The efficacy of electronic health-supported home exercise interventions for patients with osteoarthritis of the knee: Systematic review
MetadataShow full item record
©Axel Georg Meender Schäfer, Christoff Zalpour, Harry von Piekartz, Toby Maxwell Hall, Volker Paelke. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.04.2018.
Background: Osteoarthritis of the knee is the most common cause for disability and limited mobility in the elderly, with considerable individual suffering and high direct and indirect disease-related costs. Nonsurgical interventions such as exercise, enhanced physical activity, and self-management have shown beneficial effects for pain reduction, physical function, and quality of life (QoL), but access to these treatments may be limited. Therefore, home therapy is strongly recommended. However, adherence to these programs is low. Patients report lack of motivation, feedback, and personal interaction as the main barriers to home therapy adherence. To overcome these barriers, electronic health (eHealth) is seen as a promising opportunity. Although beneficial effects have been shown in the literature for other chronic diseases such as chronic pain, cardiovascular disease, and diabetes, a systematic literature review on the efficacy of eHealth interventions for patients with osteoarthritis of knee is missing so far. Objective: The aim of this study was to compare the efficacy of eHealth-supported home exercise interventions with no or other interventions regarding pain, physical function, and health-related QoL in patients with osteoarthritis of the knee. Methods: MEDLINE, CENTRAL, CINAHL, and PEDro were systematically searched using the keywords osteoarthritis knee, eHealth, and exercise. An inverse variance random-effects meta-analysis was carried out pooling standardized mean differences (SMDs) of individual studies. The Cochrane tool was used to assess risk of bias in individual studies, and the quality of evidence across studies was evaluated following the Grading of Recommendations, Assessment, Development, and Evaluation approach. Results: The literature search yielded a total of 648 results. After screening of titles, abstracts, and full-texts, seven randomized controlled trials were included. Pooling the data of individual studies demonstrated beneficial short-term (pain SMD=-0.31, 95% CI -0.58 to -0.04, low quality; QoL SMD=0.24, 95% CI 0.05-0.43, moderate quality) and long-term effects (pain -0.30, 95% CI -0.07 to -0.53, moderate quality; physical function 0.41, 95% CI 0.17-0.64, high quality; and QoL SMD=0.27, 95% CI 0.06-0.47, high quality). Conclusions: eHealth-supported exercise interventions resulted in less pain, improved physical function, and health-related QoL compared with no or other interventions; however, these improvements were small (SMD<0.5) and may not make a meaningful difference for individual patients. Low adherence is seen as one limiting factor of eHealth interventions. Future research should focus on participatory development of eHealth technology integrating evidence-based principles of exercise science and ways of increasing patient motivation and adherence.
Showing items related by title, author, creator and subject.
High-speed resistance training and balance training for people with knee osteoarthritis to reduce falls risk: Study protocol for a pilot randomized controlled trialLevinger, P.; Dunn, J.; Bifera, N.; Butson, M.; Elias, G.; Hill, Keith (2017)Background: The number of falls experienced by people with knee osteoarthritis (OA) is almost double the number experienced by people with no OA. The neuromuscular elements required to arrest a fall are more impaired in ...
Turner, Sian Elizabeth (2009)Background and research questions. The characterization of chronic persistent asthma in an older adult population is not well defined. This is due to the difficulties in separating the diagnosis of asthma from that of ...
Telephone-Delivered Exercise Advice and Behavior Change Support by Physical Therapists for People With Knee Osteoarthritis: Protocol for the Telecare Randomized Controlled TrialHinman, R.; Lawford, B.; Campbell, P.; Briggs, Andrew; Gale, J.; Bills, C.; French, S.; Kasza, J.; Forbes, A.; Harris, A.; Bunker, S.; Delany, C.; Bennell, K. (2017)Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. ...