Gait biomechanics and functional outcomes as predictors of response to a hip strengthening exercise program in knee osteoarthritis patients

Abstract

s / Osteoarthritis and Cartilage 23 (2015) A82eA416 A371 study were to evaluate the feasibility and outcome of the newly developed protocol. Methods: Forty-nine patients with knee osteoarthritis and severe knee pain (NRS 7) were included in this study. Analgesics were prescribed following an incremental protocol. The incremental steps were (1) acetaminophen, (2)NSAIDs, (3)weak opioids and (4) an intra-articular steroid injection. After six weeks a supervised exercise therapy program for 12 weeks was added, consisting of muscle strengthening exercises and training of daily activities. Feasibility was evaluated by information about analgesics, pain reduction, exercise therapy content and the opinion of patients, rheumatologists andphysical therapists. Knee painwas assessed with NRS-pain and activity limitations were assessed with WOMAC-PF. Data were collected at baseline, after six weeks, and after 18 weeks. Results: Eighty-two percent of the patients were able to exercise according to the protocol. In intention-to-treat analyses statistically significant and clinically relevant improvements in pain (mean change 30% from baseline, p<0.001) and activity limitations (mean change 15% from baseline, p<0.001) were found after the combined intervention protocol with analgesics and exercise therapy. Improvements in pain (p<0.001) and activity limitations (p1⁄40.002) were found after six weeks of analgesic use. Further improvements in pain (p<0.001) and activity limitations (p1⁄40.004) were found after twelve weeks of exercise therapy in per protocol analyses in patients who were able to exercise according to the protocol. Conclusions: The combined intervention of analgesics and exercise therapy allows most patients with knee osteoarthritis and severe pain to participate in exercise therapy, leading to reduction of pain and activity limitations. Although the results are promising, they need to be confirmed in a randomized controlled trial. 611 GAIT BIOMECHANICS AND FUNCTIONAL OUTCOMES AS PREDICTORS OF RESPONSE TO A HIP STRENGTHENING EXERCISE PROGRAM IN KNEE OSTEOARTHRITIS PATIENTS D. Kobsar, S.T. Osis, B.A. Hettinga, R. Ferber. Univ. of Calgary, Calgary, AB,