrs) with radiographic evidence of mild/moderate medial compartment OA were randomized to either a progressive home based knee exercise program (n = 88) or a control program (n = 89). All patients were given oxaprozin 1,200 mg per os daily.
Results: We observed significant reduction from baseline in activity related pain (VAS); and improvement in SPW and SPS test time, passive range of motion, and PASE after 8 weeks in both groups. These changes were significantly greater (p < 0.05) in the exercise versus sham group.
Conclusion: Addition of a progressive exercise program to nonsteroidal antiinflammatory therapy in patients with knee OA can improve measures of activity and activity related pain more than medication alone.
“Effectiveness of home exercise on pain and disability from osteoarthritis of the knee: a randomised controlled trial“
Abstract
Objective—To assess the effect of a home based exercise programme, designed to improve quadriceps strength, on knee pain and disability.
Methods: 191 men and women with knee pain aged 40-80 were recruited from the community and randomised to exercise (n=113) or no intervention (n=78). The exercise group performed strengthening exercises daily for six months. The primary outcome measure was change in knee pain (Western Ontario McMaster Osteoarthritis index (WOMAC)). Secondary measures included visual analogue scales (VAS) for pain on stairs and walking and WOMAC physical function scores.
Results: WOMAC pain score reduced by 22.5% in the exercise group and by 6.2% in the control group (between group difference p<0.05, unpaired t test).VAS scores for pain also reduced in the exercise group compared with the control group (p<0.05). Physical function scores reduced by 17.4% in the exercise group and were unchanged in controls (p<0.05).
Conclusion:A simple programme of home quadriceps exercises can significantly improve self reported knee pain and function.
“Impact of an exercise and walking protocol on quality of life for elderly people with OA of the knee“
Abstract
Background and purpose: The knee is the weight-bearing joint most commonly affected by osteoarthritis (OA). The symptoms of pain, morning stiffness of short duration and physical dysfunction in the activities of daily living (ADL) can have an effect on many aspects of health, affecting quality of life. Regular and moderate physical activity adapted to individuals’ life-styles and education, and joint protection strategies have been advocated as conservative management. The purpose of the present study was to assess the impact of an exercise and walking protocol on the quality of life of elderly people with knee OA.
Method: The study design was a randomized controlled clinical trial. The subjects comprised 50 elderly people, aged 65 or more, with knee OA who had been referred to the geriatric outpatient unit for rehabilitation. Changes in severity of pain and quality of life were compared between a control group (CG) and an experimental group (EG). Both groups participated in an educational session and the EG also received a 12-week exercise and walking protocol. Both groups were assessed at baseline and after three and six months by an independent observer. The Lequesne Index of Knee OA Severity (LI), the Health Assessment Questionnaire (HAQ) and the Medical Outcomes Short-Form Health Survey (SF-36) were used as measurement instruments.
Results: In the CG, the measures of quality of life (SF-36), the HAQ and the LI between subjects did not yield statistically significant differences over the three measurement points. For the EG, there was a significant improvement in function, measured by HAQ, and decreasing OA symptom severity, measured by LI. For the SF-36 there were significant improvements in physical function, functional role limitation and pain. Comparisons between the groups showed statistically significant differences after three and six months for all measures, except for the SF-36 emotional domains.
Conclusion: The exercise protocol and walking programme had a positive effect on the quality of life of elderly individuals with knee OA.
“[The contribution of home based exercise programme in case of osteoarthritis of the knee]”
Abstract
Background: Knee Osteoarthritis is the most frequent articular disease. It may cause disability and handicap.
Aim of the study: to assess the effect of a home based exercice programme in a Tunisian population having knee osteoarthritis, associated with medical treatment and education.
Methods: Prospective study during three months, including 34 Tunisian patients with knee osteoarthritis. A clinical and functional assessment of the patients was made using respectively the visual analogic scale for the pain, the Lequesne index, the Functional Independence Measure and the womac function score for the function, the HAQ and SF 36 for the assessment of the quality of life.
Results: Visual analogic scores for pain were reduced in the exercise group. Lequesne index scores reduced significantly in the exercise group and were unchanged in the controls. Quality of life was greater in the exercise group compared with the controls.
Conclusion: Home based exercise programme contributes to relieving pain, maintaining function and to ameliorate the quality of life of people having knee osteoarthritis.