Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 8, 2025
Open Peer Review Period: Jan 8, 2025 - Mar 5, 2025
Date Accepted: Mar 31, 2025
(closed for review but you can still tweet)
Effects of an e-learning program (PEAK, physiotherapy exercise and physical activity for knee osteoarthritis) on Chinese physical therapists' confidence and knowledge: a randomized controlled trial
ABSTRACT
Background:
Knee osteoarthritis (OA) imposes a significant burden in China due to its high prevalence, aging population, and rising obesity rates. Despite clinical guidelines recommending evidence-based care, limited practitioner training and inadequate telehealth integration hinder effective OA management.
Objective:
To evaluate the effectiveness of an e-learning program in improving the confidence and knowledge of Chinese physical therapists in managing knee OA and to explore their perceptions of the program.
Methods:
A randomized controlled trial with two parallel arms involved 81 rehabilitation practitioners from 18 Chinese provinces. The intervention group completed a four-week online training program (PEAK-Chinese), while the control group received no training. Primary outcomes were self-reported confidence in OA management (11-point scale). Secondary outcomes included knowledge (Chinese Knee Osteoarthritis Knowledge Scale, KOAKS) and likelihood of clinical application of core OA treatments. Process measures and semi-structured interviews captured participants' training perceptions. Quantitative data were analyzed using regression models, t-tests, and descriptive statistics, while interviews with 10 participants underwent thematic analysis.
Results:
A total of 80 participants completed the outcome measures at 4 weeks. The intervention group demonstrated significant improvements in confidence for managing OA with exercise-based programs (adjusted mean difference [AMD] = 3.27, 95% CI: 2.72–3.81), prescribing exercise (AMD = 3.13, 95% CI: 2.55–3.72), and delivering telehealth (AMD = 4.41, 95% CI: 3.77–5.05). KOAKS scores also improved significantly (mean change = 9.46); however, such as those about OA concepts and the use of scans, remained unchanged. Over 60% of intervention participants rated the course as "extremely useful." Interviews emphasized the need for cultural adaptation and practical telehealth training with real-life scenarios to enhance program applicability.
Conclusions:
The PEAK program improved Chinese practitioners' confidence and knowledge in managing knee OA, underscoring e-learning's potential to support evidence-based OA care in China. Enhancing cultural relevance and incorporating practical training could further optimize its clinical applicability. Clinical Trial: ChiCTR2400091007
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