Effect of Home-Based versus Clinic-Based Exercise Training on Balance and Function in the Geriatric Population with Knee Osteoarthritis: A Non Randomised Controlled Trial

Abstract

Introduction: Knee Osteoarthritis (OA) affects 30-40% of the population worldwide by the age of 65 years and is associated with proprioception loss, postural instability, and fall risk. Strengthening and balance exercises at home can prevent these issues. The Otago home exercise program is commonly used for fall prevention in the elderly. Aim: To compare the effects of home-based and clinic-based exercise training on balance and function in geriatric individuals with knee OA. Materials and Methods: A non randomised controlled trial (NRCT) was conducted from October 2017 to December 2017 at an old age home and residential zone of Ahmedabad city. Nineteen participants were divided into two groups: group A (home-based exercise) with nine participants, and group B (clinicbased exercise) with ten participants. The exercises were based on the Otago program. The study duration was eight weeks, and outcome measures included the Berg Balance Scale (BBS) for static and dynamic balance, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for physical function, the Timed Up and Go (TUG) test for dynamic balance, and the Visual Analog Scale (VAS) for knee pain. Data analysis was performed using Statistical Package for the Social Science (SPSS) version 22.0, employing the Wilcoxon and Mann-Whitney tests for within group and between group comparisons, respectively. Results: Group A (home-based exercise) showed significant improvements in BBS (p-value=0.007), WOMAC (p-value=0.007), and TUG (p-value=0.027). Group B (clinic-based exercise) also showed significant improvements in BBS (p=0.005), WOMAC (p=0.005), and TUG (p=0.041). When comparing the two groups, significant differences were found in BBS (p=0.013) and WOMAC (p=0.039), but not in TUG (p=0.864) and VAS (p=0.908). The clinic-based exercise group demonstrated greater improvement, as indicated by higher pre and postintervention readings. Conclusion: This study concludes that both home-based and clinic-based exercises are effective in improving balance and physical function in geriatric individuals with knee OA. However, clinic-based exercise interventions showed greater improvement, as evidenced by higher pre and postintervention readings in the clinic-based exercise group.