medwireNews: People with knee osteoarthritis (OA) taking part in an internet-based exercise program experience significant improvements in pain and function compared with those given usual care, suggest findings from a randomized controlled trial published in JAMA Network Open.
The study included 105 people aged 45 years or older (approximately 70% women) with knee OA who were randomly assigned to take part in a 6-week program accessed via a smartphone app that provided daily exercise recommendations and informative texts, or to continue with usual self-management care as advised by a primary care provider.
The iBEAT-OA investigators, led by Ana Valdes from the University of Nottingham in the UK, note that participants were encouraged to adhere to the exercise program via a combination of daily emails, notifications, and virtual physiotherapist contact; the average adherence was 87.9% of sessions completed.
At baseline, the average pain score – measured on a numeric rating scale ranging from 0 (no pain) to 10 (worst pain imaginable) points – was 4.4 points in the intervention group and 4.7 points in the control arm. These scores decreased significantly by an average of 1.8 points from baseline to week 6 in the intervention group, compared with a nonsignificant decrease of 0.3 points in the control group, equating to a significant between-group difference of 1.5 points.
There were also significantly greater improvements in a number of secondary outcomes, including average WOMAC pain, stiffness, and physical function scores, among participants in the intervention compared with the control group.
“Our findings suggest that digital treatment has the potential to decrease the osteoarthritis burden on both the health care systems and patients,” write the researchers, noting that “[a]dvantages of a digitally delivered treatment may include lower costs and easier access for patients living in remote areas where transport may be an added obstacle.”
Moreover, “[i]n a pandemic, such as the ongoing COVID-19 pandemic, digitally delivered care can continue without interruption,” they add.
The researchers say that “factors associated with the superiority of the internet-based program vs self-management in this study are not clear,” and speculate that “daily delivery of individualized treatment, together with support, engagement, and nudging from health care professionals, may have played a role.”
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