Abstract
BackgroundExercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA.MethodsA three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up.ResultsOne hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group.ConclusionsCE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients.Trial registrationChinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.
Highlights
Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA)
No statistically significant differences were observed between Baduanjin qigong training (BDJ) vs quadriceps strengthening exercises (QSE) (χ2 = 0.745, P = 0.270) and BDJ vs combined exercise (CE) groups (χ2 = 1.729, P = 0.153)
Our study suggests that compared to an intervention only involving QSE or BDJ, a combining program of QSE and Baduanjin was more effective in reducing pain intensity in older KOA patients, improving their physical functioning, self-efficacy, and health-related quality-of-life (HRQoL)
Summary
Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). Osteoarthritis (OA), the third highest risk factor for disability in the elderly, can lead to pain, loss of function, and reduced quality-of-life (QoL) [1]. As the global population ages, the number of elderly with OA is increasing in both low- and high-income countries [2]. Knee osteoarthritis (KOA) accounts for over 80% of OA patients [3]. In China, years lived with disability (YLDs) for KOA per 100,000 population was 968 in 2012, with 60% of YLDs contributed by individuals aged over 60 years [5]. Exercise therapy is perhaps the most efficient non-pharmacologic treatment for KOA due to its low-cost, high safety, and facile operation [7, 8]. The KOA clinical guidelines issued by the American College of Rheumatology, states exercise interventions, including aerobic, resistance, and aquatic exercise are highly recommended [9]
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