One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis: the EXERPHARMA randomized trial

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis.

DESIGN: 12-months follow-up from a randomized controlled trial. Participants with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions.

RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance was achieved for 49% of the participants in NEMEX (≥12 sessions) and 7% in PHARMA (half the daily dose of acetaminophen/NSAIDs ≥ 28 days). Within-group improvements in NEMEX were considered to be clinically relevant (≥10 points) for all KOOS-subscales, except Sport/Rec whereas, no between-groups difference in the primary outcome KOOS ADL (3.6 [-2.1 to 9.2]; P = 0.216) was observed. For KOOS Symptoms, a statistically significant difference of 7.6 points (2.6-12.7; P = 0.004) was observed in favor of NEMEX with 47% improving ≥10 points.

CONCLUSIONS: No difference in improvement in difficulty with ADL was observed. NEMEX improved knee symptoms to a greater extent with half of patients reporting clinically relevant improvements. CLINICALTRIALS.

GOV IDENTIFIER: NCT01638962 (July 3, 2012).

ETHICAL COMMITTEE: S-20110153.

OriginalsprogEngelsk
TidsskriftOsteoarthritis and Cartilage
Vol/bind26
Udgave nummer1
Sider (fra-til)28-33
ISSN1063-4584
DOI
StatusUdgivet - jan. 2018

Fingeraftryk

Knee Osteoarthritis
Sports
Knee Injuries
Knee
Exercise
Outcome Assessment (Health Care)
Acetaminophen
Compliance
Body Mass Index
Randomized Controlled Trials
Quality of Life

Citer dette

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title = "One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis: the EXERPHARMA randomized trial",
abstract = "OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis.DESIGN: 12-months follow-up from a randomized controlled trial. Participants with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions.RESULTS: Ninety-three patients (57{\%} women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85{\%} being available at 12-months follow-up. Good compliance was achieved for 49{\%} of the participants in NEMEX (≥12 sessions) and 7{\%} in PHARMA (half the daily dose of acetaminophen/NSAIDs ≥ 28 days). Within-group improvements in NEMEX were considered to be clinically relevant (≥10 points) for all KOOS-subscales, except Sport/Rec whereas, no between-groups difference in the primary outcome KOOS ADL (3.6 [-2.1 to 9.2]; P = 0.216) was observed. For KOOS Symptoms, a statistically significant difference of 7.6 points (2.6-12.7; P = 0.004) was observed in favor of NEMEX with 47{\%} improving ≥10 points.CONCLUSIONS: No difference in improvement in difficulty with ADL was observed. NEMEX improved knee symptoms to a greater extent with half of patients reporting clinically relevant improvements. CLINICALTRIALS.GOV IDENTIFIER: NCT01638962 (July 3, 2012).ETHICAL COMMITTEE: S-20110153.",
keywords = "Journal Article, Knee, Knee joint, Exercise, Pain management, Osteoarthritis, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Prospective Studies, Follow-Up Studies, Humans, Middle Aged, Patient Education as Topic/methods, Analgesics, Non-Narcotic/therapeutic use, Male, Treatment Outcome, Pamphlets, Activities of Daily Living, Osteoarthritis, Knee/therapy, Acetaminophen/therapeutic use, Female, Aged, Exercise Therapy/methods, Drug Therapy, Combination",
author = "A Holsgaard-Larsen and R Christensen and B Clausen and J S{\o}ndergaard and Andriacchi, {T P} and Roos, {E M}",
note = "Copyright {\circledC} 2017 Osteoarthritis Research Society International. All rights reserved.",
year = "2018",
month = "1",
doi = "10.1016/j.joca.2017.10.015",
language = "English",
volume = "26",
pages = "28--33",
journal = "Osteoarthritis and Cartilage",
issn = "1063-4584",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - One year effectiveness of neuromuscular exercise compared with instruction in analgesic use on knee function in patients with early knee osteoarthritis

T2 - the EXERPHARMA randomized trial

AU - Holsgaard-Larsen, A

AU - Christensen, R

AU - Clausen, B

AU - Søndergaard, J

AU - Andriacchi, T P

AU - Roos, E M

N1 - Copyright © 2017 Osteoarthritis Research Society International. All rights reserved.

