JMIR Publications

ABSTRACT

Background:

Telerehabilitation is a promising digital health strategy for improving clinical and psychosocial outcomes in patients with knee Osteoarthritis (OA), however, the effect of different telerehabilitation approaches on knee OA is unclear.

Objective:

This study examined the effect of a Clinic-based Strengthening Exercise (CbSE) and Asynchronous Video-based Strengthening Exercise (AVbSE) on pain, range of motion, muscle strength, quality of life, and physical function among patients with knee OA.

Methods:

Fifty-two consenting patients participated in this 8-week experimental study; they were assigned to either CbSE or AVbSE group. CbSE is a circuit exercise module comprising knee flexion and extension warm-up in sitting (3-5 repetitions), quadriceps isometric setting; quadriceps strengthening exercise; hamstring clenches; wall squat and a cooldown of knee flexion and extension. The AVbSE is an asynchronous video-based version of CbSE.

Results:

On comparison between both CbSE and AVbSE at the 4th week, there was no significant difference in outcome parameters except osteoarthritis knee and hip quality of life (OAKHQoL) domains of mental health (p = 0.004), pain (p = 0.001), social support (p = 0.009) and social activities (p = 0.033) with higher AvbSE mean scores. At the end of the 8th week, a higher score was observed for the CbSE group in the QVAS current pain domain (p = 0.038) while a higher mean score was observed for the mental health (p = 0.037) and pain (p = 0.008) domains of the OAKHQoL measure in the AVbSE groupCbSE was higher for the physical performance domain of Ibadan Knee/Hip Osteoarthritis Outcome Measure (IKHOAM) at the 8th week. Both CbSE and AVbSE produced significant effects in all the outcomes (p < 0.05) across baseline, 4th and 8th week of the study except in muscle strength, social support, social activities domains of OAKHQoL and the activity limitation and performance restriction domain of IKHOAM where no main effect of time was observed (p > 0.05).

Conclusions:

Clinic-based strengthening exercise circuit training and its asynchronous video-based variant effectively reduce pain, impairments and disability and increase patients' quality of life. While AVbSE was associated with higher improvement in most OAKHQoL domains, CbSE led to higher improvement in average pain. This is the first study to implement an asynchronous digital health tool for rehabilitation for Nigerian patients with OA. Clinical Trial: Not Applicable.