Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial

Mariëtte de Rooij, Marike van der Leeden, John Cheung, Martin van der Esch, Arja Häkkinen, Daniël Haverkamp, Leo D. Roorda, Jos Twisk, Joke Vollebregt, Willem F. Lems, Joost Dekker

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. Methods: In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ≥30 kg/m2), with severity score ≥2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Results: Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B = −7.43 [95% confidence interval (95% CI) −9.99, −4.87], P < 0.001; and 6MWT: B = 34.16 [95% CI 17.68, 50.64], P < 0.001) in favor of the intervention group. At 3 months followup, the mean improvements in the intervention group were 33% on the WOMAC scale and 15% on the 6MWT. These improvements are of clinical relevance. No serious adverse events occurred during the intervention. Conclusion: This is the first study showing that tailored exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities.

Original languageEnglish
Pages (from-to)807-816
Number of pages10
JournalArthritis Care and Research
Volume69
Issue number6
DOIs
Publication statusPublished - 1 Jun 2017

Cite this

@article{2a1f6d2ddadd4243932f89b5247ddb89,
title = "Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial",
abstract = "Objective: To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. Methods: In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ≥30 kg/m2), with severity score ≥2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Results: Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B = −7.43 [95{\%} confidence interval (95{\%} CI) −9.99, −4.87], P < 0.001; and 6MWT: B = 34.16 [95{\%} CI 17.68, 50.64], P < 0.001) in favor of the intervention group. At 3 months followup, the mean improvements in the intervention group were 33{\%} on the WOMAC scale and 15{\%} on the 6MWT. These improvements are of clinical relevance. No serious adverse events occurred during the intervention. Conclusion: This is the first study showing that tailored exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities.",
author = "{de Rooij}, Mari{\"e}tte and {van der Leeden}, Marike and John Cheung and {van der Esch}, Martin and Arja H{\"a}kkinen and Dani{\"e}l Haverkamp and Roorda, {Leo D.} and Jos Twisk and Joke Vollebregt and Lems, {Willem F.} and Joost Dekker",
year = "2017",
month = "6",
day = "1",
doi = "10.1002/acr.23013",
language = "English",
volume = "69",
pages = "807--816",
journal = "Arthritis Care & Research",
issn = "2151-464X",
publisher = "John Wiley and Sons Inc.",
number = "6",

}

Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity : A Randomized Controlled Trial. / de Rooij, Mariëtte; van der Leeden, Marike; Cheung, John; van der Esch, Martin; Häkkinen, Arja; Haverkamp, Daniël; Roorda, Leo D.; Twisk, Jos; Vollebregt, Joke; Lems, Willem F.; Dekker, Joost.

In: Arthritis Care and Research, Vol. 69, No. 6, 01.06.2017, p. 807-816.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity

T2 - A Randomized Controlled Trial

AU - de Rooij, Mariëtte

AU - van der Leeden, Marike

AU - Cheung, John

AU - van der Esch, Martin

AU - Häkkinen, Arja

AU - Haverkamp, Daniël

AU - Roorda, Leo D.

AU - Twisk, Jos

AU - Vollebregt, Joke

AU - Lems, Willem F.

AU - Dekker, Joost

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Objective: To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. Methods: In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ≥30 kg/m2), with severity score ≥2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Results: Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B = −7.43 [95% confidence interval (95% CI) −9.99, −4.87], P < 0.001; and 6MWT: B = 34.16 [95% CI 17.68, 50.64], P < 0.001) in favor of the intervention group. At 3 months followup, the mean improvements in the intervention group were 33% on the WOMAC scale and 15% on the 6MWT. These improvements are of clinical relevance. No serious adverse events occurred during the intervention. Conclusion: This is the first study showing that tailored exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities.

AB - Objective: To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. Methods: In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ≥30 kg/m2), with severity score ≥2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Results: Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B = −7.43 [95% confidence interval (95% CI) −9.99, −4.87], P < 0.001; and 6MWT: B = 34.16 [95% CI 17.68, 50.64], P < 0.001) in favor of the intervention group. At 3 months followup, the mean improvements in the intervention group were 33% on the WOMAC scale and 15% on the 6MWT. These improvements are of clinical relevance. No serious adverse events occurred during the intervention. Conclusion: This is the first study showing that tailored exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities.

UR - http://www.scopus.com/inward/record.url?scp=85018788607&partnerID=8YFLogxK

U2 - 10.1002/acr.23013

DO - 10.1002/acr.23013

M3 - Article

VL - 69

SP - 807

EP - 816

JO - Arthritis Care & Research

JF - Arthritis Care & Research

SN - 2151-464X

IS - 6

ER -