PY - 2018/1

Y1 - 2018/1

N2 - OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis.DESIGN: 12-months follow-up from a randomized controlled trial. Participants with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions.RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance was achieved for 49% of the participants in NEMEX (≥12 sessions) and 7% in PHARMA (half the daily dose of acetaminophen/NSAIDs ≥ 28 days). Within-group improvements in NEMEX were considered to be clinically relevant (≥10 points) for all KOOS-subscales, except Sport/Rec whereas, no between-groups difference in the primary outcome KOOS ADL (3.6 [-2.1 to 9.2]; P = 0.216) was observed. For KOOS Symptoms, a statistically significant difference of 7.6 points (2.6-12.7; P = 0.004) was observed in favor of NEMEX with 47% improving ≥10 points.CONCLUSIONS: No difference in improvement in difficulty with ADL was observed. NEMEX improved knee symptoms to a greater extent with half of patients reporting clinically relevant improvements. CLINICALTRIALS.GOV IDENTIFIER: NCT01638962 (July 3, 2012).ETHICAL COMMITTEE: S-20110153.

AB - OBJECTIVE: To test long-term effectiveness of neuromuscular exercise (NEMEX) with instructions in optimized pharmacological treatment (PHARMA) on activities of daily living (ADL) in patients with early knee osteoarthritis.DESIGN: 12-months follow-up from a randomized controlled trial. Participants with mild-to-moderate medial tibiofemoral knee osteoarthritis were randomly allocated to 8 weeks NEMEX or PHARMA. The primary outcome measure was the ADL-subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcome measures included the other four KOOS-subscales, the University of California Activity Score (UCLA) and the European Quality of Life-5 Dimensions.RESULTS: Ninety-three patients (57% women, 58 ± 8 years, body mass index 27 ± 4 kg/m(2)) were randomized to NEMEX (n = 47) or PHARMA group (n = 46) with data from 85% being available at 12-months follow-up. Good compliance was achieved for 49% of the participants in NEMEX (≥12 sessions) and 7% in PHARMA (half the daily dose of acetaminophen/NSAIDs ≥ 28 days). Within-group improvements in NEMEX were considered to be clinically relevant (≥10 points) for all KOOS-subscales, except Sport/Rec whereas, no between-groups difference in the primary outcome KOOS ADL (3.6 [-2.1 to 9.2]; P = 0.216) was observed. For KOOS Symptoms, a statistically significant difference of 7.6 points (2.6-12.7; P = 0.004) was observed in favor of NEMEX with 47% improving ≥10 points.CONCLUSIONS: No difference in improvement in difficulty with ADL was observed. NEMEX improved knee symptoms to a greater extent with half of patients reporting clinically relevant improvements. CLINICALTRIALS.GOV IDENTIFIER: NCT01638962 (July 3, 2012).ETHICAL COMMITTEE: S-20110153.

KW - Journal Article

KW - Knee

KW - Knee joint

KW - Exercise

KW - Pain management

KW - Osteoarthritis

KW - Anti-Inflammatory Agents, Non-Steroidal/therapeutic use

KW - Prospective Studies

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Patient Education as Topic/methods

KW - Analgesics, Non-Narcotic/therapeutic use

KW - Male

KW - Treatment Outcome

KW - Pamphlets

KW - Activities of Daily Living

KW - Osteoarthritis, Knee/therapy

KW - Acetaminophen/therapeutic use

KW - Female

KW - Aged

KW - Exercise Therapy/methods

KW - Drug Therapy, Combination

U2 - 10.1016/j.joca.2017.10.015

DO - 10.1016/j.joca.2017.10.015

M3 - Journal article

C2 - 29107059

VL - 26

SP - 28

EP - 33

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

SN - 1063-4584

IS - 1

ER -