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

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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.

Original languageEnglish
JournalOsteoarthritis and Cartilage
Volume26
Issue number1
Pages (from-to)28-33
ISSN1063-4584
DOIs
Publication statusPublished - Jan 2018

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

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