The PLE(2)NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial

The Influence of Physical Exercises on the Flexibility of Older Individuals with Knee Osteoarthritis: A Systematic Review

Background

Flexibility is a component of functional capacity and is relevant in maintaining the musculature and structures adjacent to the joints. Then, the improvement of the flexibility must be a critical goal in the rehabilitation programs. By improving flexibility in knee osteoarthritis (KOA) individuals, the pain is relieved, the risk of injury is reduced, and the need for surgical interventions is delayed. We aimed to summarize the available literature on the influence of different physical exercise modalities on flexibility in older KOA individuals.

Methods

This study followed the PRISMA statement and registered in PROSPERO (CRD42020195786). Seven databases (MEDLINE/PubMed; PEDro; CINAHL; Scopus; Web of Science; Embase; and SPORTDiscus) were screened for papers published prior to Sep 6, 2022. The PEDro scale, Cochrane collaborations, and ROBINS-I tools were used to evaluate the methodological quality and risk of bias.

Results

Ten studies (including 438 participants diagnosed with KOA) fulfilled the eligibility criteria, and nine concluded that flexibility was improved after a physical exercise program.

Conclusion

Despite the modality, physical exercise improves flexibility in older KOA individuals, improving the functional capacity. Health professionals engaged in KOA rehabilitation should use physical exercise as a strategy to improve the flexibility of this population.

The effectiveness of a randomised clinical trial of PLE2 NO self-management and exercise programme for knee osteoarthritis to improve self-efficacy

OBJECTIVE

This study aims to assess the effectiveness of a 12-weeks self-management and exercise intervention to improve self-efficacy in older individuals with knee osteoarthritis (KOA) DESIGN: Randomised Controlled Trial.

SETTING

Four different community settings.

SUBJECTS

Eighty individuals aged 60 years or over with clinical and radiographic knee osteoarthritis.

INTERVENTION

The subjects were randomly assigned to (1) a combined self-management and exercise programme (treatment group) and (2) an educational programme (control group).

MAIN MEASURES

The primary outcome was self-efficacy and secondary outcomes were physical activity, health-related quality of life and skill-related physical fitness measures.

RESULTS

Sixty-seven participants, mean age 69.1 (5.8) years, completed the study: 32 in the control group and 35 in the treatment group. A significant group effect favourable to the treatment group was observed in the following variables: self-efficacy (F[2,64] = 9.2, p = 0.003), physical activity (F[2,64] = 43.6, p < 0.001) and balance for most painful knee (F(2,64) = 4.87, p = 0.031) and less painful knee (F[2,64] = 6.94, p = 0.010). No improvements regarding health-related quality of life, gait speed and agility were found. This study supports the importance of a combined self-management and exercise intervention to improve self-efficacy and physical activity in KOA individuals.

A randomized controlled trial of a combined self-management and exercise intervention for elderly people with osteoarthritis of the knee: the PLE2NO program

OBJECTIVE

To assess the effectiveness of a 12-week self-management and exercise intervention (the PLE²NO program) in elderly individuals with knee osteoarthritis.

DESIGN

Randomized controlled trial.

SETTING

Four different community settings.

SUBJECTS

Eighty individuals aged 60 years or older with clinical and radiographic knee osteoarthritis enrolled in the study.

INTERVENTION

A combined self-management and exercise intervention (treatment group) and an educational intervention (control group).

MAIN MEASURES

The primary outcomes were pain and other knee osteoarthritis symptoms (swelling, crackling, limitation on movement, and stiffness), self-management behaviors (communication with physician and cognitive symptom management), and functional lower limb strength. Secondary outcomes were knee osteoarthritis-specific health-related quality of life, self-perceived health, aerobic capacity, lower and upper limb flexibility, and handgrip strength.

RESULTS

In all, 67 participants, mean age 69.1 ± 5.8 years, completed the study: 32 in the Educational Group and 35 in the Self-Management and Exercise Group. A significant group effect favorable to the Self-Management and Exercise Group was observed in the following variables: communication with the physicians ( P = .048), aerobic capacity ( P = .035), and functional lower limb strength ( P = .015). Although no significant group effect was detected, clinical improvements in pain (31%) and knee osteoarthritis symptoms (29%) were observed in the experimental group. No improvements regarding cognitive symptom management, self-perceived health, lower limb flexibility, and handgrip strength were found.

CONCLUSION

This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.