Sustainability Strategies Of A 3-week Preventive Measure In Patients With Knee Osteoarthritis

Abstract

Knee osteoarthritis as a degenerative joint disease is particularly relevant for occupational groups whose activities are associated with high loads or unfavorable postures over long periods of time. In the sense of effective secondary prevention, the BG Trauma Hospital of Hamburg uses a multimodal therapy concept, the so-called Kniekolleg. Data are now available for a two-year follow-up so that not only acute effects of the three-week start-up intervention, but also sustainability effects for long-term exercise adherence after two refresher courses, each after 12 month, can be reported. PURPOSE: Craftsmen and workers in the construction industry are at an increased risk of developing knee osteoarthritis due to their work-related burdens. In order to maintain the ability to work, occupational co-operative measures for secondary prevention can be carried out (Kniekolleg). The aim was to evaluate the efficacy after two years, depending on the degree of exercise adherence. METHODS: In a repeated measurements design (T1 before, T2 after Kniekolleg, T3 after one year (first refresher), T4 after two years (second refresher)), 140 construction patients were assessed for their dynamic muscular strength (knee extension, 60°/s), their quality of life (SF-36) and their characteristics for knee osteoarthritis (WOMAC). They were evaluated using analyses of variances, whereby one group trained after the Kniekolleg in the gym with instruction (G1 n=63), one group completed a home training program (G2 n=38) and one group did not train (G3 n=39). RESULTS: For all parameters, significant acute efficacy and 2-year sustainability effects were observed (p≤0.05, d: 0.2-0.8). There was no interaction with adherence during training after the Kniekolleg (p> 0.05). CONCLUSION: The Kniekolleg has proved to be effective in the long term, with a critical questioning of future research, why there are no differences between guided, reduced or even missing long-term maintenance training.