Effects of activity modification in older population having osteoarthritis of knee: a randomized clinical trial

Abstract

Purpose: The purpose of this study was to assess whether modification of the activities can decrease symptoms, improve functional ability and the quality of life in older adults with knee osteoarthritis (OA) who are accustomed to a traditional lifestyle which includes postures and activities that increase mechanical stress in the knee joints. Methods: In this prospective randomized clinical trial, total 157 adults (both male and female), age between 60-75 years having mechanical pain in the knee joints, difficulty in some of their activities of daily living (due to dysfunction of knee joint) and mild to moderate degree of radio-graphic changes of knee OA were included. All of the participants were previously continuing a traditional lifestyle which includes frequent squatting, climbing stairs, prolong standing, lifting heavy weights, using low sitting stools etc. for last forty to fifty years. They were randomly divided into two groups. Group 1 (n= 77) was treated with shortwave diathermy and Ibuprofen for initial two weeks and exercise and activity modification was continued throughout the whole period of study. Group 2 (n= 80) was treated with shortwave diathermy and Ibuprofen for initial two weeks and exercise was continued throughout the whole period of study. After initial assessment at entry, condition of the patients were assessed further after 3 weeks and 6 weeks, according to pain, functional capacity, and quality of life parameters. Visual analogue scale (VAS) and Western Ontario McMaster osteoarthritis index (WOMAC) of pain score were used to evaluate pain. While WOMAC physical function index was used to measure the functional capacity. Quality of life was assessed by the Nottingham Health Profile questionnaire (NHPQ). 69 from Group 1 and 67 from Group 2 reported timely in the subsequent visits after 3 and 6 weeks of their entry. In Group 1,all of the participants who reported regularly more or less followed the activity modification instructions. Results: After 3 weeks, there was no statistically significant difference of VAS scores and WOMAC pain and physical functional scores in between two groups.Result of the NHPQ also did not show statistically significant difference between the groups. After 6 weeks, VAS scores and WOMAC pain and physical functional scores were statistically lower in Group 1 than in the Group 2 (P<0.001). Result of the NHPQ also showed a statistically significant improvement in the group 1 when compared to the Group 2 (P<0.05). Conclusions: From the findings of this study we conclude that activity modification play an important role in decreasing pain, improving functional capability and providing better quality of life in older population with knee OA.