Objective functional results in patients with knee osteoarthritis submitted to a 2-day educational programme: A prospective randomised clinical trial

Abstract

Background Although education is recommended for the treatment of knee osteoarthritis (KOA), its effectiveness in osteoarthritis (OA) remains low according to subjective questionnaires. The timed-up-And-go (TUG) and five-Times-sit-To-stand tests (FTSST) reflect muscle strength and balance and could be used as objective measures of effectiveness. Aim To measure the effect of an educational programme in patients with KOA by TUG and FTSST and correlate these results to those of subjective questionnaires. Methods Prospective randomised controlled trial of patients with KOA. Participants (n=198) were allocated into four groups. Three groups participated in 2 days of lectures with 1 (group 1), 2 (group 2) and 3-month (group 3) intervals between classes. Group 4 had no classes. Participants were asked to exercise at least three times a week. Half of the patients from all groups received bimonthly telephone calls reinforcing diet and exercise instructions. All four groups received the printed and video material presented in the classes. At baseline and at 1 year after initial assessment, patients performed the FTSST and TUG and answered WOMAC, Lequesne, SF-36 and Visual Analogue Scale questionnaires. Results The TUG results did not change at 1 year follow-up, whereas FTSST improved (average difference of 4.66, p<0.001) irrespective of the implementation of classes or telephone calls. Both baseline and 1 year TUG and FTSST results correlated weakly (r<0.3) to the subjective functional, pain and quality of life results (p<0.001). Conclusions This educational programme improved function as determined by lower limb muscle strength (FTSST) irrespective of the patients' subjective non-improvement. Trial registration number Clinical trials registration number: NCT01572051. Level of evidence Level 1A.